Mobile Psychosocial Treatment for Clients in Methadone Maintenance
In our ongoing study, “Computer Delivery of Effective Psychosocial Interventions in Methadone Treatment,” we are evaluating the effectiveness of an interactive computer-delivered, evidence-based psychosocial intervention – the Therapeutic Education System (TES) in a sample of clients in methadone maintenance treatment. The TES contains over 65 modules to improve skills and behaviors including: family/social relations, communication and decision-making, management of negative moods and depression, time and financial management. Many modules relate specifically to drug use (e.g., drug refusal skills, managing thoughts about using drugs, prevention of HIV and hepatitis C). Clients in standard methadone counseling will be compared to clients in methadone counseling plus TES on drug use (using urine toxicology), treatment retention, self-reported drug use, HIV risk behavior, therapeutic alliance and psychosocial functioning. In addition, a comprehensive economic analysis of adding TES to standard methadone treatment will be performed.
In this competitive revision, we will develop and evaluate the feasibility, acceptability and potential utility of a prototype of an innovative, mobile phone-based, psychosocial treatment intervention, to allow participants to access key elements of the web-based intervention at any time and outside of their formal treatment setting. Specifically, we plan to develop a mobile phone-based intervention consisting of two primary elements of effective psychosocial interventions for substance use disorders and to evaluate this intervention in 25 participants in methadone maintenance receiving methadone counseling plus TES.
If the mobile intervention appears feasible and acceptable, it may be expanded for examination of efficacy in a large-scale trial. In addition, if the technology shows promise, the potential applications to other psychosocial interventions are enormous. The ability to bring therapeutic interventions into an individual’s natural environment and provide therapeutic support on-demand could greatly improve the potency of psychosocial interventions. In addition, this technology may be well-suited as a relapse prevention tool for individuals leaving treatment (or leaving a period of incarceration), whereby individuals could be prompted to monitor the extent to which they are maintaining gains from a prior treatment episode or to utilize skills they recently learned in treatment via their mobile phones. Thus, this project may generate clinically important empirical data regarding the use of technology in promoting new models of treatment delivery that may enable rapid and widespread diffusion of science-based interventions.