Abstract
BackgroundThe automatic tendency to attend to and focus on substance-related cues in the environment (attentional bias), has been found to contribute to the persistence of addiction. Attentional bias modification (ABM) interventions might, therefore, contribute to treatment outcome and the reduction of relapse rates. Based on some promising research findings, we designed a study to test the clinical relevance of ABM as an add-on component of regular intervention for alcohol and cannabis patients.Design/MethodsThe current protocol describes a study which will investigate the effectiveness and cost-effectiveness of a newly developed home-delivered, multi-session, internet-based ABM (iABM) intervention as an add-on to treatment as usual (TAU). TAU consists of cognitive behavioural therapy-based treatment according to the Dutch guidelines for the treatment of addiction. Participants (N = 213) will be outpatients from specialized addiction care institutions diagnosed with alcohol or cannabis dependency who will be randomly assigned to one of three conditions: TAU + iABM; TAU + placebo condition; TAU-only. Primary outcome measures are substance use, craving, and rates of relapse. Changes in attentional bias will be measured to investigate whether changes in primary outcome measures can be attributed to the modification of attentional bias. Indices of cost-effectiveness and secondary physical and psychological complaints (depression, anxiety, and stress) are assessed as secondary outcome measures.DiscussionThis randomized control trial will be the first to investigate whether a home-delivered, multi-session iABM intervention is (cost-) effective in reducing relapse rates in alcohol and cannabis dependency as an add-on to TAU, compared with an active and a waiting list control group. If proven effective, this ABM intervention could be easily implemented as a home-delivered component of current TAU.Trial registrationNetherlands Trial Register, NTR5497, registered on 18th September 2015.
Highlights
The automatic tendency to attend to and focus on substance-related cues in the environment, has been found to contribute to the persistence of addiction
We describe the design of a randomized control trial to investigate the effectiveness of an internet-based multisession Attentional bias modification (ABM) training as an add-on intervention to regular face-to-face treatment (TAU) in alcohol and cannabis dependent outpatients
To the best of our knowledge, this study will be the first Randomized control trial (RCT) to test the effects of an internet-based attentional bias modification intervention, integrated with a complete cognitive behavioural therapybased treatment, on treatment outcome and relapse rates in alcohol and cannabis dependency
Summary
Relapse rates in alcohol and drug use disorders remain high even after conventional treatment has been initially successful This emphasizes the need for more (cost-) effective therapies in addiction care. A final strength of the study is that by gamifying the iABM intervention, we hope to improve upon prior approaches to ABM interventions This more dynamic training mirrors the reality of engaging and disengaging of attention to a greater degree than previously used ABM intervention for substance use disorders. This study will contribute to the knowledge concerning the effectiveness of adding a novel ABM intervention to TAU in substance use disorders, by determining whether this serves to enhances positive treatment effects and reduces rates of relapse.
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