Key articles (Carroll et al., 2008; 2009; 2011; 2014; Olmstead, Ostrow, & Carroll, 2010)
Randomized Controlled Trial:
77 individuals seeking treatment in an outpatient setting. Carroll et al. (2008)
A. Standard treatment, OR
B. Standard treatment plus bi-weekly access to CBT4CBT
Findings:
- Participants assigned to the CBT4CBT condition submitted significantly more urine specimens that were negative for any type of drugs, especially cocaine and tended to have longer continuous periods of abstinence during treatment.
- The CBT4CBT program was more positively evaluated by participants.
- In the CBT4CBT condition, outcome was more strongly associated with treatment engagement than in TAU; further, completion of homework assignments in CBT4CBT was significantly correlated with outcome and a significant predictor of Tx involvement.
- The number of days abstinent was not significantly different between groups, nor was the retention rate between the two treatment conditions.
Conclusion: CBT4CBT plus clinical practice is more effective in reducing drug use during treatment than standard outpatient therapy alone.
Randomized Controlled Trial:
101 cocaine-dependent individuals maintained on Methadone.
A. Methadone plus counseling, OR
B. Standard treatment plus weekly access to CBT4CBT
Findings:
- CBT Participants were significantly more likely to attain 3 or more consecutive weeks of abstinence from cocaine,
- had significantly more negative urines for all drugs but only among those who completed the 8-week trial
- had greater reduction in cocaine use at 6 months follow up, showing durability of the intervention
Conclusion: CBT4CBT added to methadone maintenance is more effective in reducing drug use during treatment than MM alone and has lasting results in those who complete treatment
Other CBT4CBT Findings:
- Participants had more negative urines and longer continuous periods of abstinence during treatment than in TAU
- Outcomes in CBT4CBT were more strongly associated with treatment engagement
- Completion of homework assignments in CBT4CBT was significantly correlated with outcome and a significant predictor of Tx involvement
- Demonstrated “durability” of effects.
CBT4CBT References
Carroll, K.M., Ball, S.A., Martino, S. Nich, C., Gordon, M.A., Portnoy, G.A. & Rounsaville, B.J. (2008). Computer-assisted delivery of cognitive behavioral therapy for addiction: A randomized trial of CBT4CBT. The American Journal of Psychiatry, 165:7, 881-889. PMCID: PMC2562873.
Carroll, K.M., Ball, S.A., Martino, S., Nich, C., Babuscio, T. A. & Rounsaville, B.J. (2009). Enduring effects of a computer-assisted training program for cognitive behavioral therapy: A six-month follow-up of CBT4CBT. Drug and Alcohol Dependence, 100, 178-181. PMCID: PMC2742309
(in press: April 14, 2014) Carroll, K.M, Kiluk, B.D., Nich, C., Gordon, M.A., Portnoy, G.A., Martino, D.R., & Ball, S.A. (in press). Computer-Assisted Delivery of Cognitive-Behavioral Therapy: Efficacy and durability of CBT4CBT among cocaine-dependent individuals maintained on methadone. The American Journal of Psychiatry.
Jia, Z., Worhunsky, P.D., Carroll, K.M., Rounsaville, B.J., Stevens, M.C., Pearlson, G.D.,. Potenza, M.N. (2011). An initial study of neural responses to monetary incentives as related to treatment outcomes in cocaine dependence. Biological Psychiatry, 70, 553-560. PMCID: PMC3162064
Campbell, A.M., Nunes, E.V., Miele, G.M., Matthews, A.., Polsky, D., Ghitza, U., Turrigiano, E., VanVeldhuisen, P., Chapdelaine, R., Froias, A., Stitzer, M.L.,Carroll, (2014). Internet-delivered treatment for substance abuse: A multisite randomized controlled trial. American Journal of Psychiatry, 171,6, 683-690.
Olmstead, T.A., Ostrow, C.R. & Carroll, K.M. (2010). Cost effectiveness effectiveness of computer-assisted training in cognitive-behavioral therapy as an adjunct to standard care for addiction. Drug and Alcohol Dependence, 110, 200-207. NIHMSID: NIHMS197660
Marsch, L.A., Carroll, K.M., Kiluk, B.D. (2014) Technology-based interventions for the treatment and recovery management of substance use disorders: A JSAT special issue. Journal of Substance Abuse Treatment 46,1, 1-4.
Carroll, K.M. & Rounsaville, B.J. (2010). Computer-assisted therapy in psychiatry: Be brave, its a new world. Current Psychiatry Reports, 12, 426-432.PMCID: PMC2967758.
Brewer, J.A., Worhunsky, P.D., Carroll, K.M., Rounsaville, B.J. & Potenza, M.N. (2008). Pretreatment brain activation during Stroop task is associated with treatment outcomes in cocaine dependent patients. Biological Psychiatry, 64, 998-1004. PMCID: PMC2601637
Xu, J., DeVito, E.,E., Worhunsky, P.D., Carroll, K.M., Rounsaville, B.J., & Potenza, M.N. (2010). White matter integrity Is associated with treatment outcome measures in cocaine dependence. Neuropsychopharmac
Kiluk, B.D., Nich, C., Carroll, K.M. (2010). Neurocognitive indicators predict results of an informed consent quiz among substance dependent treatment seekers entering a randomized clinical trial. Journal of Studies on Alcohol and Drugs, 71, 704-712. PMCID: PMC2930500
Kiluk, B.D., Nich, C., Babuscio, T.A., & Carroll, K.M. (2010). Quality versus quantity: Acquisition of coping skills following computerized cognitive behavioral therapy for substance use disorders. Addiction, 105: 2120-2127.PMCID: PMC2975828
Sugarman, D.E, Nich, C., & Carroll, K.M. (2010). Coping strategy use following computerized cognitive behavioral therapy for substance use disorders.Psychology of Addictive Behavior, 24, 689-695. PMCID: PMC3059590
Carroll, K.M., Kiluk, B.D., Nich, C., Babuscio, T.A., Brewer, J.A., Potenza, M.N., Ball, S.A., Martino, S., Rounsaville, B.J. & Lejuez, C.W. (2011). Cognitive function and treatment response in a randomized clinical trial of computer-based training for cognitive behavioral therapy (CBT4CBT). Substance Use and Misuse, 46, 23-34: PMCID: PMC3083447
Potenza, M.N., Sofuoglu, M., Carroll, K.M., & Rounsaville, B.J. (2011). Neuroscience of behavioral and pharmacological treatments for addictions.Neuron, 69, 695-712. PMCID: PMC3063555
Kiluk, B.D., Nich, C. & Carroll, K.M. (2011). Relationship of cognitive function and the acquisition of coping skills in computer assisted treatment for substance use disorders. Drug and Alcohol Dependence, 114(2-3):169-76PMCID: PMC3046302
Kiluk, B.D.., Sugarman, D.E., Nich, C., Gibbons, C.R., Martino, S., Rounsaville, B.J. & Carroll, K.M. (2011). A methodological analysis of randomized clinical trials of computer-assisted therapies for psychiatric disorders: Towards improved standards for an emerging field. American Journal of Psychiatry, 168: 790-799. PMCID: PMC3607199. Noted as a highly influential article of the year. R. Balon, “Clinical Factor 2011”, Psychotherapy and Psychosomatics, 2012, 81, 199-205.
K.M., Winhusen, T., Bailey, G., Clingerman, S., Perez, L., McClue, E., Goldman, B., Crowell, A.R. (2012). Design and methodological considerations of an effectiveness trial of a computer-assisted Intervention: An example from the NIDA Clinical Trials Network. Current Clinical Trials, 33, 386-395.PMCID:PMC3268951