Cognitive-behavioral therapy (CBT) is empirically well supported for treating substance use disorders, but it remains underutilized due to various factors that tend to limit the availability of certified providers in substance abuse treatment settings. Computer-based training for CBT (CBT4CBT) has shown promise in previous studies with varied substance use disorders, and a new clinical trial conducted by researchers at Yale University School of Medicine evaluated its effectiveness as a stand-alone addition to regular treatment in a larger sample of cocaine-dependent individuals receiving methadone maintenance treatment. Participants were randomized to either receive just methadone treatment as usual or additionally receive 8 weeks of access to CBT4CBT on a dedicated computer in a private room within the clinic. Those given access to CBT4CBT were significantly more likely to have at least 3 consecutive weeks of abstinence from cocaine during the trial and also showed reduced use of other drugs. Benefits from CBT4CBT persisted beyond the treatment period, as shown in a 6-month follow-up. Although it is still not yet known how well CBT4CBT compares with clinician-delivered CBT, these results suggest that computer-based CBT may be an effective, easily disseminated alternative in areas or treatment centers where there is limited access to CBT-qualified clinicians.
To view the article online, go to: http://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2013.13070987.