Specific aims are as follows: * To adapt our existing CBT4CBT program for use with Spanish-speaking alcohol users in a web-based platform * To conduct an 8-week randomized trial evaluating the feasibility and efficacy of adding CBT4CBT-Spanish to treatment as usual in a community based treatment program in a population of 90 Spanish-speaking individuals who meet current criteria for alcohol use disorder * To evaluate the long-term durability and/or delayed emergence of treatment effects through a six month follow-up after termination of the study treatments. Given previous evidence regarding the durability of standard clinician-delivered CBT and computer-assisted CBT4CBT, we hypothesize that CBT4CBTSpanish will be significantly more effective than standard treatment alone through the follow-up.
The investigators will conduct a Stage 1 randomized clinical trial evaluating the program in which 90 Spanish-speaking individuals with alcohol use disorder will be randomized to (1) standard outpatient counseling at the Hispanic Clinic (ST; typically consisting of weekly individual and group supportive counseling) or (2) CBT4CBT-Spanish as an adjunct to ST. Other aspects of the trial will parallel those in the investogators completed trial of the English version of CBT4CBT-Alcohol to facilitate comparability across studies. Treatments will be delivered over an 8-week period with a 6-month follow-up to assess durability and/or delayed emergence of treatment effects. The primary outcome measure will be percent days of abstinence (PDA) by week. Secondary outcomes include percent heavy drinking days and number of individuals with no heavy drinking days in the last 4 weeks of treatment. Participants will be 90 individuals seeking treatment for alcohol use at the Hispanic Clinic of CMHC. The clinic treats a heterogeneous population, where 42% of those in the co-occurring treatment program report alcohol as their principal substance related issue and 43% are women. As reported above, the investigators have demonstrated the ability to recruit, randomize, retain, and follow-up high numbers of closely related samples in this setting.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
51
Participants will have access to the CBT4CBT website in Spanish as an add-on to treatment. In this treatment participants will work with a computerized program that teaches skills for stopping alcohol use and increasing coping skills, such as how to understand patterns of alcohol use, how to cope with cravings for alcohol, how to refuse offers of alcohol, and so on
ST includes individual and group therapy sessions and regular urine monitoring. Sessions will generally last for 1 hour one time per week for 8 weeks
Midwestern Connecticut Council on Alcoholism (MCCA)
Bridgeport, Connecticut, United States
Cornell Scott - Hill Health Center
New Haven, Connecticut, United States
Hispanic Clinic of CMHC
New Haven, Connecticut, United States
Midwestern Connecticut Council on Alcoholism (MCCA)
New Haven, Connecticut, United States
Multi-Cultural Ambulatory Addiction Services (MAAS)
New Haven, Connecticut, United States
The Primary Outcome Measure Will be Percent Days of Abstinence (PDA) by Week
The primary outcome measure will be percent days of abstinence (PDA) by week, presented are the raw means at each time point.
Time frame: By week for 8 weeks
Monthly Abstinence From Alcohol
Estimated means of sustained abstinence calculated as percent days per month from month 3 through 8 in post intervention follow up.
Time frame: Months 3 through 8 (6 months total)
Secondary Outcomes Include Percent Heavy Drinking Days
Percent heavy drinking days during 8 weeks of trial
Time frame: 8 weeks
Number of Individuals With no Heavy Drinking Days in the Last 4 Weeks of Treatment
Number of individuals with no heavy drinking days in the last 4 weeks of treatment
Time frame: last 4 weeks of treatment (4 weeks)
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