TY - JOUR
T1 - Internet-delivered treatment for substance abuse
T2 - A multisite randomized controlled trial
AU - Campbell, Aimee N.C.
AU - Nunes, Edward V.
AU - Matthews, Abigail G.
AU - Stitzer, Maxine
AU - Miele, Gloria M.
AU - Polsky, Daniel
AU - Turrigiano, Eva
AU - Walters, Scott
AU - McClure, Erin A.
AU - Kyle, Tiffany L.
AU - Wahle, Aimee
AU - Van Veldhuisen, Paul
AU - Goldman, Bruce
AU - Babcock, Dean
AU - Stabile, Patricia Quinn
AU - Winhusen, Theresa
AU - Ghitza, Udi E.
PY - 2014/6/1
Y1 - 2014/6/1
N2 - Objective: Computer-delivered interventions have the potential to improve access to quality addiction treatment care. The objective of this study was to evaluate the effectiveness of the Therapeutic Education System (TES), an Internet-delivered behavioral intervention that includes motivational incentives, as a clinician-extender in the treatment of substance use disorders. Method: Adult men and women (N=507) entering 10 outpatient addiction treatment programs were randomly assigned to receive 12 weeks of either treatment as usual (N=252) or treatment as usual plus TES, with the intervention substituting for about 2 hours of standard care per week (N=255). TES consists of 62 computerized interactive modules covering skills for achieving andmaintaining abstinence, plus prize-based motivational incentives contingent on abstinence and treatment adherence. Treatment as usual consisted of individual and group counseling at the participating programs. The primary outcome measures were abstinence from drugs and heavy drinking (measured by twice-weekly urine drug screens and self-report) and time to dropout from treatment. Results: Compared with patients in the treatment-as-usual group, those in the TES group had a lower dropout rate (hazard ratio=0.72, 95% CI=0.57, 0.92) and a greater abstinence rate (odds ratio=1.62, 95% CI=1.12, 2.35). This effectwasmore pronounced among patients who had a positive urine drug or breath alcohol screen at study entry (N=228) (odds ratio=2.18, 95% CI=1.30, 3.68). Conclusions: Internet-delivered interventions such as TES have the potential to expand access and improve addiction treatment outcomes. Additional research is needed to assess effectiveness in non-specialty clinical settings and to differentiate the effects of the community reinforcement approach and contingency management components of TES.
AB - Objective: Computer-delivered interventions have the potential to improve access to quality addiction treatment care. The objective of this study was to evaluate the effectiveness of the Therapeutic Education System (TES), an Internet-delivered behavioral intervention that includes motivational incentives, as a clinician-extender in the treatment of substance use disorders. Method: Adult men and women (N=507) entering 10 outpatient addiction treatment programs were randomly assigned to receive 12 weeks of either treatment as usual (N=252) or treatment as usual plus TES, with the intervention substituting for about 2 hours of standard care per week (N=255). TES consists of 62 computerized interactive modules covering skills for achieving andmaintaining abstinence, plus prize-based motivational incentives contingent on abstinence and treatment adherence. Treatment as usual consisted of individual and group counseling at the participating programs. The primary outcome measures were abstinence from drugs and heavy drinking (measured by twice-weekly urine drug screens and self-report) and time to dropout from treatment. Results: Compared with patients in the treatment-as-usual group, those in the TES group had a lower dropout rate (hazard ratio=0.72, 95% CI=0.57, 0.92) and a greater abstinence rate (odds ratio=1.62, 95% CI=1.12, 2.35). This effectwasmore pronounced among patients who had a positive urine drug or breath alcohol screen at study entry (N=228) (odds ratio=2.18, 95% CI=1.30, 3.68). Conclusions: Internet-delivered interventions such as TES have the potential to expand access and improve addiction treatment outcomes. Additional research is needed to assess effectiveness in non-specialty clinical settings and to differentiate the effects of the community reinforcement approach and contingency management components of TES.
UR - http://www.scopus.com/inward/record.url?scp=84898736994&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84898736994&partnerID=8YFLogxK
U2 - 10.1176/appi.ajp.2014.13081055
DO - 10.1176/appi.ajp.2014.13081055
M3 - Article
C2 - 24700332
AN - SCOPUS:84898736994
SN - 0002-953X
VL - 171
SP - 683
EP - 690
JO - American Journal of Psychiatry
JF - American Journal of Psychiatry
IS - 6
ER -