Developing and Evaluating a Fully Integrated Treatment Program for Comorbid Social Anxiety and Alcohol Use Disorders

制定和评估共病社交焦虑和酒精使用障碍的完全综合治疗方案

基本信息

批准号：
10164494
负责人：
Kate Basia Wolitzky-Taylor
金额：
$ 10.25万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-05-20 至 2021-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10164494
关键词：
Address Administrative Supplement Administrator Adult Aftercare Alcohol abuse Alcohol consumption Alcohols Ambulatory Care Behavior Therapy COVID-19 pandemic Caring Clinic Clinical Clinical Services Clinical Trials Cognitive Therapy Combined Modality Therapy Communities Data Disease Effectiveness Emotional disorder Enrollment Evidence based treatment Focus Groups Fright Funding Goals Graduation Rates Impairment Individual Intervention Link Los Angeles Manuals Measures Mental disorders Modeling Outcome Outcome Measure Outpatients Patients Persons Principal Investigator Protocols documentation Public Health Randomized Randomized Clinical Trials Reporting Research Research Personnel Resources Services Site Social Anxiety Disorder Social Interaction Social Problems Structure Substance Use Disorder Sum Surveys Symptoms Time Treatment Protocols Treatment outcome Uncertainty Visit Wages Work active method addiction alcohol abuse therapy alcohol comorbidity alcohol related consequences alcohol use disorder base cohort community clinic comorbidity effectiveness evaluation evidence base follow-up graduate student group intervention improved improved outcome medical specialties meetings novel strategies operation outpatient programs programs recruit social anxiety therapy development treatment adherence treatment center treatment program

项目摘要

Abstract Social anxiety disorder and alcohol use disorder commonly co-occur, and are associated with significant impairment. The primary aims of the study for which an administrative supplement is being requested were to develop and evaluate a fully integrated behavioral intervention for comorbid social anxiety disorder and alcohol use disorder. In the first year of the project, we successfully developed an Intensive Outpatient Program (IOP) level of care group intervention to be delivered by community-based substance use disorder (SUD) specialty clinicians. The fully integrated treatment (FIT) combines principles and strategies of exposure-based cognitive behavioral therapy (CBT) for social anxiety disorder with the Matrix Model approach to the treatment of addiction (i.e., combining CBT and 12-step facilitation). Thus, Aim 1 has been completed. We have begun to evaluate its effectiveness in this real-world setting, in which adult treatment seekers with comorbid social anxiety and alcohol use disorders are randomized to (a) FIT IOP or (b) Matrix Model IOP for twelve weeks, and are assessed at baseline, mid-treatment, post-treatment, and a 6-month follow-up on engagement (Aim 2), and on alcohol use and social anxiety outcomes (Aim 3). The COVID-19 pandemic has led to a shut-down of the IOP program, group services, and any in-patient visits at the clinic site, for an indefinite period of time in Los Angeles. In-person visits for this type of research are also currently prohibited by the UCLA Vice Chancellor of Research. As a consequence, recruitment has halted, and we have managed only to provide remote sessions with the remaining patients who were already enrolled in the study, which is not in the spirit of our intervention that focuses on using the group as a platform for social anxiety exposure therapy. Moreover, even if we could do some assessments remotely (though others may not be possible), few patients are seeking remote services at the clinic currently and thus the pace of recruitment would not allow us to meet our project goals. Therefore, we are anticipating significant delays in completing our recruitment and enrollment goals, which are necessary for achieving sufficient statistical power to detect effects between two active treatments. In sum, we are unable to complete Aims 2 and 3 without supplemental funds. The supplemental funds would support the project coordinator, a graduate student researcher, and the Principal Investigator for the additional time needed to carry out the study; and importantly, would fund the clinicians and administrators at the community clinic who carry out their clinical services and referral/recruitment services that enable us to proceed with the clinical trial. Given the uncertainty of the shut-down of research and clinical operations, this supplement would enable us to provide salary coverage for staff to continue their work once we can resume activity.

抽象的社交焦虑障碍和酒精使用障碍通常同时发生，并且与显着相关损害。请求行政补充的研究的主要目的是开发和评估针对共病社交焦虑症和酒精的完全综合的行为干预使用障碍。在项目的第一年，我们成功开发了强化门诊计划（IOP）由社区药物滥用障碍 (SUD) 专业提供的护理小组干预水平临床医生。完全整合治疗（FIT）结合了基于暴露的认知的原则和策略使用矩阵模型方法治疗社交焦虑症的行为疗法（CBT）成瘾治疗（即结合 CBT 和 12 步促进）。至此，目标1已经完成。我们已经开始评估它的在现实世界中的有效性，其中患有共病社交焦虑和酒精的成人治疗寻求者使用障碍被随机分配至 (a) FIT IOP 或 (b) 矩阵模型 IOP，持续 12 周，并在以下时间进行评估基线、治疗中期、治疗后以及 6 个月的参与度（目标 2）和饮酒随访和社交焦虑结果（目标 3）。 COVID-19 大流行导致 IOP 项目关闭，在洛杉矶无限期的团体服务以及诊所现场的任何住院就诊。面对面加州大学洛杉矶分校研究副校长目前也禁止此类研究的访问。作为一个结果，招聘已经停止，我们只能为剩余的人员提供远程会议已经参加该研究的患者，这不符合我们专注于使用的干预精神该小组作为社交焦虑暴露疗法的平台。此外，即使我们可以做一些评估远程（尽管其他可能不可能），目前很少有患者在诊所寻求远程服务因此，招聘速度无法让我们实现项目目标。因此，我们期待严重延迟完成我们的招聘和入学目标，这是实现这一目标所必需的足够的统计能力来检测两种积极治疗之间的效果。总而言之，我们无法完成目标 2 和 3 无需补充资金。补充资金将支持项目协调员研究生研究员和首席研究员进行研究所需的额外时间；重要的是，将资助社区诊所开展临床工作的临床医生和管理人员使我们能够继续进行临床试验的服务和转介/招募服务。鉴于不确定性在研究和临床业务关闭期间，这项补助将使我们能够提供工资保障一旦我们可以恢复活动，工作人员就可以继续工作。