Internet-based Cognitive Behavioral Therapy (CBT) for Alcohol Use Disorder Is Not Inferior to Face-to-face CBT for Reducing Alcohol Consumption

Cognitive behavioral therapy (CBT) has been shown to be effective for treating alcohol use disorder (AUD), but most individuals with AUD do not receive treatment. Previous studies have indicated that internet-based CBT is also effective, but less is known about how it compares with face-to-face treatment. Researchers in Sweden recruited 301 treatment-seeking individuals with AUD through a website to compare alcohol consumption 3 and 6 months after receipt of 5 face-to-face CBT modules, or 5 internet-based CBT modules. They excluded individuals at risk for severe withdrawal or suicide and those requiring medication for AUD or with a mental illness requiring separate treatment.

• Attrition was not significantly different between the 2 groups: 33% at 3 months and 43% at 6 months.
• The face-to-face group completed more modules (4.2) than the internet group (3.7).
• The primary outcome measure—difference between groups in alcohol consumption during the previous week at 6-month follow-up—was non-inferior. Both groups had a decline in self-reported drinks from approximately 24 to 12 drinks in the past week.

Comments: This study suggests that internet-based CBT is a good option for individuals with AUD who are seeking treatment and are interested in this approach. This has the potential to expand access to treatment for AUD. Further research is needed on matching individuals to the treatment approach that works best for them.

Darius A. Rastegar, MD

Reference: Johansson M, Sinadinovic K, Gajecki M, et al. Internet-based therapy versus face-to-face therapy for alcohol use disorder, a randomized controlled non-inferiority trial. Addiction. 2021;116(5):1088–1100.