Farrokh Alemi, Ph.D. Video Introduction. Online Substance Abuse Treatment 1. Motivational counseling 2. Relapse prevention 3. Peer to peer support group.

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Presentation transcript:

Farrokh Alemi, Ph.D. Video Introduction

Online Substance Abuse Treatment 1. Motivational counseling 2. Relapse prevention 3. Peer to peer support group 4. Routine urine or hair tests 5. Limited clinic visits

Component 1 of online treatment: Motivational Counseling n Short, near daily n Individualized auto-prompts n Leading to self insight Alemi F, Haack MR, Nemes S, Aughburns R, Sinkule J, Neuhauser D. Therapeutic s. Subst Abuse Treat Prev Policy Feb 16;2:7.

No Shame Patients are more likely to report controversial issues to a computer than to a human being

Real Feelings Online counselors have more contact and lasting relationship with their clients 56% of messages had emotional content.

Component 2 of online treatment: Relapse Prevention n Weekly risk assessment n Automated analysis u Phone call u Family re-engagement u Change in treatment modality

Component 3 of online treatment: Online or On- Phone Support n Peer to peer n Confidential n 8 times more attendance n Group norm & solidarity

Component 4 of online treatment: Laboratory Tests n Routine n Not punitive

Component 5 of online treatment: Office Visits n Available on demand n Initiated by clinician or patient n Limited in number

Coming Up Does it work?

Online Services Improve Retention in Treatment Alemi F, Stephens RC, Javalghi RG, Dyches H, Butts J, Ghadiri A. A randomized trial of a telecommunications network for pregnant women who use cocaine. Med Care Oct;34(10 Suppl):OS n 82 pregnant patients with cocaine addiction

Peer to Peer Support Reduces Utilization n 53 recovering parents of infants n Randomly assigned n Changes in utilization over 4 months Alemi F, Mosavel M, Stephens RC, Ghadiri A, Krishnaswamy J, Thakkar H. Electronic self-help and support groups. Med Care Oct;34(10 Suppl):OS32-44.

Patients Prefer Online Counseling n ~300 recovering patients n Central intake, referred to both n Online counseling included support group, home monitoring, average of 3 contacts per week Mosavel M. The use of a telephone-based communication tool by low-income substance abusers. J Health Commun Jul-Aug;10(5):

Reminders Change Patients Behavior n 213 mothers of infants n Urban clinic n Computer call before each scheduled appointment Alemi F, Alemagno SA, Goldhagen J, Ash L, Finkelstein B, Lavin A, Butts J, Ghadiri A. Computer reminders improve on-time immunization rates. Med Care Oct;34(10 Suppl):OS45-51.

Online Services to Homeless Patients

Study of Impact Patients asked in 4 States 79 Signed Consent 39 Usual Care + Computer 40 Online Care + Computer 17 Completed Exit Interview 26 Completed Exit Interview

Online Counseling May Reduce Positive Urines Alemi F, Haack M, Nemes S, Harge A, Baghi H. Impact of online counseling on drug use: a pilot study. Qual Manag Health Care Jan-Mar;19(1):62-9.

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