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

  • C. K. Farren (a1), J. Milnes (a1), K. Lambe (a1) and S. Ahern (a1)

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.


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


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.


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.

Corresponding author
*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:
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Andersson, G, Cuijpers, P (2009). Internet-based and other computerized psychological treatments for adult depression: a meta-analysis. Cognitive Behavior Therapy 38, 196205.
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, 168176.
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, 225231.
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, 20032017.
Bertolucci, PHF, Brucki, SMD, Campacci, SRJ (1994). The Mini-Mental State Examination in a general population: impact of educational status. Arq Neuro-Psiquiatria 52, 17.
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, 330341.
Brown, SA, Carrello, PD, Vik, PW, Porter, RJ (1998). Change in alcohol effect and self-efficacy expectancies during addiction treatment. Substance Abuse 19, 155167.
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, 483491.
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, 24692494.
Carroll, KM, Onken, LS (2005). Behavioral therapies for drug abuse. American Journal of Psychiatry 162, 14521460.
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, 881888.
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, 178181.
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, 20232032.
DiClemente, CC, Carbonari, JP, Montgomery, RPG, Hughes, SO (1994). The alcohol abstinence self-efficacy scale. Journal of Studies on Alcohol 55, 141148.
Farren, CK, McElroy, S (2008). Treatment response of bipolar and depressed alcoholics following an inpatient dual diagnosis program. Journal of Affective Disorders 106, 265272.
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, 527533.
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, 317321.
Foroushani, PS, Schneider, J, Assareh, N (2011). Meta-review of the effectiveness of computerized CBT in treating depression. BMC Psychiatry 11, 131135.
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, 189198.
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, 421426.
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, 10681075.
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, 5562.
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, 16951704.
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, 112.
Project MATCH, RG (1997). Matching alcoholism treatment to client heterogeneity: project MATCH posttreatment drinking outcomes. Journal of Studies on Alcohol 58, 729.
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, 4654.
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, 277289.
Rooke, S, Thorsteinsson, E, Karpin, A, Copeland, J, Allsop, D (2010). Computer-delivered interventions for alcohol and tobacco use: a meta-analysis. Addiction 105, 13811390.
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, 393402.
Spitzer, R, Williams, J (1992). Structured Clinical Interview for DSM IV. New York, Biometric Research Department, New York State Psychiatric Institute.
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, 319328.
Twomey, C, O’Reilly, G, Byrne, M (2013). Computerised cognitive behavioural therapy: helping Ireland log on. Irish Journal of Psychological Medicine 30, 2956.
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.
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, 11581164.
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Irish Journal of Psychological Medicine
  • ISSN: 0790-9667
  • EISSN: 2051-6967
  • URL: /core/journals/irish-journal-of-psychological-medicine
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