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Computerised cognitive behavioural therapy for alcohol use disorder: a pilot randomised control trial

Published online by Cambridge University Press:  04 December 2014

C. K. Farren ,
J. Milnes ,
K. Lambe  and
S. Ahern
C. K. Farren*
Affiliation:
Trinity College Dublin, St Patrick’s University Hospital, Dublin, Ireland
J. Milnes
Affiliation:
Trinity College Dublin, St Patrick’s University Hospital, Dublin, Ireland
K. Lambe
Affiliation:
Trinity College Dublin, St Patrick’s University Hospital, Dublin, Ireland
S. Ahern
Affiliation:
Trinity College Dublin, St Patrick’s University Hospital, Dublin, Ireland
*
*Address for correspondence: C. K. Farren, MB, Ph.D., FRCPI, MRCPsych, Trinity College Dublin, St Patrick’s University Hospital, James Street, Dublin 8, Ireland. (Email: [email protected])
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Abstract

Background

Cognitive behavioural therapy (CBT) has been used in the treatment of alcohol use disorder (AUD), generally in individual or group therapy, but not via computer.

Aim

This study examined the effectiveness of an interactive, personalised, computer-based CBT therapy in a randomised control trial.

Methods

We studied a group of 55 patients with AUD, randomised to either 5-hour-long computerised CBT sessions or a placebo cognitive-stimulating session, together with a 4-week inpatient rehabilitation treatment, and followed them for 3 months.

Results

There was a high degree of patient adherence to the protocol. Both groups did well, with a significant fall in alcohol outcome measures including number of drinks per drinking day, and number of drinking days, and an increase in abstinence rates in both groups to an equivalent level. The CBT group attended alcoholics anonymous groups more frequently, and had significant alterations in their alcohol self-efficacy outcomes, which correlated with their drinking outcomes. We concluded that computerised CBT is a potentially useful clinical tool that warrants further investigation in different treatment settings for AUD.

Keywords

Alcoholcognitive behavioural therapycomputeroutcome measurestrial
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 32 , Issue 3 , September 2015 , pp. 237 - 246
Copyright
© College of Psychiatrists of Ireland 2014 

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References

Andersson, G, Cuijpers, P (2009). Internet-based and other computerized psychological treatments for adult depression: a meta-analysis. Cognitive Behavior Therapy 38, 196–205.Google Scholar
Agyapong, VI, Ahern, S, McLoughlin, D, Farren, CK (2012). Supportive text messaging for depression and comorbid alcohol use disorder: single-blind randomised trial. Journal of Affective Disorders 141, 168–176.Google Scholar
Anton, R, Moak, DH, Latham, P (1996). The obsessive-compulsive drinking scale: a new method of assessing outcome in alcoholism treatment studies. Archives of General Psychiatry 53, 225–231.Google Scholar
Anton, R, O’Malley, S, Ciraulo, D, Cisler, R, Couper, D, Donovan, D, Hosking, J, Johnson, B, LoCastro, J, Longabaugh, R, Mason, B, Mattson, M, Miller, W, Pettinati, H, Randall, C, Swift, R, Weiss, R, Williams, L, Zweben, A (2006). Combination pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized clinical trial. JAMA 295, 2003–2017.Google Scholar
Bertolucci, PHF, Brucki, SMD, Campacci, SRJ (1994). The Mini-Mental State Examination in a general population: impact of educational status. Arq Neuro-Psiquiatria 52, 1–7.Google Scholar
Blankers, M, Koeter, MJW, Schippers, GM (2011). Internet therapy versus internet self-help versus no treatment for problematic alcohol use: a randomized controlled trial. Journal of Consulting and Clinical Psychology 79, 330–341.Google Scholar
Brown, SA, Carrello, PD, Vik, PW, Porter, RJ (1998). Change in alcohol effect and self-efficacy expectancies during addiction treatment. Substance Abuse 19, 155–167.CrossRefGoogle ScholarPubMed
Brown, SA, Christiansen, BA, Goldman, MS (1987). The alcohol expectancy questionnaire: an instrument for the assessment of adolescent and adult alcohol expectancies. Journal of Studies on Alcohol 48, 483–491.Google Scholar
Carey, KB, Scott-Sheldon, LAJ, Carey, MP, De Martini, KS (2007). Individual-level interventions to reduce college student drinking: A meta-analytic review. Addictive Behaviors 32, 2469–2494.Google Scholar
Carroll, KM, Onken, LS (2005). Behavioral therapies for drug abuse. American Journal of Psychiatry 162, 1452–1460.Google Scholar
Carroll, KM, Ball, SA, Martino, S, Nich, C, Babuscio, TA, Nuro, KF, Gordon, MA, Portnoy, GA, Rounsaville, BJ (2008). Computer-assisted delivery of cognitive-behavioral therapy for addiction: a randomized trial of CBT4CBT. American Journal of Psychiatry 165, 881–888.Google Scholar
Carroll, KM, Ball, SA, Martino, S, Nich, C, Babuscio, TA, Rounsaville, BJ (2009). Enduring effects of a computer-assisted raining program for cognitive behavioral therapy: a 6-month follow-up of CBT4CBT. Drug and Alcohol Dependence 100, 178–181.Google Scholar
Cunningham, JA, Wild, TC, Cordingley, J, van Mierlo, T, Humphreys, K (2009). A randomized controlled trial of an internet-based intervention for alcohol abusers. Addiction 104, 2023–2032.Google Scholar
DiClemente, CC, Carbonari, JP, Montgomery, RPG, Hughes, SO (1994). The alcohol abstinence self-efficacy scale. Journal of Studies on Alcohol 55, 141–148.Google Scholar
Farren, CK, McElroy, S (2008). Treatment response of bipolar and depressed alcoholics following an inpatient dual diagnosis program. Journal of Affective Disorders 106, 265–272.Google Scholar
Farren, CK, McElroy, S (2010). Predictive factors for relapse after an integrated inpatient treatment program for unipolar depressed and bipolar alcoholics. Alcohol and Alcoholism 45, 527–533.Google Scholar
Farren, CK, Scimeca, M, Wu, R, O’Malley, SS (2009). A double-blind, placebo controlled study of sertraline with naltrexone for alcohol dependence. Drug and Alcohol Dependence 99, 317–321.Google Scholar
Foroushani, PS, Schneider, J, Assareh, N (2011). Meta-review of the effectiveness of computerized CBT in treating depression. BMC Psychiatry 11, 131–135.CrossRefGoogle ScholarPubMed
Folstein, MF, Folstein, SE, McHugh, PR (1975). ‘Mini-Mental State’: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189–198.Google Scholar
Gossop, M, Harris, J, Best, D, Man, LH, Manning, V, Marshall, J, Strang, J (2003). Is attendance at alcoholics anonymous meetings after inpatient treatment related to imporved outcomes? A 6-month follow-up study. Alcohol and Alcoholism 38, 421–426.CrossRefGoogle Scholar
Kenardy, JA, Dow, MGT, Johnson, DW, Newman, MG, Thomson, A, Taylor, CB (2003). A comparison of delivery methods of cognitive-behavioral therapy for panic disorder: an international multi-centre trial. Journal of Consulting and Clinical Psychology 71, 1068–1075.Google Scholar
McCrone, P, Knapp, M, Proudfoot, J, Ryden, C, Cavanagh, K, Shapiro, DA, llson, S, Gray, JA, Goldberg, D, Mann, A, Marks, I, Everitt, B, Tylee, A (2004). Cost-effectiveness of computerised cognitive-behavioral therapy for anxiety and depression in primary care: randomised controlled trial. British Journal of Psychiatry 185, 55–62.Google Scholar
O’Malley, SS, Rounsaville, BJ, Farren, C, Namkoong, K, Wu, R, Robinson, J, O’Connor, PG (2003). Initial and maintenance naltrexone treatment for alcohol dependence using primary care vs specialty care. Archives of Internal Medicine 163, 1695–1704.Google Scholar
Postel, MG, de Haan, HA, ter Huurne, ED, Becker, ES, de Jong, CA (2010). Effectiveness of a web-based intervention for problem drinkers and reasons for dropout: randomized controlled trial. Journal of Medical Internet Research 12, 1–12.Google Scholar
Project MATCH, RG (1997). Matching alcoholism treatment to client heterogeneity: project MATCH posttreatment drinking outcomes. Journal of Studies on Alcohol 58, 7–29.Google Scholar
Proudfoot, J, Ryden, C, Everitt, B, Shapiro, DA, Goldberg, D, Mann, A, Tylee, A, Marks, I, Gray, JA (2004). Clinical efficacy of computerised cognitive-behavioral therapy for anxiety and depression in primary care: randomised controlled trial. British Journal of Psychiatry 185, 46–54.Google Scholar
Proudfoot, J, Swain, S, Widmer, S, Watkins, E, Goldberg, D, Marks, I, Mann, A, Gray, JA (2003). The development and beta-testing of a computer-therapy program for anxiety and depression: hurdles and lessons. Computers in Human Behavior 19, 277–289.Google Scholar
Rooke, S, Thorsteinsson, E, Karpin, A, Copeland, J, Allsop, D (2010). Computer-delivered interventions for alcohol and tobacco use: a meta-analysis. Addiction 105, 1381–1390.Google Scholar
Sobell, L, Sobell, M, Leo, G, Cancill, A (1988). Reliability of a timeline method: assessing normal drinker reports of recent drinking and a comparative evaluation across several populations. British Journal of Addiction 83, 393–402.Google Scholar
Spitzer, R, Williams, J (1992). Structured Clinical Interview for DSM IV. New York, Biometric Research Department, New York State Psychiatric Institute.Google Scholar
Spek, V, Cuijpers, P, Nyklicek, I, Riper, H, Keyser, J, Pop, V (2007). Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychological Medicine 37, 319–328.Google Scholar
Twomey, C, O’Reilly, G, Byrne, M (2013). Computerised cognitive behavioural therapy: helping Ireland log on. Irish Journal of Psychological Medicine 30, 29–56.Google Scholar
Wallace, P, Murray, E, McCambridge, J, Khadjesari, Z, White, IR, Thompson, SG, Kalaitzaki, E, Godfrey, C, Linke, S (2011). On-line randomized controlled trial of an internet based psychologically enhanced intervention for people with hazardous alcohol consumption. PLoS One 6, e 14740.Google Scholar
Wright, JH, Wright, AS, Albano, AM, Basco, MR, Goldsmith, LJ, Raffield, T, Otto, MW (2005). Computer assisted cognitive therapy for depression: maintaining efficacy while reducing therapist time. American Journal of Psychiatry 162, 1158–1164.Google Scholar