Developing and Implementing an Online Relapse Prevention Psychotherapy Program for Patients with Alcohol Use Disorder: Protocol for a Randomized Controlled Trial (Preprint)

Abstract

BACKGROUND Alcohol use disorder (AUD) is characterized by problematic alcohol use accompanied by clinically significant distress. Patients with AUD frequently experience high relapse rates and only one in five remain abstinent 12 months post-treatment. Traditional face-to-face relapse prevention treatment (RPT) is a form of cognitive behavioural therapy that examines one's situational triggers, maladaptive thought processes, self-efficacy, and motivation. However, access to this treatment is frequently limited due to its high cost, long waitlists, and inaccessibility. An online adaptation of RPT (e-RPT) could address these limitations by providing a more cost-effective and accessible delivery method for mental health care in this population. OBJECTIVE This study protocol aims to establish the first academic e-RPT program to address AUD in the general population. The primary objective of this study is to compare the efficacy of e-RPT to face-to-face RPT at decreasing relapse rates. The secondary objective is to assess the effects of e-RPT on quality of life, self-efficacy, resilience, and depressive symptomatology. The tertiary objective is to evaluate cost-effectiveness of e-RPT compared to face-to-face RPT. METHODS Adult participants (n = 60) with a confirmed diagnosis of AUD will be randomly assigned to receive ten sessions of e-RPT or face-to-face RPT. e-RPT will consist of 10 predesigned modules and homework with asynchronous personalized feedback from a therapist. Face-to-face RPT will comprise 10 one-hour face-to-face sessions with a therapist. The predesigned modules and the face-to-face sessions will present the same content and structure. Self-efficacy, resilience, depressive symptomatology, and alcohol consumption will be measured through various questionnaires at baseline, mid-treatment, and end of treatment. RESULTS Participant recruitment is expected to begin in October 2022 through targeted advertisements and physician referrals. Completed data collection and analysis are expected to conclude by October 2023. Outcome data will be assessed using linear and binomial regression (continuous and categorical outcomes respectively). Qualitative data will be analyzed using thematic analysis methods. CONCLUSIONS The current study will be the first to examine the effectiveness of e-RPT compared to face-to-face RPT. It is posited that online care can present benefits in terms of accessibility and affordability compared to traditional face-to-face psychotherapy. CLINICALTRIAL clinicaltrials.gov (NCT05579210)