DOI
https://doi.org/10.25772/CM62-HN55
Author ORCID Identifier
https://orcid.org/0000-0002-6862-9548
Defense Date
2025
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Clinical Psychology
First Advisor
Dr. Dace Svikis
Second Advisor
Dr. Caitlin E. Martin
Third Advisor
Dr. Rosalie Corona
Fourth Advisor
Dr. Lori Keyser-Marcus
Fifth Advisor
Dr. Kristina Hood
Abstract
Alcohol use disorder (AUD) is the most common substance use disorder. However, most people with AUD do not receive treatment. Among those who do, it is only moderately effective largely due to the heterogeneity of people with AUD. Many of these individuals, particularly those with mild AUD, can reduce or cease alcohol use without specialized treatment. However, efforts to refer those with more severe AUD to community residential or outpatient programs have been largely unsuccessful, especially among women who often face practical barriers like lack of transportation and childcare. Technology offers innovative opportunities to make treatment more readily accessible to those in need. Computer-Based Training for Cognitive Behavioral Therapy (CBT4CBT) is a web-based intervention with demonstrated effectiveness as an adjunct to standard AUD and other drug use disorder treatment programming. To-date, however, it has not been tested with non-treatment seeking men and women with AUD. For the current two-arm clinical trial, a sample of non-treatment seeking people with AUD was recruited using ResearchMatch.org and randomized (3:1) to complete the CBT4CBT program or an assessment only control stratified by sex assigned at birth (N=160 total; females: n=83 CBT4CBT, n=26 Control; males: n=39 CBT4CBT, n=12 Control). Study assessments including self-reported AUD outcomes were administered to all participants at baseline, immediately post-intervention period, and at one-month following the intervention period. Participants in the CBT4CBT group were significantly less likely to report any heavy drinking days at the one-month follow-up than those in the control condition. Findings were even more pronounced among those who completed all study visits, with the CBT4CBT group reporting significantly lower likelihood of heavy drinking and better overall wellbeing in recovery compared to the control group. Notably, for female participants, the significant difference was at the post-intervention assessment, and for male participants, it was at the one-month follow-up. Acceptability ratings and usability measures for the CBT4CBT intervention were high among male and female participants and comparable to studies among treatment seeking individuals. Exploratory analyses examined associations between neurofunctional and social environment domains and AUD outcomes after access to the CBT4CBT program and identified promising areas for future study. The present study expanded on the current literature supporting the use of CBT4CBT in alcohol and other drug use disorder treatment settings and provides benchmark data on the use of CBT4CBT in a sample of non-treatment seeking people with AUD. Findings have important clinical and research implications for expanding access to evidence-based addiction treatment outside of traditional treatment settings.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
7-14-2025