12 May Internet-Delivered Approach Helps Keep Addicts in Treatment
As a rule, effective substance treatment programs rely on in-person participation that takes place in either a one-on-one or group setting. However, advances in web-based technology now make it possible to supplement this standard treatment with remotely delivered therapy. In a study published in April 2014 in The American Journal of Psychiatry, researchers from the National Institute on Drug Abuse and over a dozen other institutions assessed the potential usefulness of one particular Internet-based approach, called the Therapeutic Education System, in augmenting the benefits of substance treatment delivered in a traditional setting.
To a certain degree, the course of substance treatment varies according to the substance in question and the severity of the problems affecting a given individual. However, treatment programs in the U.S. commonly adhere to a set of core principles, including the appropriate use of medications to counter the effects of withdrawal and reduce the risks for a relapse, as well as the appropriate use of counseling, psychotherapy or behavioral therapy to help recovering individuals change the thoughts, beliefs and actions that support abusive and addictive patterns of substance intake. Forms of substance addiction that are frequently treated with medication include alcoholism, opioid addiction and nicotine addiction. Counseling and therapy are more widely used and often play a primary role in the treatment of forms of addiction that don’t respond well to any known medication-based approach. Specific non-medication-based therapeutic approaches used in outpatient facilities in the U.S. include cognitive behavioral therapy, contingency management, motivational interviewing and multidimensional family therapy.
Therapeutic Education System
The Therapeutic Education System (TES) is an electronic, Internet-based form of a therapeutic concept called the Community Reinforcement Approach Plus Vouchers or the Community Reinforcement Approach Plus Contingency Management. This concept uses a mixture of things such as family-centered individual counseling, substance avoidance training, vocational training, healthy social network development and voucher-based incentives to help participants establish a sustainable lifestyle not anchored in drug or alcohol use. The Therapeutic Education System converts the Community Reinforcement Approach into 62 modules that can be accessed remotely on a computer. Each of these modules provides an interactive experience and features the multimedia techniques common to the Internet and computers in general. Collectively, they cover topics that include learning how to decline invitations to substance use, learning functional ways to deal with negative states of mind and learning how to improve social and personal interactions with others. Participants in TES go at their own pace and choose their particular path through the available modules.
Effectiveness in Substance Treatment
In the study published in The American Journal of Psychiatry, the multi-institution research team made the Therapeutic Education System available to 255 adults taking part in outpatient treatment programs for various forms of substance addiction. These adults received roughly two hours of the Internet-based approach every week to augment a standard 12-week course of addiction treatment. Another 255 adults enrolled in the study also received a standard 12-week course of treatment, but did not receive access to TES. In each case, standard treatment included participation in both group and individualized counseling sessions.
The researchers used two main measurements to gauge the effectiveness of TES: the ability to completely avoid drug use and/or excessive alcohol intake, and the ability to stay involved in substance treatment. When they compared the results in these two areas between the TES recipients and non-recipients, they concluded that the adults who received the Internet-based treatment in addition to group and individualized counseling stayed enrolled in their programs more often than their counterparts who received only group and individualized counseling. The researchers also concluded that the TES recipients typically had a greater ability to stay away from the use of drugs and/or alcohol.
The authors of the study published in The American Journal of Psychiatry note that the individuals who benefitted the most from the combination of traditional in-person therapy and Internet-based therapy were not actively involved in drug or alcohol use when the study began. Two hundred twenty-eight people fit into this category. The authors believe that Internet-based treatment approaches like the Therapeutic Education System can potentially lead to a significant boost in the results of addiction treatment, in addition to substantially widening the availability of effective treatment options. However, they also point toward a need for further research to determine which particular aspects of the TES approach provide the greatest benefits.
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