Computer-assisted behavioral therapy and contingency management for cannabis use disorder.
Computer-assisted behavioral treatments hold promise for enhancing access to and reducing costs of treatments for substance use disorders. This study assessed the efficacy of a computer-assisted version of an efficacious, multicomponent treatment for cannabis use disorders (CUD), that is, motivational enhancement therapy, cognitive-behavioral therapy, and abstinence-based contingency-management (MET/CBT/CM). An initial cost comparison was also performed. Seventy-five adult participants, 59% Black, seeking treatment for CUD received either, MET only (BRIEF), therapist-delivered MET/CBT/CM (THERAPIST), or computer-delivered MET/CBT/CM (COMPUTER). During treatment, the THERAPIST and COMPUTER conditions engendered longer durations of continuous cannabis abstinence than BRIEF (p < .05), but did not differ from each other. Abstinence rates and reduction in days of use over time were maintained in COMPUTER at least as well as in THERAPIST. COMPUTER averaged approximately $130 (p < .05) less per case than THERAPIST in therapist costs, which offset most of the costs of CM. Results add to promising findings that illustrate potential for computer-assisted delivery methods to enhance access to evidence-based care, reduce costs, and possibly improve outcomes. The observed maintenance effects and the cost findings require replication in larger clinical trials.
Department of Psychiatry, Geisel School of Medicine at Dartmouth.
Alan J
AJ
Budney
Department of Psychiatry, Geisel School of Medicine at Dartmouth.
Catherine
C
Stanger
Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences.
J Mick
JM
Tilford
Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth.
Emily B
EB
Scherer
Department of Veterans Affairs, Orlando Veterans Administration Medical Center.
Pamela C
PC
Brown
Biostatistics Shared Resource, Geisel School of Medicine at Dartmouth.
Zhongze
Z
Li
Biostatistics Shared Resource, Geisel School of Medicine at Dartmouth.
Zhigang
Z
Li
Innovative Programs Research Group, University of Washington.
Denise D
DD
Walker
D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000628:therapy*; D008875:Middle Aged; D009042:Motivation; D062405:Motivational Interviewing / Q000379:methods*; D011614:Psychotherapy, Brief / Q000379:methods; D019966:Substance-Related Disorders; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult