High-intensity therapist-guided internet-based cognitive behavior therapy for alcohol use disorders – a pilot study.

Background: A large proportion of people with alcohol problems do not seek psychological treatment, but access to such treatment could potentially be increased by delivering it over the Internet. Cognitive behavior therapy (CBT) is widely regarded as one of the psychological treatments for alcohol problems for which evidence is most robust. This study piloted a new, therapist-guided internet-based CBT program (entitled ePlus), directed towards people with alcohol use disorders. Methods: Participants in the study (n=13) were recruited through an alcohol self-help web site and were, after initial internet screening, diagnostically assessed by telephone. Eligible participants were offered access to the therapist-guided 12-week program. The main outcomes were treatment usage data and standard drinks consumed the preceding week, measured with the self-rated Timeline Followback (TLFB). Participant data were collected at screening, immediately pre-treatment, post-treatment and three months post-treatment. Results: Most participants were active throughout the treatment and found it highly acceptable. Significant reductions in alcohol consumption with a large within-group effect size were found at the three-month follow-up. Secondary outcome measures of craving and self-efficacy, as well as depression and quality of life, also showed significant improvements with moderate to large within-group effect sizes. Conclusions: Therapist-guided internet-based CBT may be a feasible and effective alternative for people with alcohol use disorders. In view of the high acceptability and the large within-group effect sizes found in this small pilot, a randomized controlled trial investigating treatment efficacy is warranted. Trial registration: ClinicalTrials.gov (NCT02384278).