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Randomized Controlled Trial
. 2016 Jul 6;11(7):e0157817.
doi: 10.1371/journal.pone.0157817. eCollection 2016.

Guided and Unguided Internet-Based Treatment for Problematic Alcohol Use - A Randomized Controlled Pilot Trial

Christopher Sundström  1 , Mikael Gajecki  1 , Magnus Johansson  1   2   3 , Matthijs Blankers  4   5   6 , Kristina Sinadinovic  1   3 , Erik Stenlund-Gens  7 , Anne H Berman  1   3
Affiliations
Randomized Controlled Trial

Guided and Unguided Internet-Based Treatment for Problematic Alcohol Use - A Randomized Controlled Pilot Trial

Christopher Sundström et al. PLoS One. .

Abstract

Background: The Internet has increasingly been studied as mode of delivery for interventions targeting problematic alcohol use. Most interventions have been fully automated, but some research suggests that adding counselor guidance may improve alcohol consumption outcomes.

Methods: An eight-module Internet-based self-help program based on cognitive behavioral therapy (CBT) was tested among Internet help-seekers. Eighty participants with problematic alcohol use according to the Alcohol Use Disorders Identification Test (AUDIT; scores of ≥ 6 for women and ≥ 8 for men) were recruited online from an open access website and randomized into three different groups. All groups were offered the same self-help program, but participants in two of the three groups received Internet-based counselor guidance in addition to the self-help program. One of the guidance groups was given a choice between guidance via asynchronous text messages or synchronous text-based chat, while the other guidance group received counselor guidance via asynchronous text messages only.

Results: In the choice group, 65% (13 of 20 participants) chose guidance via asynchronous text messages. At the 10-week post-treatment follow-up, an intention-to-treat (ITT) analysis showed that participants in the two guidance groups (choice and messages) reported significantly lower past week alcohol consumption compared to the group without guidance; 10.8 (SD = 12.1) versus 22.6 (SD = 18.4); p = 0.001; Cohen's d = 0.77. Participants in both guidance groups reported significantly lower scores on the AUDIT at follow-up compared to the group without guidance, with a mean score of 14.4 (SD = 5.2) versus 18.2 (SD = 5.9); p = 0.003; Cohen's d = 0.68. A higher proportion of participants in the guidance groups said that they would recommend the program compared to the group without guidance (81% for choice; 93% for messages versus 47% for self-help).

Conclusion: Self-help programs for problematic alcohol use can be more effective in reducing alcohol consumption over a 10-week period when counselor guidance is added.

Trial registration: Clinicaltrials.gov NCT02384304.

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Conflict of interest statement

Competing Interests: All the authors declare that no competing interests exist. All authors but one declare no connection with any tobacco, alcohol, pharmaceutical or gaming industry. Berman is a board member of a Research Council funded by Svenska Spel (https://svenskaspel.se/), a company wholly owned by the Swedish state and whose entire profits go to the national treasury. The authors have no connection to AFA Insurance aside from receiving the research grant noted in the Financial Disclosure statement. There are no employment/consultancy, patents, products in development or marketed products to declare. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Flowchart showing enrollment procedure, randomization and analysis (ITT = Intention to Treat).
Fig 2
Fig 2. Proportion of participants completing each module in the two guidance groups (by choice or messages) and in the self-help group.
See this image and copyright information in PMC

References

    1. WHO. Global Status Report on Alcohol 2014. Geneva: World Health Organisation, 2014.
    1. Cunningham JA, Breslin FC. Only one in three people with alcohol abuse or dependence ever seek treatment. Addictive behaviors. 2004;29(1):221–3. - PubMed
    1. Gainsbury S, Blaszczynski A. A systematic review of Internet-based therapy for the treatment of addictions. Clinical Psychology Review. 2011;31(490.–). 10.1016/j.cpr.2010.11.007 - DOI - PubMed
    1. Cunningham JA, Wild TC, Cordingley J, van Mierlo T, Humphreys K. A randomized controlled trial of an internet-based intervention for alcohol abusers. Addiction. 2009;104:2023–32. 10.1111/j.1360-0443.2009.02726.x - DOI - PMC - PubMed
    1. Bewick BM, West RM, Barkham M, Mulhern B, Marlow R, Traviss G, et al. The effectiveness of a Web-based personalized feedback and social norms alcohol intervention on United Kingdom university students: randomized controlled trial. J Med Internet Res. 2013;15(7):e137 Epub 2013/07/26. 10.2196/jmir.2581 ; PubMed Central PMCID: PMCPmc3742391. - DOI - PMC - PubMed

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