Technology Enhanced Behavioral Activation Treatment for Substance Use
Condition: Substance-Related Disorders; Depressive Disorder; Behavioral Symptoms; Risk-Taking; Sexual Behavior
MeSH terms: Substance-Related Disorders; Depressive Disorder; Behavioral Symptoms
Study type: Interventional

Summary: 
      The purpose of this study is to:

        1. test the effect of a smartphone enhanced LETS ACT (LETS ACT-SE) on frequency of
           substance use

        2. use functional magnetic resonance imaging (fMRI) to test the relationship between
           neuromarkers of reward sensitivity on frequency of substance use.
    

Detailed description: 
      Comorbid substance use disorder (SUD) and depression is highly prevalent and associated with
      elevated rates of post treatment relapse to substance use, HIV risk behavior, and associated
      poor mental and physical health outcomes. Further, rates of substance use and depression
      disproportionately affect minority groups and those living in poverty. Although efficacious,
      the often complex, specialized nature of CBT poses problems in its integration into substance
      use treatment programs. Budget cuts for mental health and substance use treatment both
      nationally and in the state of North Carolina, reduce availability of publically funded
      treatment programs and staff to patient ratios. To address this limitation, a behavioral
      activation (BA) treatment, the Life Enhancement Treatment for Substance Use (LETS ACT), was
      developed to treat depressive symptoms among a predominantly African American sample of low
      income illicit drug users currently receiving residential substance use treatment.
      Collectively, two Stage I studies and 1 year follow-up data from the investigators Stage II
      R01DA026424 indicate that compared to a control condition, LETS ACT is associated with
      significantly better outcomes for treatment retention, post treatment abstinence, HIV sexual
      risk behavior, depressive symptoms, and environmental reward.

      Although these strong outcomes suggest that LETS ACT may be ready for a Stage III
      dissemination trial, it is of note that there was a significant indirect effect of LETS ACT
      homework compliance on post treatment substance use and HIV sexual risk behavior via the
      theoretically proposed BA mechanism of action, environmental reward. In the context of
      limited access to care, these findings point to the need to identify cost-effective
      delivery-vehicles to increase treatment engagement outside of clinician sessions. Further,
      identifying neuroscience based biomarkers (neuromarkers) underlying key theoretical aspects
      of BA (i.e., reward sensitivity), and their relation to heterogeneity in BA treatment
      response among substance users with depression, are critical for the identification of
      accurately targeted interventions.
    

Intervention name(s): LETS ACT; LETS ACT-SE; Treatment as Usual
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): The Life Enhancement Treatment for Substance Use (LETS ACT); Participants assigned to the smartphone-enhanced LETS ACT (LETS ACT-SE) condition will be provided the exact same treatment as outlined in LETS ACT, except that LETS ACT-SE participants will record their daily goals using smartphone technology.; Participants will receive the treatment typically provided to patients at the substance use treatment facility.
Other intervention name(s): Behavioral Activation; Life Enhancement Treatment for Substance Use; Behavioral Activation; Smartphone-Enhanced LETS ACT; TAU
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Mental Disorders; Mood Disorders; Behavioral Activation