Date of Award


Degree Type


Degree Name

Doctor of Philosophy



Major Professor

Todd M. Moore

Committee Members

Gregory L. Stuart, Derek R. Hopko, David A. Patterson


Substance use is highly prevalent in the United States, and although treatments designed to reduce substance use have shown promise, relapse rates between 40% and 70% following treatment have been reported in recent studies. Given the high rate and chronicity of relapse following substance abuse treatment, conducting research aimed to develop techniques to lower the risk of relapse following treatment is imperative. A promising option to reduce relapse is to use treatment reminder cues, or cues that are salient features of the treatment environment that can be used to extend the effects of treatment into non-treatment settings. This study investigated the effects of treatment reminder cues on rates of relapse in 50 male and female individuals entering intensive outpatient treatment for substance abuse. It utilized a one-month randomized and controlled design using state-of-the-art electronic handheld computer technology. Participants in the experimental condition were prompted to read and respond to four treatment reminder cues per day in addition to one daily diary survey assessing for a variety of proximal variables related to relapse. All participants were asked to complete assessment questionnaires of relevant variables that may affect relapse at baseline and 1-month follow-up. Chi-square tests were used to determine if adding treatment reminder cues to standard treatment resulted in less relapse relative to standard treatment alone, and whether onset occurred significantly later for those receiving treatment reminder cues. Binary logistic regression analyses investigated the extent to which compliance with treatment reminder cues was associated with relapse. Results indicated that twice as many individuals in the control group relapsed compared to the experimental group, which approached statistical significance. In addition, those in the experimental group relapsed substantially later than did those in the control group. Results indicated no effect of increased compliance on decreased relapse. Overall, this study holds the promise of providing a simple, inexpensive, and effective strategy for attenuating rates of relapse or delaying the onset of return to use by extending the context of treatment beyond the immediate therapeutic setting. Clinical and research implications, and future directions for substance abuse research are discussed.

Files over 3MB may be slow to open. For best results, right-click and select "save as..."