in either condition offering CBT4CBT compared to TAU (CBT4CBT+TAU=65%; CBT4CBT alone, 63%, TAU 26%). Percentages of participants with no heavy drinking days in the last 4 weeks of treatment were 9% for TAU, 37% for TAU+CBT4CBT, and 33% for CBT4CBT as a virtual standalone. In addition to validating CBT4CBT for alcohol as an adjunct to treatment compared with standard care, this trial also indicated that CBT4CBT as a standalone was safe and highly acceptable to participants as an alternative to unstructured group therapy. Moreover, CBT4CBT as a standalone produced better retention and comparable outcomes at much lower cost, as multiple individuals assigned to TAU dropped out or were withdrawn from treatment and later sought expensive inpatient care (Kiluk et al., 2016). Similar findings are emerging from a recently completed study evaluating the drug version of CBT4CBT as a virtual stand-alone intervention in a diverse group of treatment-seeking substance users (Clinical Trials.gov NCT01442597). CBT4CBT has now moved into Stage 3 and 4, with a number of ongoing dissemination trials evaluating it as a standalone to enhance SBIRT (Screening, Brief Intervention, and Referral to Treatment) in primary care settings by providing the intervention on site rather than referring individuals to specialty care,
