Kiluk BD, Benitez B, DeVito EE, et al. A Digital Cognitive Behavioral Therapy Program for Adults With Alcohol Use Disorder: A Randomized Clinical Trial. JAMA Netw Open. 2024;7(9):e2435205. doi:10.1001/jamanetworkopen.2024.35205
This 3-arm, parallel-group, randomized controlled trial tested a digital cognitive behavioral therapy program (CBT4CBT) for alcohol use disorder (AUD) against treatment as usual (TAU) and clinician-delivered CBT. A total of 90 participants seeking outpatient treatment for AUD were randomly assigned to one of the three groups. Over half (59; 65.6%) completed treatment: TAU (21; 61.8%), clinician CBT (16; 50.0%), and digital CBT (22; 66.7%). Participants spent an average of 37.6 (SD = 18.5) days in treatment, with no differences between groups. All treatments increased the percentage of days abstinent (PDA) from baseline to week 8: TAU 49.3% to 69.3%, CBT 53.7% to 68.1%, and digital CBT 47.6% to 75.1%, with no differences between treatments. Additional analysis of the 6-month follow-up period revealed that PDA changed differently across treatment arms only among individuals who completed treatment. For those individuals, from treatment end to 6 months, PDA dropped from 72.5% to 61.2% in CBT but rose from 76.6% to 85.9% in digital CBT. Over the full 8-month period, digital CBT increased PDA faster than TAU and CBT. Digital CBT also outperformed other treatments in improving knowledge on repeat assessments and in enhancing coping skills. Despite differential treatment effects on self-reported alcohol use, rates of negative ethyl glucuronide urine test results did not differ significantly across conditions. Taken together, these findings suggest that digital CBT with brief clinical monitoring is an effective and appealing treatment for AUD, which should continue to be explored in further research.