Sundström Christopher, Kraepelien Martin, Eék Niels, Fahlke Claudia, Kaldo Viktor, Berman Anne H
Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Centre for Psychiatry Research, Norra Stationsgatan 69, -113 64, Stockholm, SE, Sweden.
Department of Psychology, University of Gothenburg, Gothenborg, Gothenborg, Sweden.
BMC Psychiatry. 2017 May 26;17(1):197. doi: 10.1186/s12888-017-1355-6.
A large proportion of individuals 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 recognized as one of the psychological treatments for alcohol problems for which evidence is most robust. This study evaluated a new, therapist-guided internet-based CBT program (entitled ePlus) for individuals with alcohol use disorders.
Participants in the study (n = 13) were recruited through an alcohol self-help web site ( www.alkoholhjalpen.se ) and, after initial internet screening, were diagnostically assessed by telephone. Eligible participants were offered access to the therapist-guided 12-week program. The main outcomes were treatment usage data (module completion, treatment satisfaction) as well as glasses of alcohol consumed the preceding week, measured with the self-rated Timeline Followback (TLFB). Participant data were collected at screening (T0), immediately pre-treatment (T1), post-treatment (T2) and 3 months post-treatment (T3).
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.
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.
ClinicalTrials.gov ( NCT02384278 , February 26, 2015).
很大一部分有酒精问题的人并未寻求心理治疗，但通过互联网提供心理治疗可能会增加获得此类治疗的机会。认知行为疗法（CBT）被广泛认为是对酒精问题最有效的心理治疗方法之一。本研究评估了一种新的、由治疗师指导的基于互联网的针对酒精使用障碍患者的CBT项目（名为ePlus）。
通过一个酒精自助网站（www.alkoholhjalpen.se）招募了本研究的参与者（n = 13），在进行初步的互联网筛查后，通过电话进行诊断评估。符合条件的参与者可以参加由治疗师指导的为期12周的项目。主要结果是治疗使用数据（模块完成情况、治疗满意度）以及前一周饮用的酒精杯数，采用自评时间线追溯法（TLFB）进行测量。在筛查时（T0）、治疗前即刻（T1）、治疗后（T2）和治疗后3个月（T3）收集参与者的数据。
大多数参与者在整个治疗过程中都很积极，并认为该治疗非常可接受。在三个月的随访中发现酒精摄入量显著减少，组内效应量较大。对渴望和自我效能的次要结果测量，以及抑郁和生活质量，也显示出有中度至较大的组内效应量的显著改善。
由治疗师指导的基于互联网的CBT可能是酒精使用障碍患者可行且有效的替代治疗方法。鉴于在这个小型试点研究中发现的高可接受性和较大的组内效应量，有必要进行一项调查治疗效果的随机对照试验。
ClinicalTrials.gov（NCT02384278，2015年2月26日）。
