Defense Date


Document Type


Degree Name

Doctor of Philosophy



First Advisor

Dace Svikis, PhD


Women with substance use disorders (SUD) face unique barriers to substance use treatment, and as a result, are less likely than their male counterparts to seek treatment for the disorder. Cognitive behavioral therapy (CBT) is an evidence-based treatment known to reduce relapse rates by teaching clients to recognize and respond to their cues for substance use. Recent research suggests CBT may be particularly of benefit to women. Despite the effectiveness of CBT, its dissemination in clinical practice is limited due to a range of barriers (e.g., time, cost). Computer-based training for cognitive behavioral therapy (CBT4CBT) offers an opportunity to improve the quality and reach of SUD treatment services that is both feasible and cost-effective. Research to date has supported the effectiveness of CBT4CBT in outpatient settings; however, it has not yet been tested in residential treatment. The present study was a two-arm clinical trial comparing women randomized to either standard residential treatment plus access to the CBT4CBT program (N = 34) or residential treatment alone (TAU; N = 29). Assessments occurred at baseline, discharge from residential care, and at 4 and 12-weeks post-discharge. Although the present study was not powered for statistical significance, findings were in the predicted direction, with women in the CBT4CBT group reporting lower likelihood of relapse, longer time to relapse, and fewer days of substance use in the follow-up period compared to TAU. This pattern was most evident for women not receiving pharmacological treatment for opioid use disorder. Exploratory analyses examined correlates of treatment outcomes, as well as the acceptability and feasibility of implementing CBT4CBT in a residential treatment program. Primary outcome variables were used for effect size estimations to determine the sample size needed for an adequately powered RCT of the intervention. The present study expanded on the current literature supporting the use of CBT4CBT in outpatient settings and provides benchmark data on the use of CBT4CBT in a residential treatment program for women with SUDs. This body of research has important implications for SUD treatment, with potential to expand the reach of evidence-based addiction treatment across different modalities and patient populations.


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