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• Are individually tailored time-varying treatments composed of • a sequence of critical treatment decisions • tailoring variables • decision rules, one per critical decision; decision rules input tailoring variables and output individualized treatment recommendation(s). • Operationalize clinical practice. • Overall goal: prevent relapse to alcohol abuse • Critical treatment decisions: which treatment to provide first?; which treatment to provide second? • Tailoring variable: heavy drinking days Decision Rules First alcohol dependent individuals are provided Naltrexone along with Medical Management. IF an individual experiences 3 or more heavy drinking days prior to 8 weeks THEN the individual's Naltrexone treatment is augmented with Combine Behavioral Intervention. ELSE IF the individual successfully completes 8 weeks with fewer than 3 heavy drinking days THEN the individual is provided a prescription to Naltrexone along with Telephone Disease Management. • From the individual/patient/client's point of view: a sequence of (individualized) treatments • From the clinical scientist's point of view: a sequence of decision rules that recommend one or more treatments at each critical decision. More examples of critical treatment decisions and tailoring variables • Critical treatment decisions: how long to try the first treatment?; how should a treatment be delivered?; how intensive should a treatment be? When to stop/start treatment? • Tailoring variables: severity of illness, presence of comorbid mental or physical conditions, family support, adherence to present treatment, side effects resulting from present treatment, symptoms while in treatment.

Summary of the SRNT Treatment Network Webinar: Getting SMART About Developing Individualized Sequences of Health Interventions