A Review of Digital Tools for Alcohol Problems

We and others have been developing and evaluating digital tools to help people with alcohol problems for over 20 years now. And an analysis of the field (the first) has just been published. It gets a bit into the weeds but if you’ll stick with it, there’s good news at the end.

Brian Kiluk and colleagues have published the results of a meta-analysis* of randomized clinical trials of tech-delivered interventions for heavy drinking (click here for an abstract). They found 15 studies that used cognitive behavioral strategies to reduce heavy drinking. (Four were from our research group.) Their findings and conclusions mirror and expand on those we’ve found in our studies over the years.

The authors considered how the comparison groups could influence conclusions. Here’s a summary of their findings.

Tech-Delivered Interventions Compared to “Treatment as Usual”

The designs here compared the digital tool (A) to the typical alcohol treatment (B), an A vs. B design. In this context, none of the tech-delivered interventions had superior outcomes when compared to more traditional interventions.

Tech-Delivered Interventions compared to In-Person Treatment with a Therapist

Another A vs B design, two studies examined this comparison and neither found the tech-delivered intervention to be superior to working in-person with a therapist.

Tech-Delivered Interventions as a Stand-alone Intervention

When compared to a minimal treatment control group, tech-delivered interventions had a positive and statistically significant effect. Overall the effect size was small (g .20) but there was a good deal of variability of the effect size within these studies. The effect sizes ranged from .03 to .53. Our early Behavioral Self-Control Program had the largest effect size, .53 with outcomes out to a 12-month follow-up. A .53 effect size is considered large.

Tech-Delivered Interventions Added to “Treatment as Usual”

The designs here compared the effect of combining the digital tool (A) with a typical treatment (B). Here the comparison is A+B, vs B. Most comparisons were with people in treatment for alcohol problems. Our studies in this group though had mutual support groups including SMART Recovery and Moderation Management.

This type of comparison had the biggest impact on outcomes. Many of the studies had had medium to large effect sizes. Again, our protocols were in the group that had the most significant outcomes.

The results support what my research team and I have been reporting for years now. Tech-delivered interventions can be helpful to many people as a stand-alone intervention. When used in the context of mutual support groups or treatment, they significantly improve outcomes beyond those of the support group or treatment alone.

*A meta-analysis is a systematic procedure for statistically combining the results of many different studies in an area of interest (click here for a more detailed description).