BackgroundThe continuing gap between the number of people requiring treatment for substance use disorders and those receiving treatment suggests the need to develop new approaches to service delivery. Meanwhile, the use of technology to provide counseling and support in the substance abuse field is exploding. Despite the increase in the use of technology in treatment, little is known about the impact of technology-supported interventions on access to services for substance use disorders. The E-TREAT intervention brings together the evidence-based practice of Motivational Interviewing and theories of Persuasive Technology to sustain clients' motivation to change substance use behaviors, provide support for change, and facilitate continuity across treatment settings.MethodsThis study used descriptive statistics, tests of statistical significance, and logistic regression to explore the characteristics and perceptions of the first 157 people who agreed to participate in E-TREAT and the predictors of their active engagement in E-TREAT services. In addition, responses to open-ended questions about the participants' experiences with the intervention were analyzed.ResultsThe data reveal that clients who engaged in E-TREAT were more likely than those who did not engage to be female, have children and report a positive relationship with their recovery coach, and were less likely to have completed treatment for a substance use disorder in the past. A majority of people engaging in E-TREAT reported that it was helpful to talk with others with similar problems and that the program assisted them in developing a sense of community.ConclusionsThe authors conclude that technology-assisted interventions hold promise in expanding access to treatment for substance use disorders especially for women and parents. Further, the characteristics of the relationship with a coach or helper may be critical to engagement in technology-supported interventions. Additional investigation into ways technology may be useful to enhance treatment access for certain subgroups is needed.

Trauma survivors and their spouses/partners who seek therapy may present with unique dynamics due to the effects of previous trauma. The current paper provides an analysis of a clinical case vignette for understanding the effects of trauma when only one partner reports a trauma history-single-trauma couples. The description of the singletrauma couple includes the relevant trauma history, anecdotal case information, and a session transcript, which identify primary issues experienced by the couple. The authors emphasize the importance of using a "trauma lens" when working with couples and families to avoid overlooking important cues about the individual and systemic effects of traumatic stress. Clinical and research implications are also described.