Cognitive Behavioural Therapy for Alcoholism
Recruiting in Palo Alto (17 mi)
+3 other locations
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Yale University
Disqualifiers: Suicidal ideation, Schizophrenia, Bipolar, others
No Placebo Group
Trial Summary
What is the purpose of this trial?This study will conduct a randomized clinical trial comparing levels of treatment initiation, engagement, and alcohol outcomes for a novel treatment strategy (CBT4CBT delivered in the Black church) compared with traditional outpatient specialty addiction treatment for a large sample of Black adults with AUD.
The purpose of this randomized clinical trial is to determine which setting (church or specialty clinic) (1) has better treatment initiation and retention rates and (2) better AUD outcomes as measured by percentage of days abstinent (PDA) (8 weeks, 3, 6 and 9 months follow up).
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your doctor.
What data supports the effectiveness of the treatment CBT4CBT for alcoholism?
Research shows that CBT4CBT, a computer-based version of cognitive behavioral therapy, has been effective in reducing alcohol and drug use in various settings. It helps people learn new skills to cope with triggers for substance use, and these benefits have been shown to last even after the treatment ends.
12345Is CBT4CBT safe for humans?
Research on CBT4CBT, a computer-based cognitive behavioral therapy, has shown it to be safe for people with substance use disorders, including alcohol use. Studies have not reported any significant safety concerns, making it a generally safe option for treatment.
23567How is CBT4CBT different from other treatments for alcoholism?
CBT4CBT is unique because it delivers cognitive behavioral therapy (CBT) through a computer, making it more accessible and cost-effective compared to traditional in-person therapy. This approach allows for personalized, interactive sessions that can be done at the patient's convenience, potentially reaching more people who need help with alcohol use disorder.
23578Eligibility Criteria
This trial is for Black adults with Alcohol Use Disorder (AUD) who are at least 18 years old, have had some drinking in the past month, and can speak English. They must not be currently receiving substance use treatment or have severe mental health issues like active suicidal thoughts or unstable psychotic disorders.Inclusion Criteria
I am 18 years old or older.
English-speaking
current AUD as their principal substance use disorder, confirmed via MINI100 interview, with some drinking in the past 28 days
Exclusion Criteria
current engagement in substance use treatment,
I am open to being assigned to any treatment group and may have a history of substance use.
I do not have thoughts of harming myself or others and do not suffer from severe mental health disorders.
+1 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive either CBT4CBT in the Black Church or treatment as usual at MCCA for alcohol use disorder
8 weeks
Weekly sessions
Follow-up
Participants are monitored for safety and effectiveness after treatment
9 months
Follow-up assessments at 3, 6, and 9 months
Participant Groups
The study is testing a new way to help people with AUD by using a program called CBT4CBT delivered in Black churches. It's being compared to traditional outpatient addiction treatments. The goal is to see which setting helps more with starting treatment, staying engaged, and reducing alcohol use over time.
2Treatment groups
Experimental Treatment
Active Control
Group I: CBT4CBT in the Black ChurchExperimental Treatment1 Intervention
The 'CBT for CBT' program is modeled closely on our NIDA-published CBT manual. Seven core skill modules will cover the following topics, which correspond to the major session topics in the manual:
Understanding and changing patterns of alcohol use, Coping with craving, Substance refusal skills, Seemingly irrelevant decisions, Planning for emergencies, and Problem-solving skills. Staying Safe
Group II: Community Based Treatment as UsualActive Control1 Intervention
Treatment as usual, typically groups, offered by a specialty community based treatment center (MCCA)
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Midwestern Connecticut Council on Alcoholism (McCa)New Haven, CT
The Substance Abuse Training Unit (SATU)New Haven, CT
Beulah Heights First Pentecostal ChurchNew Haven, CT
Dixwell Ave Congregational United Church of ChristNew Haven, CT
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Who Is Running the Clinical Trial?
Yale UniversityLead Sponsor
NYU Langone HealthLead Sponsor
National Institute on Alcohol Abuse and Alcoholism (NIAAA)Collaborator
References
Enduring effects of a computer-assisted training program for cognitive behavioral therapy: a 6-month follow-up of CBT4CBT. [2021]To evaluate the durability of effects of a computer-assisted version of cognitive behavioral therapy (CBT) as treatment for substance dependence through a 6-month follow-up.
Computer-assisted delivery of cognitive-behavioral therapy: efficacy and durability of CBT4CBT among cocaine-dependent individuals maintained on methadone. [2023]A previous pilot trial evaluating computer-based training for cognitive-behavioral therapy (CBT4CBT) in 77 heterogeneous substance users (alcohol, marijuana, cocaine, and opioids) demonstrated preliminary support for its efficacy in the context of a community-based outpatient clinic. The authors conducted a more definitive trial in a larger, more homogeneous sample.
A pilot randomized trial of CBT4CBT for women in residential treatment for substance use disorders. [2022]Despite the effectiveness of cognitive behavioral therapy (CBT) for treatment of substance use disorder, dissemination to clinical practice is limited due to a range of barriers (e.g., time, cost). Computer-based training for cognitive behavioral therapy (CBT4CBT) offers a feasible and cost-effective opportunity to improve the quality and reach of SUD treatment. Research to date has supported the effectiveness of CBT4CBT in outpatient settings; however, research has not yet tested it in residential treatment.
Computerized Cognitive Behavioral Therapy for Substance Use Disorders: A Summary of the Evidence and Potential Mechanisms of Behavior Change. [2023]Cognitive-behavioral therapy (CBT) is one of the most evaluated behavioral interventions for substance use disorders, with considerable empirical evidence supporting its efficacy. However, despite CBT's strong support from efficacy trials, broad dissemination and implementation have been challenging. Furthermore, there remains limited understanding regarding CBT's mechanisms of behavior change; the theory-driven assumption that individuals acquire new skills for coping with triggers for substance use has notoriously lacked statistical support. The emergence of computer-delivered interventions has the potential to address dissemination and implementation challenges, as well as offer advantages toward understanding treatment mechanisms. This article will provide a summary of the current evidence supporting one particular computerized CBT program, CBT4CBT. Multiple clinical trials in different treatment settings have indicated CBT4CBT's efficacy at reducing rates of alcohol and drug use when provided as an add-on to standard addiction treatment, as well as when provided with minimal clinical monitoring (i.e., virtual stand-alone). These effects have also been relatively durable after treatment termination, consistent with findings of traditional CBT. It is important to note that the evaluation of individuals' cognitive and behavioral coping skills prior and following treatment has indicated the acquisition/improvement of these skills may be a mechanism of behavior change for those who engage with CBT4CBT. Thus, computerized delivery may be a strategy for enhancing individuals' learning of cognitive and behavioral skills for successfully avoiding substance use. Future work should aim to identify the optimal type of setting, clinician role, and patient characteristics for targeted dissemination and implementation.
Randomized Clinical Trial of Computerized and Clinician-Delivered CBT in Comparison With Standard Outpatient Treatment for Substance Use Disorders: Primary Within-Treatment and Follow-Up Outcomes. [2019]Previous trials have demonstrated the efficacy and durability of computer-based cognitive-behavioral therapy (CBT4CBT) as an add-on to standard outpatient care in a range of treatment-seeking populations. In this study, the authors evaluated the efficacy and safety of CBT4CBT as a virtual stand-alone treatment, delivered with minimal clinical monitoring, and clinician-delivered cognitive-behavioral therapy (CBT) compared with treatment as usual in a heterogeneous sample of treatment-seeking outpatients with substance use disorders.
Improving internet-delivered cognitive behaviour therapy for alcohol misuse: Patient perspectives following program completion. [2021]Although Internet-delivered cognitive behaviour therapy (ICBT) for alcohol misuse is efficacious in research trials, it is not routinely available in practice. Moreover, there is considerable variability in engagement and outcomes of ICBT for alcohol misuse across studies. The Alcohol Change Course (ACC) is an ICBT program that is offered free of charge by an online clinic in Saskatchewan, Canada, which seeks to fill this service gap, while also conducting research to direct future improvements of ICBT. As there is limited qualitative patient-oriented research designed to improve ICBT for alcohol misuse, in this study, we describe patient perceptions of the ACC post-treatment. Specifically, post-treatment feedback was obtained from 191 of 312 patients who enrolled in the ACC. Qualitative thematic analysis was used to examine post-treatment written comments related to what patients liked and disliked about the course, which skills were most helpful for them, and their suggestions for future patients. The majority of patients endorsed being very satisfied or satisfied with the course (n = 133, 69.6%) and 94.2% (n = 180) perceived the course as being worth their time. Worksheets (n = 61, 31.9%) and reflections of others (n = 40, 20.9%) received the most praise. Coping with cravings (n = 63, 33.0%), and identifying and managing risky situations (n = 46, 24.1%) were reported as the most helpful skills. Several suggestions for refining the course were provided with the most frequent recommendation being a desire for increased personal interaction (n = 24, 12.6%) followed by a desire for wanting more information (n = 22, 11.5%). Many patients offered advice for future ACC patients, including suggestions to make a commitment (n = 47, 24.6%), do all of the work (n = 29, 15.2%), and keep a consistent approach to the course (n = 24, 12.6%). The results provide valuable patient-oriented directions for improving ICBT for alcohol misuse.
A pilot economic evaluation of computerized cognitive behavioral therapy for alcohol use disorder as an addition and alternative to traditional therapy. [2023]Computer-based delivery of cognitive behavioral therapy (CBT) may be a less costly approach to increase dissemination and implementation of evidence-based treatments for alcohol use disorder (AUD). However, comprehensive evaluations of costs, cost-effectiveness, and cost-benefit of computer-delivered interventions are rare.
Computerised cognitive behavioural therapy for alcohol use disorder: a pilot randomised control trial. [2019]Cognitive behavioural therapy (CBT) has been used in the treatment of alcohol use disorder (AUD), generally in individual or group therapy, but not via computer. Aim This study examined the effectiveness of an interactive, personalised, computer-based CBT therapy in a randomised control trial.