Internet Therapy versus Internet Self-help versus No Treatment for Problematic Alcohol Use: a Randomized Controlled Trial
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Abstract
Background :
Problematic alcohol use is the number three leading contributor to global burden of disease, partly because the majority of problem drinkers is not receiving treatment. Internet-based alcohol interventions attract an otherwise untreated population, but its effectiveness has to be established yet.
Objective
The current study examined the effectiveness of internet-based therapy (Therapy Alcohol Online, TAO) and internet-based self-help (Self-help Alcohol Online, SAO) for problematic alcohol users.
Method
Adult problem drinkers (N = 205; 51% female; mean age = 42 years old; mean Alcohol Use Disorders Identification Test (AUDIT) score = 20) were randomly assigned to either TAO, SAO, or an untreated waiting list (WL). Participants in the TAO condition received 7 individual text-chat counseling sessions. Both TAO and SAO interventions were based on cognitive behavioral therapy (CBT) and motivational interviewing (MI) techniques. Assessments were planned at baseline, three months and six months after randomization. Primary outcome variables were 7-day time line-follow-back alcohol consumption (TLFB) and treatment response. Secondary outcome variables included measures on quality of life (i.e. EQ-5D).
Results :
Using generalized estimating equations regression models, intention-to-treat analyses demonstrated significant effects of TAO versus WL and SAO versus WL on TLFB drinking counts at three months. Differences between TAO and SAO were not significant at three months, but were after six months, with larger effects for TAO. Similar patterns of results emerged for treatment response and Quality of life outcome analyses.
Conclusions :
Results support the effectiveness of CBT/MI based internet therapy and internet self-help for problematic alcohol users. After six months, the internet therapy program led to more positive results than the internet self-help program.
Problematic alcohol use is the number three leading contributor to global burden of disease, partly because the majority of problem drinkers is not receiving treatment. Internet-based alcohol interventions attract an otherwise untreated population, but its effectiveness has to be established yet.
Objective
The current study examined the effectiveness of internet-based therapy (Therapy Alcohol Online, TAO) and internet-based self-help (Self-help Alcohol Online, SAO) for problematic alcohol users.
Method
Adult problem drinkers (N = 205; 51% female; mean age = 42 years old; mean Alcohol Use Disorders Identification Test (AUDIT) score = 20) were randomly assigned to either TAO, SAO, or an untreated waiting list (WL). Participants in the TAO condition received 7 individual text-chat counseling sessions. Both TAO and SAO interventions were based on cognitive behavioral therapy (CBT) and motivational interviewing (MI) techniques. Assessments were planned at baseline, three months and six months after randomization. Primary outcome variables were 7-day time line-follow-back alcohol consumption (TLFB) and treatment response. Secondary outcome variables included measures on quality of life (i.e. EQ-5D).
Results :
Using generalized estimating equations regression models, intention-to-treat analyses demonstrated significant effects of TAO versus WL and SAO versus WL on TLFB drinking counts at three months. Differences between TAO and SAO were not significant at three months, but were after six months, with larger effects for TAO. Similar patterns of results emerged for treatment response and Quality of life outcome analyses.
Conclusions :
Results support the effectiveness of CBT/MI based internet therapy and internet self-help for problematic alcohol users. After six months, the internet therapy program led to more positive results than the internet self-help program.
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