title: Computerized behavior therapy for opioid-dependent outpatients: a randomized controlled trial.
abstract: The authors evaluated the efficacy of an interactive, computer-based behavioral therapy intervention, grounded in the community reinforcement approach (CRA) plus voucher-based contingency management model of behavior therapy. Our randomized, controlled trial was conducted at a university-based research clinic. Participants comprised 135 volunteer adult outpatients who met DSM-IV criteria for opioid dependence. All participants received maintenance treatment with buprenorphine and were randomly assigned to one of three treatments: (a) therapist-delivered CRA treatment with vouchers, (b) computer-assisted CRA treatment with vouchers, or (c) standard treatment. The therapist-delivered and computer-assisted CRA plus vouchers interventions produced comparable weeks of continuous opioid and cocaine abstinence (M = 7.98 and 7.78, respectively) and significantly greater weeks of abstinence than the standard intervention (M = 4.69; p < .05), yet participants in the computer-assisted CRA condition had over 80% of their intervention delivered by an interactive computer program. The comparable efficacy obtained with computer-assisted and therapist-delivered therapy may enable more widespread dissemination of the evidence-based CRA plus vouchers intervention in a manner that is cost-effective and ensures treatment fidelity.
authors.affiliation: University of Arkansas for Medical Sciences, College of Medicine, Little Rock, AR 72205, USA. wbickel@uams.edu
authors.forename: Warren K
authors.initials: WK
authors.lastname: Bickel
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Marsch
authors.forename: August R
authors.initials: AR
authors.lastname: Buchhalter
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Badger
mesh_terms: D000328:Adult; D000438:Alcohols / Q000097:blood / Q000652:urine; D001521:Behavior Therapy / Q000379:methods*; D002047:Buprenorphine / Q000627:therapeutic use; D017076:Computer-Aided Design; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D009292:Narcotic Antagonists / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000523:psychology / Q000628:therapy*; D012054:Reinforcement, Psychology; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000438:Alcohols; D009292:Narcotic Antagonists; D002047:Buprenorphine