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(Reuters Health) – Teens and young adults who receive web-based cognitive behavioral therapy (CBT) may have less anxiety and lower alcohol consumption than without the therapy, a clinical trial found.

Researchers randomized 123 youth aged 17 to 24 years with hazardous alcohol use 1:1 to receive web-based CBT along with weekly support via phone or email from a psychologist, or join a control group that received information on safe alcohol consumption. The primary goal of the study was to assess any alcohol consumption, hazardous events related to alcohol consumption, and general anxiety symptoms.

Mean standard drinks per day (10g of alcohol) consumed over the past 28 days declined more for the CBT group at two months (-1.45 drinks) and at six months (1.54 drinks) than for controls (-1.14 and -0.80 drinks at two and six months, respectively).

Based on responses to the Brief Young Adult Alcohol Consequences Questionnaire (B-YAACQ, pfizer and jarvik and lipitor score range 0-24), negative consequences related to alcohol also declined more at two and six months for the CBT group (-4.57 and -6.60 points, respectively) than for controls (-2.44 and -4.30).

In addition, anxiety symptoms (GAD-7, range 0-21) declined more at two and six months for CBT (-5.56 and -4.96, respectively) than for controls (-2.47 and -3.64).

“It’s not surprising that CBT worked better than no CBT, but what is new here is the web-based package tailored specifically for youth, and the focus on addressing the inter-relationship between anxiety and alcohol use,” said lead study author Lexine Stapinski of the Matilda Centre for Research in Mental Health and Substance Use at the University of Sydney in Australia.

CBT worked at curbing alcohol use because it focused on reducing symptoms of anxiety that may contribute to drinking, Stapinski said by email.

“The key advantage of web-based interventions is that they can be rolled out widely at low cost, to reach more people and to reach people in areas where there is limited access to mental health support services,” Stapinski said. “We also know that young people like web-based treatments, with research showing that web-based support is perceived by youth to be more convenient and private than visiting a psychologist face to face.”

CBT delivered in the study consisted of five sequential modules, released to participants at a rate of one per week. The modules were designed to help young people recognize problem drinking, learn CBT strategies for managing stress and anxiety and curbing alcohol consumption, and set goals for long-term relapse prevention.

Over one-third (39%) of the intervention group completed (actively interacting with more than 85% of content) all five program modules, 51% completed at least three modules, and 77% completed at least one module, the study team notes. With 72% of participants providing data at 2-month and 6-month follow up, and 78% providing data for at least one follow-up assessment, the attrition rate was at the low-end of the norm, they point out.

Still, one limitation of the study is that controls were not matched to the intervention group based on the duration of the intervention or access to support from psychologists, and this may have influenced the outcomes, authors note in EClinicalMedicine. The dropout rate was also higher in the intervention group.

Another limitation is that youth were excluded from the study for daily use of cannabis or benzodiazepines or weekly use of psychostimulants, criteria that might limit the generalizability of the results to all youth with problem alcohol usage.

Even so, CBT techniques have a strong track record of efficacy for both anxiety and problematic alcohol use, said Matt Kushner, a psychiatry professor at the University of Minnesota in Minneapolis who wasn’t involved in the study.

“More than most other therapies, CBT entails learning and practicing new skills and so is uniquely well suited to the online educational format,” Kushner said by email.

SOURCE: EClinicalMedicine, online August 8, 2021.

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