Transcript Slides - Open Online Courses

Farrokh Alemi, Ph.D.
Video Introduction
Online Substance
Abuse Treatment
1.
2.
3.
4.
5.
Motivational counseling
Relapse prevention
Peer to peer support group
Routine urine or hair tests
Limited clinic visits
Component 1 of online treatment:
Motivational
Counseling



Short, near daily
Individualized auto-prompts
Leading to self insight
Alemi F, Haack MR, Nemes S, Aughburns R, Sinkule J, Neuhauser D. Therapeutic emails.
Subst Abuse Treat Prev Policy. 2007 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


Weekly risk assessment
Automated analysis
 Phone
call
 Family re-engagement
 Change in treatment modality
Component 3 of online treatment:
Online or OnPhone Support




Peer to peer
Confidential
8 times more attendance
Group norm & solidarity
Component 4 of online treatment:
Laboratory Tests


Routine
Not punitive
Component 5 of online treatment:
Office Visits



Available on demand
Initiated by clinician or patient
Limited in number
Coming
Up
Does it work?
Online Services Improve
Retention in Treatment

82 pregnant patients with cocaine
addiction
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. 1996 Oct;34(10
Suppl):OS10-20.
Peer to Peer Support
Reduces Utilization



53 recovering parents of infants
Randomly assigned
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. 1996 Oct;34(10 Suppl):OS32-44.
Patients Prefer
Online Counseling



~300 recovering patients
Central intake, referred to both
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. 2005 Jul-Aug;10(5):451-63.
Reminders Change
Patients’ Behavior



213 mothers of
infants
Urban clinic
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. 1996 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. 2010 Jan-Mar;19(1):62-9.
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