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Randomized Controlled Trial
. 2025 Apr 1:269:112585.
doi: 10.1016/j.drugalcdep.2025.112585. Epub 2025 Jan 29.

Exploring reasons behind the initiation of and compliance with proactive alcohol e-therapy: A qualitative study

Kia Kejlskov Egan  1 , Tine Tjørnhøj-Thomsen  1 , Ulrik Becker  1 , Janne Schurmann Tolstrup  2
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Free article
Randomized Controlled Trial

Exploring reasons behind the initiation of and compliance with proactive alcohol e-therapy: A qualitative study

Kia Kejlskov Egan et al. Drug Alcohol Depend. .
Free article

Abstract

Background: This paper is embedded in a randomized controlled trial that examined the effectiveness of psychosocial alcohol therapy delivered either via video conference (proactive alcohol e-therapy) or face-to-face (standard care). The trial demonstrated that proactive alcohol e-therapy increased treatment initiation and treatment compliance compared to standard care while achieving comparable reductions in alcohol intake among individuals with problematic alcohol use. In this study, we explored why participants initiated and complied with proactive alcohol e-therapy.

Methods: A thematic analysis was completed based on ten semi-structured interviews with participants engaged in proactive alcohol e-therapy and observations of 21 therapy sessions.

Results: Participants initiated proactive alcohol e-therapy because the recruitment process framed problematic alcohol use and alcohol treatment in a way that aligned with their self-image. The framing also helped alleviate the stigmatizing and prejudiced perceptions participants held about problematic alcohol use and treatment. Participants' treatment compliance relied on the flexibility of the online format, which allowed for seamless and discreet integration into daily life. Additionally, treatment compliance depended on the establishment of a trustful dialogue with the therapist and the participants' perception of therapy.

Conclusions: Effective communication was crucial in the decision-making process leading to treatment initiation. Treatment compliance was driven by the online format's capacity to meet individual preferences and needs and by a strong therapist-client alliance. These findings highlight the practical dynamics of proactive alcohol e-therapy and illustrate the value of qualitative research methods within the field of online alcohol treatment.

Keywords: Alcohol; Alcohol treatment; E-health; Online intervention; Qualitative study; participant experience.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Ulrik Becker reports a relationship with Novaví that includes: speaking and lecture fees and travel reimbursement. During the study period, the National Institute of Public Health, University of Southern Denmark, received a grant from Novaví to evaluate their other treatment offers. This evaluation was conducted by Kia Kejlskov Egan and Ulrik Becker. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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