Cited by 263Substance Abuse Treatment and OutcomesDigital Mental Health InterventionsGambling Behavior and Treatments

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Internet-Delivered Treatment for Substance Abuse: A Multisite Randomized Controlled Trial

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Campbell, Aimee N.C., Nunes, Edward V., Matthews, Abigail G., Stitzer, Maxine, Miele, Gloria M., Polsky, Daniel, Turrigiano, Eva, Walters, Scott, McClure, Erin A., Kyle, Tiffany L., Wahle, Aimee, Van Veldhuisen, Paul, Goldman, Bruce, Babcock, Dean, Stabile, Patricia Quinn, Winhusen, Theresa, Ghitza, Udi E.·2014·American Journal of Psychiatry

DOI 10.1176/appi.ajp.2014.13081055PMC PMC4079279

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Abstract

OBJECTIVE: Computer-delivered interventions have the potential to improve access to quality addiction treatment care. The objective of this study was to evaluate the effectiveness of the Therapeutic Education System (TES), an Internet-delivered behavioral intervention that includes motivational incentives, as a clinician-extender in the treatment of substance use disorders. METHOD: Adult men and women (N=507) entering 10 outpatient addiction treatment programs were randomly assigned to receive 12 weeks of either treatment as usual (N=252) or treatment as usual plus TES, with the intervention substituting for about 2 hours of standard care per week (N=255). TES consists of 62 computerized interactive modules covering skills for achieving and maintaining abstinence, plus prize-based motivational incentives contingent on abstinence and treatment adherence. Treatment as usual consisted of individual and group counseling at the participating programs. The primary outcome measures were abstinence from drugs and heavy drinking (measured by twice-weekly urine drug screens and self-report) and time to dropout from treatment. RESULTS: Compared with patients in the treatment-as-usual group, those in the TES group had a lower dropout rate (hazard ratio=0.72, 95% CI=0.57, 0.92) and a greater abstinence rate (odds ratio=1.62, 95% CI=1.12, 2.35). This effect was more pronounced among patients who had a positive urine drug or breath alcohol screen at study entry (N=228) (odds ratio=2.18, 95% CI=1.30, 3.68). CONCLUSIONS: Internet-delivered interventions such as TES have the potential to expand access and improve addiction treatment outcomes. Additional research is needed to assess effectiveness in non-specialty clinical settings and to differentiate the effects of the community reinforcement approach and contingency management components of TES.

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Authors: Campbell, A. N. C., Nunes, E. V., Matthews, A. G., Stitzer, M., Miele, G. M., Polsky, D., Turrigiano, E., Walters, S., McClure, E. A., Kyle, T. L., Wahle, A., Van Veldhuisen, P., Goldman, B., Babcock, D., Stabile, P. Q., Winhusen, T., & Ghitza, U. E.
Affiliations: St. Luke's-Roosevelt Hospital Center (US)
From New York State Psychiatric Institute, New York; Department of Psychiatry, Columbia University, New York; Department of Psychiatry and Behavioral Health, St. Luke’s Roosevelt Hospital Center, New York; EMMES Corporation, Rockville, Md.; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore; School of Medicine, University of Pennsylvania, Philadelphia; School of Public Health, University of North Texas Health Science Center, Fort Worth; Clinical...
ORCID: Campbell, Aimee N.C.
Nunes, Edward V.
Matthews, Abigail G.
Stitzer, Maxine
Miele, Gloria M.
Polsky, Daniel
Walters, Scott
McClure, Erin A.
Kyle, Tiffany L.
Winhusen, Theresa
Ghitza, Udi E.
Venue: American Journal of Psychiatry
Publisher: American Psychiatric Association Publishing
Published: 2014-06
Volume: 171
Issue: 6
Pages: 683-690
ISSN: 0002-953X (ISSN-L)
1535-7228
DOI: 10.1176/appi.ajp.2014.13081055
PMC: PMC4079279
OpenAlex: W1963819178
Cited by: 263
References: 38
Citations by year: 2026: 18 · 2025: 15 · 2024: 23 · 2023: 26 · 2022: 30 · 2021: 27 · 2020: 28 · 2019: 23 · 2018: 19 · 2017: 15 · 2016: 17 · 2015: 15 · 2014: 6
FWCI: 13.38
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: American Journal of Psychiatry (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (5u10da013034-15)
National Institute on Drug Abuse (U10DA013720, U10DA013035, K24DA022412, DA013035, U10-DA013034, U10DA013732, U10DA015815, U10DA020024, U10DA013036, U10DA013714, U10DA015831, DA015831, UG1DA020024)
National Institute on Minority Health and Health Disparities (L60 MD006644)
National Drug Abuse Treatment Clinical Trials Network
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
Keywords: internet-delivered treatment, substance use disorders, motivational incentives, abstinence, treatment discontinuation, outpatient addiction treatment, community reinforcement, contingency management, access to addiction treatment
MeSH terms: Adult, Behavior Therapy, Female, Humans, Male, Patient Compliance, Treatment Outcome, Telemedicine, Substance-Related Disorders, Internet

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