Cognitive behavioral therapy (CBT) delivered via websites or mobile apps appears beneficial as an addition to usual care in specialty substance use settings or as standalone therapy for alcohol use, according to a meta-analysis published online in the journal Alcoholism: Clinical & Experimental Research.
“While there have been reviews indicating the efficacy of technology-based delivery of CBT for various psychiatric conditions, none have focused on efficacy for alcohol use,” researchers wrote. “The current meta-analysis was conducted to fill this research gap.”
The study focused on 15 published trials involving technology-delivered CBT-based interventions for alcohol use. Most of the studies involved participants who were heavy drinkers or were at risk for heavy drinking. The content of the technology-delivered CBT programs used in the studies varied, and the length ranged from 4 to 62 sessions or exercises. Many of the interventions involved elements of motivational interviewing, a counseling method that helps individuals find internal motivation for changing their behavior.
Although effect sizes were modest, the meta-analysis suggested an overall benefit for technology-delivered CBT interventions when used as standalone therapy for heavy drinking, compared with minimal treatment. When added to specialty substance use care, technology-delivered CBT showed a positive, significant effect on alcohol use moderation in contrast with standard treatment alone. This effect was stable over 12-month follow-up.
While technology-based CBT interventions for alcohol use could greatly enhance patient access to treatment, the varied characteristics of the trials as well as the technology-based interventions included in the meta-analysis prevent firm conclusions about the efficacy of specific programs, researchers cautioned.
They added that there is currently no suggestion for technology-based CBT to replace in-person or established treatments for alcohol use disorders.
Kiluk BD, Ray LA, Walthers J, Bernstein M, Tonigan JS, Magill M. Technology-delivered cognitive-behavioral interventions for alcohol use: a meta-analysis. Alcoholism: Clinical & Experimental Research. 2019 September 30;[Epub ahead of print].