A 12‐session relapse prevention program vs psychoeducation in the treatment of Japanese alcoholic patients: A randomized controlled trial

Abstract

Aim: Alcoholism is the most prevalent substance use disorder in Japan; the estimated number of patients and high-risk drinkers is in the millions. Although studies in the West have shown that cognitive behavioral therapy (CBT) is one of the most effective treatment strategies for alcoholic patients, there is a dearth of efficacy studies of CBT-based intervention for those patients in the non-Western setting. The aim of this study is to investigate the efficacy of a 12-session CBT-based relapse prevention program for Japanese alcoholic patients.Methods: Forty-eight alcoholic patients (M = 36, F = 12) who were admitted to an addiction treatment unit were randomly allocated either to a 12-session relapse prevention (RP) program (n = 24) or a 12-session psychoeducation (PE) program (n = 24). Both treatment programs were conducted in a group format once a week for 12 weeks.Other aspects of inpatient treatment (group meetings, etc) were the same in both groups. Self-rating scales, which measure behavioral and cognitive coping, coping response, self-efficacy, and cognition of drinking, were administered at pretreatment, mid-treatment, and posttreatment periods. The proportion of participants who relapsed at 3 and 6 months after discharge was evaluated.Results: Both RP and PE groups showed significant improvement in self-efficacy and cognition of drinking at posttreatment. However, there were no significant differences in the self-rating scales between both groups. In addition, there were no significant differences in relapse rate at 3 and 6 months after discharge between both groups. Conclusions:The 12-session CBT-based relapse prevention program and the psychoeducation program may be equally efficacious for alcoholic patients. Several factors that influenced the results are discussed.

Developing and Implementing a Web-Based Relapse Prevention Psychotherapy Program for Patients With Alcohol Use Disorder: Protocol for a Randomized Controlled Trial

“…This is a protocol for an RCT that aims to establish a novel e-RPT program to improve the mental health of patients with AUD. This program will teach effective coping techniques to maintain abstinence and reduce the risk of a relapse by applying the widely validated principles of CBT and relapse prevention [ 12 , 24 , 31 , 32 , 50 ]. Supporting the structure and design of this program, this study will apply the evidence gathered by Alavi et al [ 30 , 39 , 40 ] on the efficacy of e-CBT in managing other psychiatric disorders.…”

“…When targeted to prevent or reduce the risk of relapses after an initial alcohol reduction program, this CBT approach becomes RPT. RPT involves addressing coping skills to decrease the risk of relapse [ 21 , 50 ]. Additionally, both interpersonal and intrapersonal factors are addressed so that patients can develop the skills necessary to aid in preventing relapse.…”

“…Additionally, both interpersonal and intrapersonal factors are addressed so that patients can develop the skills necessary to aid in preventing relapse. For instance, through the development of coping mechanisms to respond effectively to stressful situations that otherwise could have led to relapse [ 12 , 50 ]. However, despite these benefits, there are many obstacles to receiving face-to-face psychotherapy, such as financial issues and logistical problems.…”

“…The use of a web-based platform like OPTT allows for the automatic and reliable collection of user analytics, which can then be used to continuously improve and optimize the delivery of web-based psychotherapy programs. Given that face-to-face RPT has been previously validated in the literature, this study hypothesizes that e-RPT will be effective at maintaining abstinence, reducing the risk of relapse and depression symptomatology, and improving quality of life, resiliency, and coping behaviors [ 12 , 24 , 31 , 32 , 50 ]. Furthermore, comparing our proposed e-RPT program to a validated face-to-face therapeutic approach (RPT) strengthens the design of this RCT and the conclusions that will stem from this evidence.…”

“…Thus, this study will intentionally oversample the experimental and control groups to account for this dropout rate. Considering the effect size for face-to-face RPT reported by Harada et al [ 50 ] (2021) for CBI (effect size=0.65), a significance level of α=.05 and a power of 0.90, a sample size of 60 (30 per arm) would be sufficient to detect substantial changes from our interventions [ 51 ]. As this is the first study aiming to establish an e-RPT program for AUD, this sample size calculation relies on data from face-to-face RPT and takes into account the established effectiveness of online psychotherapy compared to face-to-face psychotherapy [ 30 ].…”