Explicating an Evidence-Based, Theoretically Informed, Mobile Technology-Based System to Improve Outcomes for People in Recovery for Alcohol Dependence

Abstract

Post treatment relapse to uncontrolled alcohol use is common. More cost-effective approaches are needed. We believe currently available communication technology can use existing models for relapse prevention to cost-effectively improve long-term relapse prevention. This paper describes: 1) research-based elements of alcohol related relapse prevention and how they can be encompassed in Self Determination Theory (SDT) and Marlatt’s Cognitive Behavioral Relapse Prevention Model, 2) how technology could help address the needs of people seeking recovery, 3) a technology-based prototype, organized around Self Determination Theory and Marlatt’s model and 4) how we are testing a system based on the ideas in this article and related ethical and operational considerations.

Screening and Follow-Up Monitoring for Substance Use in Primary Care: An Exploration of Rural–Urban Variations

“…Incorporating substance abuse diagnosis and treatment into medical training and increasing online and telehealth based educational resources will help prepare physicians with needed knowledge and skills to care for patients with substance use disorders. 49,50 Adoption of information and communication technologies [51][52][53] such as technology-assisted interventions and mobile devices may further enhance the continuum of care and facilitate access to consultation from addiction specialists who are often not available in rural settings.…”

I Am Your Smartphone, and I Know You Are About to Smoke: The Application of Mobile Sensing and Computing Approaches to Smoking Research and Treatment

“…It might detect that the same smoker, now having quit, is approaching a place or context he frequently smoked (GPS, database of prequit smoking behavior) and suggest alternative routes (i.e., avoidance), unreinforced exposure to these contexts (i.e., extinction; O'Connell, Shiffman, & Decarlo, 2011), or other coping responses. Indeed, delivery of GPS-triggered interventions upon approach of patient-identified alcohol use locations has been suggested (Gustafson et al, 2011). Moreover, other, selfreported factors including urge to smoke upon waking (Shiffman et al, 1997) predict increased lapse probability during that day and their inclusion could be used to modulate system resources allocated to detecting lapse antecedents.…”

Digital Technology and Mental Health Interventions: Opportunities and Challenges

“…As noted above other intervention apps have been developed for borderline personality disorder (Rizvi et al, 2011), depression using context sensing to identify emotional states and intervene appropriately (Burns et al, 2011), and substance abuse using GPS to trigger reminders when someone may be entering an areas previously associated with substance use (Gustafson et al, 2011). Additionally, there are numerous applications that target specific components of CBT and may compliment practice such as programs that target gratitude, meditation, guided relaxation, therapeutic breathing and increasing positive emotion.…”

“…through galvanic skin response, heart rate variability or heart rate) to engage in stress management techniques or as noted earlier, alerts based on global positioning or geographic information to avoid high risk situations (e.g. drug use areas) as is currently being implemented through The Comprehensive Health Enhancement Support System (CHESS™) developed through the University of Wisconsin (Gustafson et al, 2011). This system integrates human services and computer technology to help individuals manage health problems by providing accessible and personalized information and support.…”