Effectiveness of guided and unguided online alcohol help: A real-life study

AIMS: Online interventions reduce the treatment gap between the number of people with alcohol misuse and people who actually receive help. This study investigated the effectiveness and predictors of success of a Belgian online help programme. METHODS: A real-life retrospective open cohort study evaluating the guided and unguided internet intervention on the Belgian online platform alcoholhulp.be. The intervention consisted of a 12-week programme based upon cognitive behaviour therapy, motivational interviewing and acceptance and commitment therapy. Inclusion criteria are age above 18 years, recording of alcohol consumption in the daily journal for at least 2 weeks, and minimum 2 chat sessions in the guided group. Outcomes were weekly alcohol consumption after 6 and 12 weeks and treatment response (drinking less than 10 or 20 standard units (SU) per week). Additional analysis was done on predictors of success. RESULTS: A total of 460 participants in the guided group and 968 in the self-help group met the inclusion criteria. Average baseline alcohol consumption in the two groups was 40 SU per week. Alcohol consumption decreased by 31 SU (Cohen's d 1.17, p < 0.001) after 12 weeks in the guided group and 23 SU (Cohen's d 0.83, p < 0.001) in the self-help group. The treatment response below 20 SU per week was 88% for the guided group and 73% for the self-help group. Significantly better results were obtained in the guided group compared to the self-help group (p < 0.005). Participants with a higher baseline alcohol consumption had a higher decrease in alcohol consumption in both groups. The personal goal to quit, the absence of drug use, a lower baseline alcohol consumption and a higher number of completed assignments predict a higher chance of treatment response. Attrition at 6 weeks was 26% in the guided group and 63% in the self-help group and increased to 59% and 82% respectively at 12 weeks. CONCLUSIONS: Both guided and unguided internet interventions are effective in reducing alcohol consumption and achieving the guideline for participants motivated to use the platform on a regular base, with better results in guided intervention.