Computer-based cognitive behaviour therapy for alcohol use and coexisting depression in rural and urban areas

Researchers

  1. Professor Amanda Baker, University of Newcastle
  2. DrFrances Kay-Lambkin, University of Newcastle; University of NSW
  3. Professor Brian Kelly, University of Newcastle

Summary

In Australia around two thirds of people with mental illness and/or AOD-use disorders fail to seek professional help for their condition. There are significant barriers to accessing treatment; for example, the sheer number of people needing help, geographical isolation, and financial difficulties. A computer-based CBT option has the potential to contribute significantly to overcoming these barriers.

In the absence of research investigating integrated computer-based treatments for people with co-occurring depression and alcohol (and other drug) use problems, and the need to develop an appropriate treatment program for this increasingly large group of the community, the SHADE study (Self-Help for Alcohol/other drugs and Depression) was developed. If this computer based therapy proved as efficacious as the therapist-delivered intervention it would be immediately available for ongoing use in general practice and other settings requiring only minimal training or additional resources.

Outcomes

Therapist- and computer-delivered treatments seemed to result in similar patterns of positive change across many of the outcome variables, indicating the two different modes of providing integrated treatment for depression and AOD-use co-morbidity perform similarly well. In particular, computer-based therapy produced similar or better improvements in the following key outcomes: poly-drug use, depression, hopelessness and suicidal tendencies, hazardous use of substances, hazardous alcohol use, and quantity/frequency of cannabis use.

These promising results are particularly important, considering the computer-delivered intervention used an average of only 12 minutes face-to-face clinician time per session compared with approximately one hour of face-to-face therapy among the therapist-delivered equivalents and the control intervention.

The researchers plan to adapt the computer-based SHADE treatment to a web-based program that is easily accessible over the Internet. They hope that this will increase the accessibility of this evidence-based treatment program and facilitate ongoing research with the target group.

The project team was awarded the 2009 National Drug and Alcohol Award for Excellence in Research.

References

Kay-Lambkin, FJ, Baker, FJ, Lewin, TJ & Carr, VJ 2008 Computer-based psychological treatment for co-morbid depression and problematic alcohol and/or cannabis use: a randomised controlled trial of clinical efficacy. Addiction, 104(3): 378-388.

FARE continues to fund and undertake research that contributes to the knowledge-base about alcohol harms and strategies to reduce them.

This research is used to inform our approach to evidence-based alcohol policy development, ensuring that the solutions we are advocating for are informed by research. FARE’s research is also often quoted by governments, other not-for-profit organisations and researchers in public discussions about alcohol, demonstrating that FARE is seen as a leading source of information.

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