Computer Based Training in Cognitive Behavioral Therapy Web-based

Computer Based Training in Cognitive Behavioral Therapy Web-based

The investigators are conducting a randomized clinical trial of our new web-based version of the CBT4CBT program to evaluate its effectiveness relative to standard outpatient counseling at SATU. The computer-based training program (CBT4CBT) focuses on teaching basic coping skills, presenting examples of effective use of coping skills in a number of realistic situations in video form, and providing opportunities for patients to practice and review new skills while receiving substance abuse treatment.

One hundred eighty drug-using individuals seeking treatment at the Substance Abuse Treatment Unit (SATU) of the Connecticut Mental Health Center will be randomized to (1) standard outpatient counseling at SATU (typically consisting of weekly group counseling), (2) individual clinician delivered CBT, or (3) web-based CBT4CBT. Treatments will be delivered over a 12-week period with a six-month follow-up after termination of the study treatments. The primary outcome measures will be reduction in substance use (frequency of drug use by time, confirmed by urine toxicology screens). Secondary outcomes will include treatment utilization and cost, several measures intended to detect whether web-based CBT4CBT retains key characteristics of traditional clinician-administered CBT (e.g., acquisition of coping skills, use of change strategies), participant characteristics which will be evaluated as potential moderators of outcome, as well as participant satisfaction and treatment credibility.

Inclusion Criteria:

• Are 18 years of age or older.
• Are applying for outpatient, non-agonist substance abuse treatment at SATU.
• Meet current DSM-IV criteria for cocaine, marijuana,opioid,or amphetamine dependence.
• Are sufficiently stable for 12 weeks of outpatient treatment.
• Can commit to 12 weeks of treatment and are willing to be randomized to treatment
• Are willing to provide locator information for follow-up.
• Are fluent in English and have a 6th grader or higher reading level

Exclusion Criteria:

• Have an untreated bipolar or schizophrenic disorder.
• Who have a current legal case pending such that incarceration during 12-week protocol is likely.
• Are physically dependent on alcohol, opioids or benzodiazepines