Published: 14-09-2020 10:24 | Updated: 28-09-2020 13:25

Web-based CBT effective for alcohol use disorder

While alcohol dependency is becoming increasingly common, it is difficult to obtain help. However, new research presented in a doctoral thesis by Magnus Johansson at Karolinska Institutet shows that web-based CBT is no less effective than face-to-face CBT.

“My research shows that web-based CBT for alcohol use disorder is just as effective as more traditional, face-to-face CBT, which means that more people can get help for their dependence irrespective of other people’s reactions, distance, time and other hindrances,” says Magnus Johansson, doctoral student at the Department of Global Public Health, Karolinska Institutet.  

Alcohol problems are common in the western world today, and in Sweden an estimated 13 per cent of men and 9 per cent of women drink more than the recommended weekly maximum of 14 and 9 small glasses of wine respectively.  

Help is hard to get

Magnus Johansson writes in his thesis “Treating Alcohol Use Disorder on the Internet” that many people need and want help to overcome their alcohol problem but find it difficult to seek help. The social stigma attached to dependence deter many from approaching a specialised clinic out of fear of being recognised and due to the distances involved. For these and other reasons, only a fraction of those who meet the criteria for an alcohol use disorder diagnosis seek treatment.  

At the same time, there is a growing interest in finding information and advice on the Internet, where for the past few years online CBT (iCBT) has also been available.  

iCBT accessible to many

Magnus Johansson, doctoral student at the Department of Global Public Health, Karolinska Institutet. Photo: Emelie Stachwesky.

 In his doctoral thesis, Magnus Johansson has examined whether iCBT is an effective treatment option for people with alcohol use disorder. His thesis is based on four studies and compares, in part, the results of iCBT with those of traditional face-to-face CBT.  

His results are based on a total of 5,635 participants, just over half of whom were women. The mean age was 40. The participants were, on average, highly motivated towards changing their alcohol habits, and a majority of them showed clear signs of anxiety and depression alongside their alcohol dependence.

The results show that iCBT is just as efficacious as therapist-led face-to-face CBT.  

“New digital techniques open new possibilities for offering treatment on the patients’ terms,” says Johansson. “Now many more people can be reached and given the chance to rebuild their health and their relationships with family, friends and colleagues.”  


Web-based self-help for problematic alcohol use: a large naturalistic study,” Johansson, M., Sinadinovic, K., Hammarberg, A., Sundström, C., Hermansson, U., Andreasson, S., & Berman, A. H., International journal of behavioral medicine, 2017, doi: 10.1007/s12529-016-9618-z.

“Sort of a nice distance: a qualitative study of the experiences of therapists working with internet-based treatment of problematic substance use,” Ekström, V., Johansson, M., Addiction science & clinical practice, 2019, doi: 10.1186/s13722-019-0173-1.   

”Internet‐based therapy vs. face‐to‐face therapy for alcohol use disorder, a randomised controlled non‐inferiority trial”. Magnus Johansson, Kristina Sinadinovic, Mikael Gajecki, Philip Lindner, Anne H. Berman, Ulric Hermansson, and Sven Andreasson, Addiction science & clinical practice, online 24 September 2020, doi: 10.1111/add.15270.


Digital help for alcohol use disorder

Similar treatments to those tested in the thesis are now available at Beroendecentrum.

Anyone preferring to start with an anonymous self-help programme can visit the Alkoholhjälpen website.