Computer-Based Recovery Support for Patients Receiving Residential Treatment for Alcohol/Drug Dependence: Relationship Between Program Use and Outcomes Audrey A. Klein, PhD, and Justin J. Anker, PhD Butler Center for Research, Hazelden Foundation, Center City, Minnesota. Abstract Objective: This analysis of administrative data examined whether use of a Web-based recovery support program was related to self-reported post-treatment alcohol use among patients attending residential treatment for a substance use disorder. Materials and Methods: The program delivered individually tailored clinical content in a multi- media format over the initial 18 months after discharge from treat- ment. Post-treatment logins to the program and access of clinical content were measured, as was post-treatment alcohol use. Results: Use of the program was frequent in the first 30 days following treatment but steadily decreased over time. Regression analyses revealed a significant relationship between the number of program logins and self-reported alcohol use in the first 6 months following treatment when controlling for other covariates related to alcohol use. Conclusion: These results replicate a previous study of the My Ongoing Recovery Experience (MORE Ò ) program (Hazelden, Center City, MN) and suggest that computerized support programs hold therapeutic potential for patients with alcohol/drug dependence. Key words: e-health, technology, telehealth Introduction T he use of Web-based disease management programs to manage chronic health conditions has increased over the last several years, and these programs show promise in managing diseases such as cancer, diabetes, obesity, and hypertension. 1–3 Substance use disorders are chronic disorders characterized by high rates of relapse, 4–6 and studies indicate that Web-based programs are also effective in preventing relapse in pa- tients with these disorders, 7,8 particularly when used to supplement therapist-delivered interventions. 9,10 However, patient engagement with these programs is often low. 7,8,11 Many computerized interventions for alcohol/drug use have fo- cused on either formal treatment (such as computer-based cognitive behavioral therapy) or preventative methods such as screening and brief intervention. 8,12 The efficacy of Web-based recovery support programs in preventing relapse among individuals recently treated for substance dependence has yet to be extensively examined. Several years ago, Hazelden (Center City, MN), a private nonprofit addiction treatment center, launched an innovative, novel comput- erized recovery support program called My Ongoing Recovery Ex- perience (MORE Ò ). MORE was developed by a team of licensed alcohol and drug counselors and mental health professionals for use with adult patients completing residential treatment for alcohol or drug dependence at Hazelden sites. The program incorporates con- cepts from a variety of evidence-based treatment approaches, such as Twelve Step facilitation, motivational interviewing, and cognitive behavioral therapy. Designed specifically as a post-treatment recovery support/continuing care program, the program provides patients with a wide variety of recovery-related information and services for a period of 18 months following discharge from treat- ment. MORE is an iteratively tailored, Web-based, mixed-media program that provides interactive recovery-related activities, videos, an extensive electronic library of clinical content, opportunities for contact and fellowship with other recovering individuals, and addi- tional sources of support. The videos cover a wide range of content, including patient testimonials and information on topics such as how to manage a co-occurring disorder, recognizing factors that may put one at risk for relapse, how to protect oneself from developing an addiction to prescription medications, and how to effectively manage stress and adverse life events. Other computerized resources include a patient journal, workbook activities for practicing and applying recently learned information, and an electronic library of articles pertaining to specific issues such as relapse prevention, dealing with cravings, maintaining emotional health, and forming healthy relationships. Participants also have access to a large network of Hazelden alumni and a number of resources for staying in contact with other individuals in recovery, such as recovery blogs, forums, podcasts, and online Twelve Step meetings. The program also includes telephone and e-mail contact between patients and recovery coaches, who are licensed alcohol and drug counselors employed by Hazelden. The majority of clinical content is delivered over the computer through seven distinct program modules, each of which begins with an electronically administered assessment where patients provide detailed information about sub- stance use and other aspects of life functioning. Based on the re- sponses, the module then delivers content individually tailored to the needs of the patient. The modules are administered in a sequential manner over an 18-month period, and modules need to be completed in order. In other words, content from later modules is only available 104 TELEMEDICINE and e-HEALTH FEBRUARY 2013 DOI: 10.1089/tmj.2012.0107