The Addiction Comprehensive Health Enhancement Support System (ACHESS) is a relapse-prevention program administered through a smartphone application. The ACHESS application is designed to improve continuing care for adults in recovery from alcohol use disorders by providing ongoing emotional and instrumental support. The app is aimed at providing monitoring, information, communication, and social support services to patients, including ways for patients and counselors to keep in contact.
ACHESS is grounded in self-determination theory and cognitive-behavioral relapse prevention. Self-determination theory posits that satisfying three fundamental needs contributes to adaptive functioning: perceived competence, a feeling of relatedness, and autonomous motivation. The three psychological needs relate to the determinants of relapse in Marlatt and George’s (1984) cognitive-behavioral, relapse-prevention model. This model suggests that both immediate determinants (high-risk situations, lack of coping response, decreased self-efficacy, and abstinence violation effects) and covert antecedents (lifestyle imbalances, urges, and cravings) can lead to relapse. ACHESS employs these concepts in the following ways to prevent relapse. It 1) offers resources to cope with pressures to relapse such as cravings, withdrawal symptoms, and high-risk situations (competence); 2) provides opportunities to give and receive social support to persevere (relatedness); and 3) develops and maintains autonomous motivation to prevent relapse (autonomy). Services included in the mobile app are designed to relate directly to each of these three fundamental needs.
The ACHESS intervention consists of a patient-facing mobile application and a web-based clinician dashboard. The intervention is typically initiated by treatment agencies providing care to patients who have been discharged from residential and inpatient treatment to support patients in addiction recovery. The application delivers immediate resources to bolster coping competency for patients experiencing risk of relapse. Surveys and assessments are designed to determine risk of relapse, enabling clinicians to intervene before relapse occurs. The application networks patients with caregivers and peers to strengthen resiliency. Features include a hot button (“Beacon”) for access to support, GPS tracking of travel near high risk areas, medication and appointment reminders, and customized surveys and content and recovery plan management.