addictive behaviours including gambling, smoking, alcohol use ... the telephone, emails, SMS messages, or mobile phone.
A systematic review of Internet-based interventions for addictive behaviours What this article is about Internet-based interventions are increasingly used to treat mental health disorders. There is evidence that treatment seekers prefer Internet-based interventions compared to face-to-face therapies. This is because Internet-based interventions can be accessed easily by a large number of people. They provide anonymity and may reduce concerns about stigma. Previous studies have also found that these interventions can lower dropout rates. Further, they can provide a cheaper option than face-to-face treatments. Some studies have reported that Internet-based interventions can reduce addictive behaviours. This article aims to review and evaluate evidence regarding the effectiveness of Internet-based interventions. The focus is on interventions for addictive behaviours including gambling, smoking, alcohol use and substance use. What was done? The researchers conducted a comprehensive scan of published studies that examined Internet-based interventions for the treatment of addictive behaviours. To be included in the review, the studies must focus on an Internet-based intervention for a recognized addictive disorder. The intervention must include at least minimal therapist support, such as over the telephone. After reviewing the title, abstract and full text, the researchers identified 16 studies. They summarized the studies in a table. Details included the authors, publication year, country, study design, sample size s and characteristics (age and sex). The table also describes the type of interventions, outcome
Why is this article important? Internet-based interventions have become more common. They represent cheaper and more accessible options than face-to-face treatments. Yet, limited studies have evaluated their effectiveness. This article reviews 16 studies that examined the use of Internet-based Interventions for addictive behaviours. All studies showed that Internet-based interventions could reduce the respective addictive behaviours. These included smoking, gambling, alcohol use, and opioid dependence. There was evidence that minimal contact with a therapist could improve treatment effectiveness. Therapist contact could occur over the telephone, emails, SMS messages, or mobile phone. measures, and main effects. The researchers ranked each of the selected studies. They categorized each study as having poor, moderate, or good quality. What you need to know All of the 16 studies demonstrated that Internetbased interventions resulted in positive treatment outcomes. The studies were found to have moderate to good quality. Nine studies focused on smoking secession and showed that Internet-based interventions could reduce smoking behaviours. These included smoking fewer cigarettes and abstaining from smoking. Studies that combined Internet treatment with communication with a therapist (e.g., via email, phone calls, etc.) were more effective. However, one
study reported that treatment outcomes were not maintained at one year later. Four studies focused on gambling and reported positive treatment effects. These studies found that gambling behaviours and problems were reduced after treatment and at follow-up. Again, the combination with therapist communication showed better success. Internet-based interventions were found to be more time-efficient and cost-effective than traditional, face-to-face treatment options. Drop-out rates were either the same or lower than face-to-face treatments. The positive effects were maintained at follow-up, ranging from 3 months to 3 years across the studies. Two studies addressed problematic alcohol use and showed favourable results. Internet-based interventions were effective in reducing alcohol use habits and consequences. One study found that faceto-face treatment had a higher impact on reducing number of drinks per day. Attrition rates were found to be high for both Internet-based and face-to-face interventions. With respect to opioid dependence, only one study assessed the effectiveness of Internet-based intervention. Treatment effects did not differ between Internet-based and face-to-face interventions. But participants expressed a preference for the Internet-based intervention. Most Internet-based Interventions incorporated cognitive behavioural therapy. Some studies also included motivation interviewing strategies or other behavioural approaches. Support from a therapist could improve treatment outcomes. Therapist support was provided either over the telephone, through SMS messages, via email, or via mobile phone. Several studies provided peer support through online discussion forums or face-to-face group therapy sessions. One study reported the use of a clinician-led virtual world group. This addition was helpful in reducing the addictive behaviour.
Who is it intended for? This review is intended for treatment counsellors as it shows that Internet-based interventions are a viable option to treat addictive behaviours. It is also useful as a guide to areas where future study and evaluation is needed. For example, future research should examine which population groups are more likely to benefit from Internet-based interventions. About the researchers Jaymee-Lee Chebli, Alexander Blaszczynski, and Sally M. Gainsbury are affiliated with the Department of Psychology at the University of Sydney in Sydney, Australia. Sally Gainsbury is also affiliated with the Centre for Gambling Education and Research at Southern Cross University in Lismore, Australia. For more information about this study, please contact Jaymee-Lee Chebli at
[email protected]. Citation Chebli, J. L., Blaszczynski, A., & Gainsbury, S. M. (2016). Internet-based interventions for addictive behaviours: A systematic review. Journal of Gambling Studies, 32(4), 1279–1304. http://dx.doi.org/10.1007/s10899-016-9599-5 Keywords Internet, treatment, addiction, gambling, alcohol, tobacco Gambling Research Exchange Ontario (GREO) Gambling Research Exchange Ontario (GREO) has partnered with the Knowledge Mobilization Unit at York University to produce Research Snapshots. GREO is an independent knowledge translation and exchange organization that aims to eliminate harm from gambling. Our goal is to support evidenceinformed decision making in responsible gambling policies, standards and practices. The work we do is intended for researchers, policy makers, gambling regulators and operators, and treatment and prevention service providers. Learn more about GREO by visiting greo.ca or emailing
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