A pilot randomized trial of CBT4CBT for women in residential treatment for substance use disorders

Sydney S Kelpin; Anna Beth Parlier-Ahmad; Nancy Jallo; Kathleen Carroll; Dace S Svikis

doi:10.1016/j.jsat.2021.108622

A pilot randomized trial of CBT4CBT for women in residential treatment for substance use disorders

J Subst Abuse Treat. 2022 Jan:132:108622. doi: 10.1016/j.jsat.2021.108622. Epub 2021 Sep 13.

Authors

Sydney S Kelpin¹, Anna Beth Parlier-Ahmad², Nancy Jallo³, Kathleen Carroll⁴, Dace S Svikis²

Affiliations

¹ Department of Psychology and Institute of Women's Health, Virginia Commonwealth University, Richmond, VA, United States of America. Electronic address: kelpinss@alumni.vcu.edu.
² Department of Psychology and Institute of Women's Health, Virginia Commonwealth University, Richmond, VA, United States of America.
³ Department of Family and Community Health Nursing, Virginia Commonwealth University School of Nursing, Richmond, VA, United states of America.
⁴ Yale School of Medicine, New Haven, CT, United States of America.

PMID: 34538690
DOI: 10.1016/j.jsat.2021.108622

Abstract

Introduction: 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.

Methods: The current study evaluated the feasibility of CBT4CBT as an adjunct to residential treatment in a sample of women with SUDs using a two-arm pilot RCT comparing women randomized to either standard residential treatment plus access to the CBT4CBT program (N = 34) or residential treatment alone (TAU; N = 29). Assessments occurred at baseline, discharge from residential care, and at 4- and 12-weeks post-discharge. The study compared the two groups over the 12-week follow-up period on relapse to any substance (Y/N), relapse to primary substance (Y/N), and days of use using chi-square for categorical and t-tests for continuous measures. The study team also performed a Kaplan-Meier analysis to compare the two groups on time to relapse.

Results: Demographically, the sample was predominantly African American (79.4%), with a mean age of 41.2 years (SD = 12.1). Although the current study was not powered for statistical significance, findings were in the predicted direction, with women in the CBT4CBT group reporting lower likelihood of relapse, longer time to relapse, and fewer days of substance use in the follow-up period compared to women in TAU.

Conclusions: This study expands the current literature supporting the use of CBT4CBT in outpatient settings. While a fully powered trial should confirm our findings, the current study provides benchmark data on the use of CBT4CBT in residential treatment for women with SUDs.

Keywords: CBT4CBT; Computer-delivered treatment; Residential treatment; Substance use disorders.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aftercare
Female
Humans
Patient Discharge
Pilot Projects
Residential Treatment
Substance-Related Disorders* / psychology
Substance-Related Disorders* / therapy
Therapy, Computer-Assisted*
Treatment Outcome