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Effects of Internet...
Effects of Internet-Based Cognitive Behavioral Therapy for Harmful Alcohol Use and Alcohol Dependence as Self-help or With Therapist Guidance : Three-Armed Randomized Trial
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- Johansson, Magnus (författare)
- Karolinska Institutet
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- Berman, Anne H., Professor (författare)
- Karolinska Institutet,Uppsala universitet,Institutionen för psykologi,Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Stockholm, Sweden.
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- Sinadinovic, Kristina (författare)
- Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Stockholm, Sweden.
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- Lindner, Philip (författare)
- Karolinska Institutet
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- Hermansson, Ulric (författare)
- Karolinska Institutet
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- Andréasson, Sven (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2021-11-24
- 2021
- Engelska.
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 23:11
- Relaterad länk:
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https://doi.org/10.2...
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https://uu.diva-port... (primary) (Raw object)
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https://www.jmir.org...
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https://urn.kb.se/re...
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https://doi.org/10.2...
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http://kipublication...
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Abstract
Ämnesord
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- BACKGROUND: Alcohol use is a major contributor to health loss. Many persons with harmful use or alcohol dependence do not obtain treatment because of limited availability or stigma. They may use internet-based interventions as an alternative way of obtaining support. Internet-based interventions have previously been shown to be effective in reducing alcohol consumption in studies that included hazardous use; however, few studies have been conducted with a specific focus on harmful use or alcohol dependence. The importance of therapist guidance in internet-based cognitive behavioral therapy (ICBT) programs is still unclear.OBJECTIVE: This trial aims to investigate the effects of a web-based alcohol program with or without therapist guidance among anonymous adult help-seekers.METHODS: A three-armed randomized controlled trial was conducted to compare therapist-guided ICBT and self-help ICBT with an information-only control condition. Swedish-speaking adult internet users with alcohol dependence (3 or more International Classification of Diseases, Tenth Revision criteria) or harmful alcohol use (alcohol use disorder identification test>15) were included in the study. Participants in the therapist-guided ICBT and self-help ICBT groups had 12-week access to a program consisting of 5 main modules, as well as a drinking calendar with automatic feedback. Guidance was given by experienced therapists trained in motivational interviewing. The primary outcome measure was weekly alcohol consumption in standard drinks (12 g of ethanol). Secondary outcomes were alcohol-related problems measured using the total alcohol use disorder identification test-score, diagnostic criteria for alcohol dependence and alcohol use disorder, depression, anxiety, health, readiness to change, and access to other treatments or support. Follow-up was conducted 3 (posttreatment) and 6 months after recruitment.RESULTS: During the recruitment period, from March 2015 to March 2017, 1169 participants were included. Participants had a mean age of 45 (SD 13) years, and 56.72% (663/1169) were women. At the 3-month follow-up, the therapist-guided ICBT and control groups differed significantly in weekly alcohol consumption (-3.84, 95% Cl -6.53 to -1.16; t417=2.81; P=.005; Cohen d=0.27). No significant differences were found in weekly alcohol consumption between the self-help ICBT group and the therapist-guided ICBT at 3 months, between the self-help ICBT and the control group at 3 months, or between any of the groups at the 6-month follow-up. A limitation of the study was the large number of participants who were completely lost to follow-up (477/1169, 40.8%).CONCLUSIONS: In this study, a therapist-guided ICBT program was not found to be more effective than the same program in a self-help ICBT version for reducing alcohol consumption or other alcohol-related outcomes. In the short run, therapist-guided ICBT was more effective than information. Only some internet help-seekers may need a multisession program and therapist guidance to change their drinking when they use internet-based interventions.TRIAL REGISTRATION: ClinicalTrials.gov NCT02377726; https://clinicaltrials.gov/ct2/show/NCT02377726.
Ämnesord
- SAMHÄLLSVETENSKAP -- Psykologi -- Tillämpad psykologi (hsv//swe)
- SOCIAL SCIENCES -- Psychology -- Applied Psychology (hsv//eng)
Nyckelord
- CBT
- ICBT
- alcohol dependence
- alcohol use
- alcohol use disorders
- cognitive behavioral therapy
- eHealth
- help-seeking behavior
- internet-based cognitive behavioral therapy
- internet-based interventions
- mobile phone
- outcomes
- substance abuse
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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