Computer-based Training in Cognitive Behavioral Therapy (CBT4CBT): New Directions for Behavioral Therapies Research

 


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Air date: Wednesday, September 17, 2008, 3:00:00 PM
Category: BSSR Lecture Series
Runtime: -3 minutes
NLM Title: Computer-based training in cognitive behavioral therapy (CBT4CBT) : new directions for behavioral therapies research [electronic resource] / Kathleen M. Carroll.
Author: Carroll, Kathleen.
National Institutes of Health (U.S.)
Publisher: [Bethesda, Md. : National Institutes of Health, 2008]
Abstract: (CIT): As is the case in many areas of health care but perhaps most evident in the treatment of addiction, there is a tremendous gap between research and practice. In response to this issue, Dr. Carroll and her colleagues developed a computer assisted version of cognitive behavioral therapy (CBT4CBT). CBT has a strong record of efficacy across a range of substance use and psychiatric disorders. The skills-based approaches of CBT are extremely well suited to a computer-based, multimedia format. The multimedia style of CBT4CBT includes presentation of material in a range of formats including multiple videotaped examples that allow users to actually see professionally produced "movies" of people implementing CBT coping skills in realistic settings. Other examples include interactive graphics and games, verbal instructions and audio voice-overs, interactive assessments, and practice exercises ("homework"). A recently published randomized clinical trial of CBT4CBT demonstrated its efficacy in reducing substance use in a heterogeneous group of drug and alcohol users entering a community-based outpatient substance abuse clinic. The initial findings are consistent with previous work demonstrating the efficacy of computerized versions of CBT for the treatment of depression and anxiety. Dr. Carroll's and her colleagues' work on CBT4CBT extends these findings in several important ways. While previous studies have relied predominantly on unblended patient self-reports of improvement, Dr. Carroll's team has demonstrated efficacy with biologically verified outcome indicators (urine and breath samples). They have been able to document significantly longer periods of abstinence among those using the CBT4CBT program. They have demonstrated enduring efficacy of the CBT4CBT program, again with biologically-verified outcomes, through a six-month follow-up evaluation.They have used independent (blind) ratings of participants' levels of coping skills before and after treatment to demonstrate that the CBT4CBT program actually teaches the targeted coping skills (relative to standard treatment) and that acquisition of these skills contributes to the enduring effects of the program (e.g., evidence of mediation). They have demonstrated that the program is highly cost effective, producing significant improvements in outcome at minimal cost. Thus, not only can computer-assisted programs such as CBT4CBT dramatically enhance availability and reduce costs of providing empirically validated therapies, but the level of quality control and standardization is an important strategy for understanding the mechanisms of effective behavioral therapies.
Subjects: Cognitive Therapy
Substance-Related Disorders--rehabilitation
Therapy, Computer-Assisted
Publication Types: Government Publications
Lectures
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NLM Classification: WM 270
NLM ID: 101486637
CIT File ID: 14653
CIT Live ID: 7170
Permanent link: http://videocast.nih.gov/launch.asp?14653