Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
J Consult Clin Psychol. 2011 Jun;79(3):330-41. doi: 10.1037/a0023498.
Problematic alcohol use is the third leading contributor to the global burden of disease, partly because the majority of problem drinkers are not receiving treatment. Internet-based alcohol interventions attract an otherwise untreated population, but their effectiveness has not yet been established. 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.
Adult problem drinkers (n = 205; 51% female; mean age = 42 years; mean Alcohol Use Disorders Identification Test score = 20) were randomly assigned to TAO, SAO, or an untreated waiting-list control group (WL). Participants in the TAO arm received 7 individual text-based chat-therapy sessions. The TAO and SAO interventions were based on cognitive-behavioral therapy and motivational interviewing techniques. Assessments were given at baseline and 3 and 6 months after randomization. Primary outcome measures were alcohol consumption and treatment response. Secondary outcome measures included measures of quality-of-life.
Using generalized estimating equation regression models, intention-to-treat analyses demonstrated significant effects for TAO versus WL (p = .002) and for SAO versus WL (p = .03) on alcohol consumption at 3 months postrandomization. Differences between TAO and SAO were not significant at 3 months postrandomization (p = .11) but were significant at 6 months postrandomization (p = .03), with larger effects obtained for TAO. There was a similar pattern of results for treatment response and quality-of-life outcome measures.
Results support the effectiveness of cognitive-behavioral therapy/motivational interviewing Internet-based therapy and Internet-based self-help for problematic alcohol users. At 6 months postrandomization, Internet-based therapy led to better results than Internet-based self-help.
酒精使用问题是导致全球疾病负担的第三大原因，部分原因是大多数酗酒者未接受治疗。基于互联网的干预措施吸引了未接受治疗的人群，但它们的有效性尚未得到证实。本研究旨在检验基于互联网的治疗（therapy alcohol online；TAO）和基于互联网的自助治疗（self-help alcohol online；SAO）对酒精使用问题者的有效性。
将 205 名成年酒精使用问题者（51%为女性；平均年龄为 42 岁；平均酒精使用障碍识别测试分数为 20）随机分配到 TAO、SAO 或未治疗的候补名单对照组（WL）。TAO 组的参与者接受了 7 次基于文本的个体聊天治疗。TAO 和 SAO 干预措施基于认知行为疗法和动机访谈技术。在基线、随机分组后 3 个月和 6 个月进行评估。主要结局指标是酒精消耗和治疗反应。次要结局指标包括生活质量评估。
使用广义估计方程回归模型，意向性治疗分析表明，在随机分组后 3 个月，TAO 与 WL 相比（p =.002）和 SAO 与 WL 相比（p =.03），酒精消耗有显著效果。在随机分组后 3 个月，TAO 与 SAO 之间的差异不显著（p =.11），但在随机分组后 6 个月时差异显著（p =.03），TAO 的效果更大。治疗反应和生活质量评估结果也呈现出类似的模式。
结果支持认知行为疗法/动机访谈基于互联网的治疗和基于互联网的自助治疗对酒精使用问题者的有效性。在随机分组后 6 个月，基于互联网的治疗比基于互联网的自助治疗效果更好。
