Promoting alcohol treatment engagement post-hospitalization with brief intervention, medications and CBT4CBT: protocol for a randomized clinical trial in a diverse patient population.

Background: Alcohol use disorder (AUD) commonly causes hospitalization, particularly for individuals disproportionately impacted by structural racism and other forms of marginalization. The optimal approach for engaging hospitalized patients with AUD in treatment post-hospital discharge is unknown. We describe the rationale, aims, and protocol for Project ENHANCE (ENhancing Hospital-initiated Alcohol TreatmeNt to InCrease Engagement), a clinical trial testing increasingly intensive approaches using a hybrid type 1 effectiveness-implementation approach.

Costs and cost-effectiveness of Shamiri, a brief, layperson-delivered intervention for Kenyan adolescents: a randomized controlled trial.

Background: Low- and middle-income countries (LMICs) have the highest socio-economic burden of mental health disorders, yet the fewest resources for treatment. Recently, many intervention strategies, including the use of brief, scalable interventions, have emerged as ways of reducing the mental health treatment gap in LMICs. But how do decision makers prioritize and optimize the allocation of limited resources? One approach is through the evaluation of delivery costs alongside intervention effectiveness of various types of interventions.

Cost-inclusive research on health psychology interventions: Why, how, and what next.

Cost-inclusive research (CIR) uses observations, interviews, self-reports, and archival records to collect data on the types, amounts, and monetary values of resources that make health psychology interventions (HPIs) possible in healthcare and community settings. These resources include time of practitioners, patients, administrators, space in clinics and hospitals, computer hardware, software, telecommunications, and transportation. CIR adopts a societal perspective by including patient resources such as time spent participating in HPIs, income foregone for participation, travel time and transportation to and from HPI sites, patients' information devices, and child- and eldercare necessitated by HPI participation.

Costs, benefits, and net benefit of 13 inpatient substance use treatments for 14,947 women and men.

In an attempt to replicate earlier findings that substance use disorder treatment (SUDTx) has monetary outcomes (benefits) for taxpayers that exceed treatment costs several times over for the average participant, costs of SUDTx were contrasted to observed costs of healthcare, criminal justice services, and economic assistance, plus potential increases in earned income, for 14,947 substance-using individuals treated at 13 intensive inpatient programs varying in gender sensitivity. Those who received higher levels of gender-sensitive treatment were expected to better offset treatment costs through greater reductions in subsequent service costs and economic assistance, and greater increases in earned income. Compared to the 24 months preceding treatment, archival data from state databases showed that use of health and criminal justice services, and receipt of economic assistance, actually increased during the 24 months following treatment, and that earned income decreased, resulting in unexpectedly negative net benefits, i.

Economic evaluation of an online single-session intervention for depression in Kenyan adolescents.

To evaluate the costs and cost-effectiveness of , an online single-session intervention (SSI) for depression among Kenyan adolescents. Data were drawn from a randomized clinical trial with = 103 Kenyan high school students (64% female, = 15.5).

Toward collaborative cost-inclusive evaluation: Adaptations and transformations for evaluators and economists.

As evaluators and economists expand their domains of research, consulting, teaching, and publication, they find themselves needing each other more and yet increasingly at odds. Often surprised at the resistance they encounter from one another, sometimes dismissive of contributions the other can make, all should consider adaptations and transformations of roles, approaches, methods, analyses, and decision-making algorithms that would allow better collaboration. The particularly multidisciplinary area of cost-inclusive evaluation requires (a) changes in approaches and methods used by evaluators and economists, (b) changes that evaluators need to make when working with economists, and (c) changes that economists need to make when working with evaluators.

A pilot economic evaluation of computerized cognitive behavioral therapy for alcohol use disorder as an addition and alternative to traditional therapy.

Background: Computer-based delivery of cognitive behavioral therapy (CBT) may be a less costly approach to increase dissemination and implementation of evidence-based treatments for alcohol use disorder (AUD). However, comprehensive evaluations of costs, cost-effectiveness, and cost-benefit of computer-delivered interventions are rare.

Methods: This study used data from a completed randomized clinical trial to evaluate the cost-effectiveness and cost-benefit of a computer-based version of CBT (CBT4CBT) for AUD.

Research on Improving Outcomes and Reducing Costs of Psychological Interventions: Toward Delivering the Best to the Most for the Least.

Treatment and prevention efforts guided by psychological theory, research, and practice can have outcomes of greater value than the resources consumed by those efforts-and outcomes superior to those attainable by other means, often at lower costs. How can we make this hope true more often, for more of the clients who need our services, despite severe resource constraints? Routinely reporting the costs, effectiveness, and benefits of psychological interventions from client, practitioner, and societal perspectives is only a beginning. We also need to use descriptive and inferential statistics to measure, report, and analyze the cost-effectiveness and cost-benefit of our interventions to discover the strongest determinants of intervention costs and outcomes.

Commentary on "Standards of Evidence for Conducting and Reporting Economic Evaluations in Prevention Science".

The current paper is a commentary on the Standards of Evidence for Conducting and Reporting Economic Evaluations in Prevention Science (Crowley et al. 2018). Although the standards got a lot right, some important issues were not addressed or could be explored further.

Patient and program costs, and outcomes, of including gender-sensitive services in intensive inpatient programs for substance use.

Gender-sensitive services (GSS) attempt to make substance use treatment better for women, but at what cost and with what results? We sought answers to these questions in a federally-funded study by measuring separately the patient and provider costs of adding GSS, outcomes, and cost-outcome relationships for 12 mixed-gender intensive inpatient programs (IIP) that varied in amounts and types of GSS. GSS costs to female inpatients included time devoted to GSS and expenses for care of dependents while in the IIP. GSS costs to providers included time spent with patients, indirect services, treatment facilities, equipment, and materials.

Social Return On Investment (SROI): Problems, solutions … and is SROI a good investment?

The conclusion of this special issue on Social Return On Investment (SROI) begins with a summary of both advantages and problems of SROI, many of which were identified in preceding articles. We also offer potential solutions for some of these problems that can be derived from standard evaluation practices and that are becoming expected in SROIs that follow guidances from international SROI networks. A remaining concern about SROI is that we do not yet know if SROI itself adds sufficient benefit to programs to justify its cost.

Introduction: Social Return On Investment (SROI).

An introduction to the issue Social Return On Investment (SROI), including an overview of problems prompting this special issue, plus definitions and examples of terms in this exciting, burgeoning area of cost-inclusive evaluation.

Keeping Clubhouses Open: Toward a Roadmap for Sustainability.

Clubhouses are recovery centers that help persons with serious mental illness obtain and maintain community-based employment, education, housing, social integration, and other services. Key informants from U.S.

Randomized Trial of Computerized Cognitive Behavioral Therapy for Alcohol Use Disorders: Efficacy as a Virtual Stand-Alone and Treatment Add-On Compared with Standard Outpatient Treatment.

Background: Cognitive behavioral therapy (CBT) is an evidence-based treatment for alcohol use disorders (AUDs), yet is rarely implemented with high fidelity in clinical practice. Computer-based delivery of CBT offers the potential to address dissemination challenges, but to date there have been no evaluations of a web-based CBT program for alcohol use within a clinical sample.

Methods: This study randomized treatment-seeking individuals with a current AUD to 1 of 3 treatments at a community outpatient facility: (i) standard treatment as usual (TAU); (ii) TAU plus on-site access to a computerized CBT targeting alcohol use (TAU + CBT4CBT); or (iii) CBT4CBT plus brief weekly clinical monitoring (CBT4CBT + monitoring).

Consumer-Operated Service Programs: monetary and donated costs and cost-effectiveness.

Objective: Examine cost differences between Consumer Operated Service Programs (COSPs) as possibly determined by a) size of program, b) use of volunteers and other donated resources, c) cost-of-living differences between program locales, d) COSP model applied, and e) delivery system used to implement the COSP model.

Methods: As part of a larger evaluation of COSP, data on operating costs, enrollments, and mobilization of donated resources were collected for eight programs representing three COSP models (drop-in centers, mutual support, and education/advocacy training). Because the 8 programs were operated in geographically diverse areas of the US, costs were examined with and without adjustment for differences in local cost of living.

Delivery Systems Can Determine Therapy Cost, and Effectiveness, More Than Type of Therapy.

We should go further than Kazdin and Blase (2011) in emphasizing the importance of the costs and effectiveness of alternative delivery systems for therapies. I propose that the manner in which therapy is delivered often determines its cost, and its effectiveness, more than the type of therapy delivered. In this article, I illustrate this argument through compiled research and describe several inexpensive delivery systems with the aid of metaphors.

Cost-effectiveness and cost-utility of cognitive therapy, rational emotive behavioral therapy, and fluoxetine (Prozac) in treating depression: a randomized clinical trial.

Cost-effectiveness and cost-utility of cognitive therapy (CT), rational emotive behavioral therapy (REBT), and fluoxetine (Prozac) for major depressive disorder (MDD) were compared in a randomized clinical trial with a Romanian sample of 170 clients. Each intervention was offered for 14 weeks, plus three booster sessions. Beck Depression Inventory (BDI) scores were obtained prior to intervention, 7 and 14 weeks following the start of intervention, and 6 months following completion of intervention.

Cost-inclusive evaluation: a banquet of approaches for including costs, benefits, and cost-effectiveness and cost-benefit analyses in your next evaluation.

An introduction to the special issue on cost-inclusive evaluation, providing a brief history of the use of costs, benefits, cost-effectiveness, and cost-benefit analyses in the evaluation of human services. Two tables present brief glossaries of terms and analyses common in cost-inclusive program evaluation.

Estimating health utilities and quality adjusted life years in seasonal affective disorder research.

Background: Seasonal affective disorder (SAD) episodes will recur annually without effective intervention. Effectiveness of such interventions is traditionally measured with depression-specific tools (e.g.

Brief relationship therapy for alcoholism: a randomized clinical trial examining clinical efficacy and cost-effectiveness.

The purpose of this study was to examine the clinical efficacy and cost effectiveness of brief relationship therapy (BRT), a shortened version of standard behavioral couples therapy (S-BCT), with alcoholic male patients (N = 100) and their nonsubstance-abusing female partners. Participants were randomly assigned to 1 of 4 treatment conditions: (a) BRT, (b) S-BCT, (c) individual-based treatment (IBT), or (d) psychoeducational attention control treatment (PACT). Equivalency testing revealed that, compared with those assigned to S-BCT, participants who were randomly assigned to BRT had equivalent posttreatment and 12-month follow-up heavy drinking outcomes.

Costs of clubhouses: an international perspective.

Costs of providing psychosocial rehabilitation services are analyzed using data from clubhouse programs in 12 countries. We explored effects of several program operating characteristics on total program cost per year, cost per member per year, and cost per visit. We also examined the relationship between program costs and the range of services offered.

Assessing the costs, benefits, cost-benefit ratio, and cost-effectiveness of marital and family treatments: why we should and how we can.

The vast majority of outcome studies examining the effects of marital and family treatments focus exclusively on indicators of and changes in familial functioning and individual members' psychosocial adjustment, but fail to measure, report, or analyze treatment costs, benefits, cost-benefit ratio, or cost-effectiveness. Because of growing concerns about spiraling health care costs, clinical and economic outcomes constitute equally important and complementary aspects of any evaluation of marital and family treatments. The twofold purpose of this article is to define different components of cost analyses of health-related interventions, including marital and family treatments, and to describe methods for calculating and integrating clinical and cost outcome information when evaluating marital and family treatments.

Assessing the costs, benefits, cost-effectiveness, and cost-benefit of psychological assessment: we should, we can, and here's how.

To the extent that assessment improves the effectiveness of treatment, prevention, or other services, it can be said to be effective. If an assessment is as effective as alternatives for improving treatment and less costly, it can be said to be cost-effective. If that improvement in the effectiveness of the service is monetary or monetizable, the assessment can be judged beneficial.