Abstract and Keywords
Cognitive-behavioral therapy (CBT) is effective across a range of substance use disorders yet implementation in many substance use treatment settings is comparatively rare due to multiple challenges, including the costly resources needed for appropriate training and supervision of clinicians. Digital technology is one strategy to address these challenges, potentially making such evidence-based therapies more broadly available to those in need of treatment. This chapter provides an overview of the development of a computerized version of CBT (CBT4CBT) as a means of exposing patients to basic CBT skills and strategies in an engaging and user-friendly manner while also allowing clinicians and treatment programs to be more efficient and effective. Empirical evidence supporting CBT4CBT from four randomized trials at the time of writing is reviewed, as well as a description of the potential benefits and applications of computerized therapies. Given their flexibility, relative ease of dissemination, and lower cost compared to clinician-delivered treatment, computerized versions of CBT (and other behavioral therapies) might be used to enhance and extend psychiatric treatment for addictions. Moreover, the level of standardization and control that characterizes computerized therapies may be useful in understanding mechanisms of effective treatments and in development of personalized interventions. While there is tremendous optimism regarding the potential of computerized therapies, such as CBT4CBT, systematic evaluation of these interventions and the methodological standards for evaluating them is still in very early stages relative to the more established behavioral and pharmacologic interventions for addictions.
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