Web Based Interventions Produce Good Results in Treating Substance Abuse

A new study in the American Journal Of Psychiatry (Volume 171, Issue 6, June 2014) shows that incorporating a web-based educational intervention in the treatment of drug abuse can not only help people stop using drugs, but can also keep them in treatment longer.

TES is a web-based version of the Community Reinforcement Approach plus Contingency Management, a packaged approach with demonstrated efficacy.  The National Institute on Drug Abuse (NIDA), part of the NIH, funded this study.

TES consists of 62 interactive modules that teach patients how to achieve and maintain abstinence from drug use and includes prize-based motivational incentives to encourage adherence to treatment.  Patients given TES were less likely to drop out of treatment than those in the control group.  Also, the web-based intervention helped patients stay abstinent from drug use, even those who were not abstinent at the beginning of the study.  With such findings, web-based interventions like TES are promising additions to drug abuse treatment.

This approach, which combines skills-oriented counseling and contingency management in an Internet-delivered behavioral intervention, produced high rates of abstinence from drugs and heavy drinking among patients with a good prognosis (those who entered the study with positive urine drug or breath alcohol screen) but doubled the likelihood of abstinence among patients with an otherwise poor prognosis.

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.

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.

Compared with patients in the treatment-as-usual group, those in the TES group had a lower dropout rate and a greater abstinence rate. This effect was more pronounced among patients who had a positive urine drug or breath alcohol screen at study entry (N=228).

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.

Tom Wilson Counseling Online Alcohol Classes currently uses similar evidenced based practices inclusing cognitive behavioral techniques, motivational enhancement therapy and stages of change theory.

Taking Alcohol Classes Online Can Help Complete Pretrial Diversion Requirements

Understanding Pretrial Diversion

A criminal conviction for an alcohol or drug offense, whether misdemeanor or felony, can create an avalanche of unintended consequences that often ends with individuals becoming further enmeshed in the legal system which can prevent them from being a productive member of the community. Tom Wilson Counseling Center specializes in online alcohol and drug abuse education for low to medium risk participants who have qualified for a pretrial diversion program in any state.

Pretrial diversion programs afford individuals an opportunity to address their behavior without resulting in a criminal conviction. These diversion programs may occur as early as street-level law enforcement intervention, or as late as court involvement, but the distinguishing characteristic is that there will not be a conviction recorded in an individual’s record.

Many pretrial diversion defendants are referred for alcohol and substance abuse intervention, with low risk offenders sent to less intensive programs while higher risk offenders are sent to more intensive programs, such as outpatient treatment. Since most programs are administered by prosecuting Attorneys, community probation supervision personnel are often tasked with identifying the higher risk offenders (who will need more intensive intervention). Most participants in the pretrial diversion program are low risk or medium risk offenders, and have the highest completion rate of their online alcohol drug education classes, and their diversion requirements.

Out-of-state offenders in pretrial diversion programs are usually referred to online alcohol drug education programs that  meet court requirements and provide the quickest way to help them avoid a black mark on their legal record.