Hadjistavropoulos Heather D, Chadwick Carly, Beck Cynthia D, Edmonds Michael, Sundström Christopher, Edwards Wendy, Ouellette Dianne, Waldrop Justin, Adlam Kelly, Bourgeault Lee, Nugent Marcie
Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina S4S 0A2, SK, Canada.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Internet Interv. 2021 Oct 16;26:100474. doi: 10.1016/j.invent.2021.100474. eCollection 2021 Dec.
Although Internet-delivered cognitive behaviour therapy (ICBT) for alcohol misuse is efficacious in research trials, it is not routinely available in practice. Moreover, there is considerable variability in engagement and outcomes of ICBT for alcohol misuse across studies. The Alcohol Change Course (ACC) is an ICBT program that is offered free of charge by an online clinic in Saskatchewan, Canada, which seeks to fill this service gap, while also conducting research to direct future improvements of ICBT. As there is limited qualitative patient-oriented research designed to improve ICBT for alcohol misuse, in this study, we describe patient perceptions of the ACC post-treatment. Specifically, post-treatment feedback was obtained from 191 of 312 patients who enrolled in the ACC. Qualitative thematic analysis was used to examine post-treatment written comments related to what patients liked and disliked about the course, which skills were most helpful for them, and their suggestions for future patients. The majority of patients endorsed being very satisfied or satisfied with the course ( = 133, 69.6%) and 94.2% ( = 180) perceived the course as being worth their time. Worksheets ( = 61, 31.9%) and reflections of others ( = 40, 20.9%) received the most praise. Coping with cravings ( = 63, 33.0%), and identifying and managing risky situations ( = 46, 24.1%) were reported as the most helpful skills. Several suggestions for refining the course were provided with the most frequent recommendation being a desire for increased personal interaction ( = 24, 12.6%) followed by a desire for wanting more information ( = 22, 11.5%). Many patients offered advice for future ACC patients, including suggestions to make a commitment ( = 47, 24.6%), do all of the work ( = 29, 15.2%), and keep a consistent approach to the course ( = 24, 12.6%). The results provide valuable patient-oriented directions for improving ICBT for alcohol misuse.
尽管互联网提供的针对酒精滥用的认知行为疗法（ICBT）在研究试验中是有效的，但在实际应用中却并非常规可用。此外，不同研究中针对酒精滥用的ICBT的参与度和治疗效果存在很大差异。“酒精改变课程”（ACC）是加拿大萨斯喀彻温省一家在线诊所免费提供的ICBT项目，旨在填补这一服务空白，同时开展研究以指导ICBT未来的改进。由于旨在改进针对酒精滥用的ICBT的以患者为导向的定性研究有限，在本研究中，我们描述了患者对ACC治疗后的看法。具体而言，从312名报名参加ACC的患者中的191名患者那里获得了治疗后的反馈。采用定性主题分析来检查与患者对课程的喜欢和不喜欢之处、哪些技能对他们最有帮助以及他们对未来患者的建议相关的治疗后书面评论。大多数患者认可对课程非常满意或满意（n = 133，69.6%），94.2%（n = 180）认为该课程值得他们花费时间。工作表（n = 61，31.9%）和他人的反思（n = 40，20.9%）得到的赞扬最多。应对渴望（n = 63，33.0%）以及识别和管理危险情况（n = 46，24.1%）被报告为最有帮助的技能。还提供了一些改进课程的建议，最常见的建议是希望增加个人互动（n = 24，12.6%），其次是希望获得更多信息（n = 22，11.5%）。许多患者为未来参加ACC的患者提供了建议，包括做出承诺的建议（n = 47，24.6%）、完成所有作业的建议（n = 29，15.2%）以及对课程保持一致态度的建议（n = 24，12.6%）。这些结果为改进针对酒精滥用的ICBT提供了有价值的以患者为导向的方向。
