abusers abstinent, study shows
Drug abusers who used a computer-assisted training program in addition to receiving
traditional counseling stayed abstinent significantly longer than those who
received counseling alone, a Yale study has shown. — By Bill Hathaway
T H I S
The findings were reported in the May 1 edition of the American Journal of
Psychiatry.
Seventy-seven people who sought treatment for drug and alcohol abuse were randomly
assigned to receive traditional counseling or to get computer-assisted training
based on principles of cognitive behavioral therapy as well as sessions with
a therapist.
The subjects who received computer-assisted training had significantly fewer
positive drug tests at the conclusion of the study, reports Kathleen M. Carroll,
professor of psychiatry and lead author of the study.
“We think this is a very exciting way of reaching more people who may have
substance use problems and providing a means of helping them learn effective
ways to change their behavior,” Carroll says.
Cognitive behavioral therapy concentrates on teaching skills and strategies
to help people change behavior patterns and has been proven to be an effective
way to treat a wide variety of psychiatric disorders. However, such therapy
is not widely available for people with substance use problems, Carroll notes.
Also, many counselors lack the time or training to fully implement cognitive
behavioral therapies for their patients, she says. Carroll and her team at
the Yale School of Medicine developed a software program to help supplement
counseling in drug addiction as well as other psychiatric disorders.
The computer-assisted therapy program consists of text, audio and videotaped
examples designed to help the user learn new ways of avoiding the use of drugs
and changing other problem behaviors.
The study volunteers had sought treatment at a substance abuse clinic in Bridgeport,
Connecticut, and met diagnostic criteria for a substance use problem with alcohol,
cocaine, opioids or marijuana. Those assigned to computer-assisted training
were exposed to six lessons, or modules, that they accessed from a computer
located at the treatment program.
Each module included a brief movie that presented a particular challenge to
the subjects’ ability to resist substance use — such as the offer
of drugs from a dealer. The narrator of the module then presented different
skills and strategies to avoid drug use and also show videotapes of individuals
employing those strategies.
“At first glance,” says Dr. William Sledge, interim chair and the
George D. and Esther S. Gross Professor of Psychiatry, “one might conclude
that this computer-based training in some way threatens the conventionally perceived
value of the relationship between the therapist and the patient. However, I do
not see it as so. Rather, [the researchers] have demonstrated how a low-cost
but carefully conceived procedure can enhance conventional treatment and add
an additional element of richness and effectiveness to its power.”
Carroll is one of 20 Yale School of Medicine faculty members who have been
designated an ISI Highly Cited researcher, a listing of the most highly influential
scientists in the world. The Yale drug and alcohol program received top ranking
among graduate programs in 2008 from the U.S. News and World Report.
The study was funded by the National Institute on Drug Abuse, part of the National
Institutes of Health.
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Campus Notes
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