Need for Technology Assisted Care:
Treatment is not readily accessible for many people with a substance use disorder.
- Limited availability of clinicians nationwide, including rural and remote areas as well as low-income and medically underserved communities exhibiting health disparities
- Limited access to SUD treatment services due to transportation challenges
- Limited SUD treatment resources in primary care settings.
Many clinicians lack proficiency in the delivery of evidence-based practices (EBPs), while the cost of doing so is often prohibitive, and as a result are often unable to implement EBPs. This results in:
- Low EBP usage
- Low EBP fidelity
Availability of TAC interventions:
Over 100 different computer-assisted therapy programs have been developed for a range of mental disorders and behavioral health problems. (Klein et al., 2012; Moore et al., 2011
TAC may consist of text, audio, video, animations, and/or other forms of multimedia. These methods may use information from medical records, physiological data capture devices, or other sources. The interventions may be interactively customized, or tailored, to an individual user’s needs.
Evidence based practices which are available through TAC interventions include:
- Cognitive Behavioral Therapy
- Community Reinforcement Approach
- Contingency Management
- Motivational Enhancement
- Motivational Interviewing
- Screening
- Brief Intervention
- Relapse Prevention
TAC which facilitates learning and skills in these EBPS have been developed for target populations with substance use disorders including:
- Alcohol Use
- Tobacco Cessation
- Gambling
- Illicit Drug Use
Clinical Considerations:
TAC may be implemented within clinical practice in the following ways:
- Integrating TAC interventions into the treatment plan
- “Prescribing” TAC interventions in treatment
- as an adjunct to enhance individual therapy
- as assignments for use in group therapy
- as homework assignments
- Processing the computer based experience with clients
- Documentation of client participation in progress notes
- Tracking participation in computer assignments.
Models for integration of TAC within clinical practice:
- Brief Intervention– particularly in settings where SUD treatment services are limited (e.g., primary care settings [FQHCs], mental health, etc.)
- Clinical purpose may include improvement of readiness for care.
- Stand-alone treatment– comprehensive service (up to 65 modules available) delivered over a structured period of time (e.g., 12 weeks)
- Clinician extender– administered as an adjunct to treatment whereby clinicians “prescribe” TBIs (or portions of) to enhance therapeutic intervention.