Implementing Computer-Based Psychotherapy Among Veterans in Outpatient Treatment for Substance Use Disorders

被引:10
|
作者
Hermes, Eric D. A. [1 ,2 ]
Rosenheck, Robert A. [1 ,2 ]
机构
[1] Vet Affairs VA Connecticut Healthcare Syst, New England Mental Illness Res Educ & Clin Ctr MI, West Haven, CT USA
[2] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA
关键词
COGNITIVE-BEHAVIORAL THERAPY; RANDOMIZED CONTROLLED-TRIAL; INSOMNIA SEVERITY INDEX; COST-EFFECTIVENESS; SLEEP; HEALTH; INTERVENTION; METAANALYSIS; CARE; DISSEMINATION;
D O I
10.1176/appi.ps.201400532
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective: Computer-based psychotherapy interventions (CBPIs) are increasingly offered as first-level access to evidence-based mental health treatment. However, their implementation has not been evaluated in public-sector outpatient settings. Methods: An evidence-based CBPI for insomnia was implemented with provider and patient education sessions, on-site Internet access, and clinician telephone support. Persons receiving care at a Veterans Health Administration substance abuse treatment clinic were screened for chronic insomnia and offered CBPI access. The feasibility of this strategy was evaluated in a pre-post design, which assessed engagement and completion rates, participant-reported acceptability, and clinical outcomes. Results: Of 100 veterans referred, 51 enrolled in the program, of whom 22 (43%) completed all sessions, 13 (26%) partially completed the program, and 16 (31%) did not engage. There were no statistically significant differences between these three groups in baseline characteristics. In the total sample, Insomnia Severity Index (ISI) scores decreased (improved) by 32% (mean+/-SD of 6.3+/-6.2 points, t=6.82, df=44, p<.001). Veterans who completed all six sessions displayed clinically and statistically significant improvements on the ISI compared with those who did not engage, as shown in a regression analysis that controlled for baseline insomnia severity, time between assessments, and sedative-hypnotic medication use (F=3.87, df=4 and 40, p <=.004). Among all participants, 67% agreed that they would engage in another CBPI in the future. When questioned about potential barriers, 36% of the full sample endorsed a preference for face-to-face therapy. Conclusions: A strategy of brief provider and patient education, on-site Internet access, and telephone support was feasible and effective for implementing CBPIs in outpatient substance abuse treatment settings for veterans.
引用
收藏
页码:176 / 183
页数:8
相关论文
共 50 条
  • [1] Substance Use Relapse Among Veterans at Termination of Treatment for Substance Use Disorders
    Betancourt, Christian A.
    Kitsantas, Panagiota
    Goldberg, Deborah G.
    Hawks, Beth A.
    MILITARY MEDICINE, 2022, 187 (11-12) : E1422 - E1431
  • [2] Substance Use Treatment Among Veterans with Liver Disease and Substance Use Disorders in the Veterans Health Administration
    Haque, Lamia
    Rosenheck, Robert
    HEPATOLOGY, 2017, 66 : 311A - 312A
  • [3] Technology Use and Interest in Computerized Psychotherapy: A Survey of Veterans in Treatment for Substance Use Disorders
    Hermes, Eric D. A.
    Tsai, Jack
    Rosenheck, Robert
    TELEMEDICINE AND E-HEALTH, 2015, 21 (09) : 721 - 728
  • [4] Predictors of outcome from computer-based treatment for substance use disorders: Results from a randomized clinical trial
    Kim, Sunny Jung
    Marsch, Lisa A.
    Guarino, Honoria
    Acosta, Michelle C.
    Aponte-Melendez, Yesenia
    DRUG AND ALCOHOL DEPENDENCE, 2015, 157 : 174 - 178
  • [5] Clinical considerations in the treatment of substance use disorders with veterans
    Borsari B.
    Capone C.
    Mastroleo N.R.
    Monti P.M.
    Journal of Contemporary Psychotherapy, 2011, 41 (4) : 247 - 253
  • [6] Meeting the Treatment Needs of Veterans with Substance Use Disorders
    Carroll, Jerome F. X.
    Hall, Charles E.
    Kearse, Roy
    Mooney, Michael
    Potestivo, Jo
    Forman, Nancy
    ALCOHOLISM TREATMENT QUARTERLY, 2016, 34 (03) : 354 - 364
  • [7] THE ROLE OF PSYCHOTHERAPY IN THE TREATMENT OF SUBSTANCE-USE DISORDERS
    NAJAVITS, LM
    WEISS, RD
    HARVARD REVIEW OF PSYCHIATRY, 1994, 2 (02) : 84 - 96
  • [8] Patterns of Treatment Utilization Before Suicide Among Male Veterans With Substance Use Disorders
    Ilgen, Mark A.
    Conner, Kenneth R.
    Roeder, Kathryn M.
    Blow, Frederic C.
    Austin, Karen
    Valenstein, Marcia
    AMERICAN JOURNAL OF PUBLIC HEALTH, 2012, 102 : S88 - S92
  • [9] Development of an In-Home Telehealth Program for Outpatient Veterans With Substance Use Disorders
    Santa Ana, Elizabeth J.
    Stallings, Deidre L.
    Rounsaville, Bruce J.
    Martino, Steve
    PSYCHOLOGICAL SERVICES, 2013, 10 (03) : 304 - 314
  • [10] E-Cigarette Use and Perceptions Among Veterans Receiving Outpatient Treatment in Veterans Affairs Substance Use and Mental Health Clinics
    Dixit, Devika
    Herbst, Ellen
    Das, Smita
    MILITARY MEDICINE, 2021, 186 (1-2) : 24 - 29