Kiluk BD. (2019). Computerized cognitive behavioral therapy for substance use disorders: A summary of the evidence and potential mechanisms of behavior change. Perspectives on Behavior Science. doi: 10.1007/s40614-019-00205-2
The author reviewed studies evaluating the efficacy and potential mechanisms of action of Computer-Based Training for Cognitive Behavioral Therapy (CBT4CBT). CBT4CBT is a 7-module computer-based intervention for substance use disorders (SUDs) based on cognitive behavioral therapy (CBT). CBT4CBT has been evaluated with individuals entering outpatient treatment for substance use, methadone-maintained individuals dependent on cocaine, individuals receiving outpatient treatment for alcohol use disorder, and Spanish-speaking individuals with SUDs. Studies demonstrate that CBT4CBT as an adjunct to treatment as usual (TAU) can promote reductions in substance use, abstinence from drugs and alcohol, and engagement in treatment. Reductions in substance use in CBT4CBT groups were maintained to 6 months in 2 studies. CBT4CBT as a stand-alone treatment produced similar reductions in substance use to in-person CBT in one trial and similar levels of abstinence to TAU in another trial. The author examined coping skills, knowledge of CBT concepts, and therapeutic alliance as potential mechanisms of action. Quality of coping skills was related to alcohol abstinence in those who received CBT4CBT, but not for those who received TAU. Greater improvements in CBT skills were observed in participants who received CBT4CBT compared to those that received TAU. Finally, participants reported similar levels of therapeutic alliance with CBT4CBT as an adjunct for TAU and their substance abuse counselor, but treatment outcomes were related to treatment alliance with the substance use counselor and not CBT4CBT. Researchers conclude that CBT4CBT has been shown to be efficacious for treating SUDs and that coping skills may be one of the mechanisms of action.