Elsevier

Clinical Psychology Review

Volume 31, Issue 1, February 2011, Pages 178-186
Clinical Psychology Review

A review of technology-assisted self-help and minimal contact therapies for drug and alcohol abuse and smoking addiction: Is human contact necessary for therapeutic efficacy?

https://doi.org/10.1016/j.cpr.2010.10.002Get rights and content

Abstract

Technology-based self-help and minimal contact therapies have been proposed as effective and low-cost interventions for addictive disorders, such as nicotine, alcohol, and drug abuse and addiction. The present article reviews the literature published before 2010 on computerized treatments for drug and alcohol abuse and dependence and smoking addiction. Treatment studies are examined by disorder as well as amount of therapist contact, ranging from self-administered therapy and predominantly self-help interventions to minimal contact therapy where the therapist is actively involved in treatment but to a lesser degree than traditional therapy and predominantly therapist-administered treatments involving regular contact with a therapist for a typical number of sessions. In the treatment of substance use and abuse it is concluded that self-administered and predominantly self-help computer-based cognitive and behavioral interventions are efficacious, but some therapist contact is important for greater and more sustained reductions in addictive behavior.

Research Highlights

► Review research on technological applications to psychotherapy for abuse and addictive disorders. ► Critical evaluation of the strengths and limitations of technology-assisted therapy studies. ► Use of extant research to determine the degree of therapist contact that is advisable.

Section snippets

Use of technology to treat addictive behaviors

Technology-based treatments have been used to address problems of substance abuse and addiction. Studies have focused on drug and alcohol abuse, dependence, and prevention, smoking addiction, and pathological gambling. Computer-assisted therapy has also been employed in the treatment of pathological gambling. Addictive behavior treatments have included web-based interventions, messaging [e.g., texting and short message service (SMS)] via hand-held computer or cellular phone, palmtop computer,

Attitudes toward technology-based therapy

Given the proliferation of data supporting efficacy of technology-based therapy and addressing concerns of critics of this burgeoning treatment modality, it is surprising that so few therapists use computers and other related technology in the administration of therapy. One national study of a random sample of therapists accredited with the British Association for Behavioural and Cognitive Psychotherapies (the lead organization for CBT in the UK) found that only 2.4% of their sample were using

Summary and conclusions

Whereas the results of these studies suggest promise of technology-based treatment, they are limited by various methodological problems. Very few studies included any follow-up assessments, thereby limiting our knowledge about the long-term effects of these treatments. Further, very few studies examined whether the technology-based treatment led to clinically significant change or even whether clients met diagnostic criteria for the treated disorder at post-therapy. This severely limits

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