Another potential, but largely unexplored advantage of technology-based, modularized CBT approaches is that they are compatible with evaluation and refinement via the MOST (Multiphase Optimization Strategy) approach of Collins and colleagues (Collins, Murphy, & Stretcher, 2007; Collins et al., 2007; Collins et al., 2014). Briefly, MOST approaches utilize factorial (and fractional factorial) designs to efficiently evaluate individual components of an intervention and their contribution to producing outcome. MOST designs have been successfully implemented in smoking research to refine multicomponent interventions for smoking (Piper et al., 2016; Schlam et al., 2016). Given that attrition remains high in most clinician- and technology-delivered interventions and few individuals actually complete a full course of the intervention, MOST strategies for refining interventions and delivering highly parsimonious and effective components to the largest possible samples have clear promise, as the majority of substance users remain in treatment for only a matter of weeks and thus it is imperative we deliver our most potent and effective interventions from the outset.
