Computer-Based Training in Cognitive Behavior Therapy (CBT4CBT)

Computer-Assisted Cognitive Behavior Therapy for Veterans With Substance Use Disorder

In this behavioral trial 80 substance abusing individuals will be randomly assigned to either treatment as usual in the substance abuse clinic of the Newington, CT VA hospital OR treatment as usual plus 8 hours of access to the 'CBT for CBT' computer program over a period of 8 weeks. Primary outcomes will be retention in treatment and reduction in substance use (percent days abstinent, confirmed by urine toxicology screens). The patients' ability to demonstrate coping skills through a computerized role-play evaluation will be a secondary outcome. A six-month follow-up will assess durability and/or delayed emergence of effects.

This pilot study aims to evaluate the feasibility and effectiveness of adding a computer based training program in Cognitive Behavior Therapy ("CBT4CBT") for the treatment of addictions in a VA substance abuse outpatient clinic. Key secondary aims are to assess the impact of adding CBT4CBT to standard care on treatment attendance, engagement, retention, and to investigate if certain process measures are associated with substance use outcomes. Approximately 80 patients enrolled in the Newington Outpatient Substance Abuse Treatment Program (SATP) will be randomly assigned to either (A) treatment as usual, or (B) treatment as usual plus exposure to the CBT4CBT program.

Inclusion Criteria:

• 18 years and older
• Recent (within 3 months) substance use
• meet current DSM-IV (Diagnostic and Statistical Manual-IV) criteria for substance use disorder
• fluent in English or at least a 6th grade reading level
• can commit to at least 8 weeks of treatment and willing to be randomized to treatment

Exclusion Criteria:

• Unstable housing situation
• Likelihood of going to prison during the intervention portion of study
• Recent opiate or benzodiazepine prescription