Improving internet-delivered cognitive behaviour therapy for alcohol misuse: Patient perspectives following program completion

Heather D Hadjistavropoulos; Carly Chadwick; Cynthia D Beck; Michael Edmonds; Christopher Sundström; Wendy Edwards; Dianne Ouellette; Justin Waldrop; Kelly Adlam; Lee Bourgeault; Marcie Nugent

doi:10.1016/j.invent.2021.100474

Improving internet-delivered cognitive behaviour therapy for alcohol misuse: Patient perspectives following program completion

Internet Interv. 2021 Oct 16:26:100474. doi: 10.1016/j.invent.2021.100474. eCollection 2021 Dec.

Affiliations

¹ Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina S4S 0A2, SK, Canada.
² Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.

Abstract

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 (n = 133, 69.6%) and 94.2% (n = 180) perceived the course as being worth their time. Worksheets (n = 61, 31.9%) and reflections of others (n = 40, 20.9%) received the most praise. Coping with cravings (n = 63, 33.0%), and identifying and managing risky situations (n = 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 (n = 24, 12.6%) followed by a desire for wanting more information (n = 22, 11.5%). Many patients offered advice for future ACC patients, including suggestions to make a commitment (n = 47, 24.6%), do all of the work (n = 29, 15.2%), and keep a consistent approach to the course (n = 24, 12.6%). The results provide valuable patient-oriented directions for improving ICBT for alcohol misuse.

Keywords: Alcohol misuse; Internet-delivered cognitive behaviour therapy; Patient perspectives; Patient-oriented; Qualitative evaluation.