We seek to renew our psychotherapy development research center (PDC) dedicated to the development, evaluation and community application of psychotherapies for drug abuse. The organizing theme is psychotherapy development and empirical testing based on the Stage Model (Rounsaville, Carroll &Onken, 2001) of psychotherapy research. The PDC's goal is to catalyze the development of innovative drug abuse treatments from the point where they are merely """"""""good ideas"""""""" to one where they are capable of widespread use as empirically supported treatments (EST's). In years 10-14 of PDC support we have successfully conducted the 4 originally proposed component research projects, completed 11 pilot projects and guided multiple new investigators to develop their first externally supported research projects on behavioral treatments. Key findings include support for efficacy of PDC developed interventions including a computer delivered version of Cognitive Behavioral Therapy (CBT4CBT), a school based Contingency Management (CM) program for adolescent smokers and an adaptively delivered version of Prize Based CM for cocaine abuse. We have also served as a national resource for psychotherapy research by consulting on 50 funded projects outside Yale, participating in 18 multisite behavioral and/or pharmacotherapy efficacy trials, developing computer-assisted training packages to foster more widespread use of efficacious substance abuse treatments and providing consultation on issues related to behavioral therapies research to numerous national and international government organizations and groups. In the past 4 years our research has been increasingly focused on examining the role of impaired executive functioning and impulsivity as fundamental components of addiction and as potential targets for interventions. This work has entailed expanding our neurocognitive assessment battery and incorporating an innovative fMRI neuroimaging paradigm in pilot and component studies. During the renewal period, research will continue to be organized around the Stage Model with a CORE facility and 3 component projects. Core staff will oversee an ambitious pilot study program and provide scientific oversight, administration, standardized psychological and neurobiological assessments, and technical assistance to center projects along with consultation and assistance to investigators and clinicians at other sites. Three late Stage II component clinical trials will examine (1) combining CBT4CBT with a cognitive-enhancement medication, (2) optimal sequences of Prize Based CM for cocaine dependence and (3) combining school based CM with nicotine replacement therapy in a school based cigarette cessation program. CENTER CHARACTERISTICS
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