Addiction: Improving Outcomes using Computer-based Therapy


A recent randomised control trial gives support to the use of computer-based therapy for treatment of addictions. The results were reported this week at the annual convention of the Association for Psychological Science in San Francisco, following publication in the American Journal of Psychiatry. Although the trial focused specifically on cocaine-dependent individuals, it replicates findings of a RCT carried out in 2008, in which participants had a wider range of substance addictions.

Results of this latest study show that those who received computer-assisted therapy were significantly more likely to attain three or more consecutive weeks of abstinence from cocaine as compared to those not receiving any form of Cognitive Behavioural Therapy (CBT) – 36% compared with 17%. And the effects appear to last; the control group also had better outcomes six months after treatment had ended.

Individuals who receive CBT learn to identify and correct problematic behaviours by applying a range of techniques.  Central elements of the therapy include anticipating likely problems, correcting harmful thought patterns, and developing effective coping strategies. The techniques enable people to counteract addiction’s powerful effects on the brain, so they can regain control of their behaviour and lives.

CBT has been shown to be an effective way to treat a variety of disorders including substance abuse. The problem is that it’s not available to everyone who could benefit. This is largely because there aren’t enough well-trained therapists to meet the need. Another reason is that only a small percentage of people with substance abuse problems seek treatment (for many reasons including the attached stigma). The computer-based therapy programme uses the same techniques as person to person CBT, but could also help overcome some of these obstacles.

Computer-based CBT therapy may have other benefits too, for instance, because the lessons use film clips, people can watch CBT techniques being played out in real life situations (by actors) – arguably much better  than a therapist describing the same coping strategies in conceptual terms. The lessons include other interactive features designed to keep participants engaged, including online games, quizzes and practice exercises.

The study was led by Yale University Psychological Scientist, Professor Kathleen Carroll, who along with several colleagues has been studying the potential of computer-assisted delivery of CBT to addicts for some time.  Carroll adds a note of caution however, reminding us not to get ahead of the data with web-based computer assisted therapies more generally; pointing out that the methodological quality of RCT’s in this area to date has been variable. Read more: Addiction Treatment MagazineAssociation of Psychological Science

CBT previously in TTA: Behavioral therapy, online and mobileMental health apps for veterans (US)

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