Evaluation of additional resources and stories within therapist-assisted internet-delivered cognitive behaviour therapy for alcohol misuse
Why this work is in the frame
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Bibliographic record
Abstract
Additional resources and stories are sometimes incorporated into Internet-delivered cognitive behaviour therapy (ICBT) for alcohol misuse to enhance treatment. Little is known, however, about how patients use and evaluate additional resources and stories, and how use and evaluation of additional resources and stories relates to satisfaction and outcomes. We examined patient use and evaluation of 8 additional resources and 8 stories among 121 patients who endorsed significant alcohol misuse and were enrolled in a 6-lesson ICBT course for alcohol misuse enhanced with additional resources and stories. The additional resources addressed anger, assertiveness and communication, cannabis use, cognitive coping, grief, PTSD, sleep, and worry. Stories varied by gender, ethnicity, occupation, and severity of alcohol problems. Primary drinking outcomes included the Timeline Follow-Back (TLFB) and heavy drinking days (HDD). Diverse secondary outcomes (e.g., depression, anxiety, cravings, anger, satisfaction) were also assessed. Large within-group effects for TLFB and HDD were found. Large effects were also observed for depression and cravings, with high treatment satisfaction. 63 % of patients accessed at least one resource ( M = 2.27 resources), with anger (35 %), cognitive coping (35 %), sleep (34 %) and worry (30 %) being the most used. When accessed, patients found resources informative and/or helpful to varying degrees (25–67 %). In terms of stories, 85 % of patients indicated they read the stories, and 89 % of those found them worthwhile; 65 % felt less alone and 55 % found they gave them skills to improve wellbeing. Increased use and positive ratings of additional resources were not significantly related to outcomes or satisfaction. However, positive ratings of stories were associated with confidence in managing symptoms and an interest in future treatment. Additionally, reading stories was associated with larger improvements on several secondary outcomes, including PTSD, anger, insomnia, and work and social adjustment. The findings suggest that adding resources and stories to ICBT is acceptable and worthwhile. A significant number of patients reviewed these materials and found them informative and/or helpful, which suggests it is likely valuable to retain these resources for those in need. Reading stories and positive ratings of stories, rather than use and positive ratings of additional resources, was associated with increased satisfaction and some larger improvements on secondary outcomes. Further research is warranted to identify strategies that will more effectively engage patients with additional resources tailored to their specific needs. • Additional resources and stories were examined in an ICBT course for alcohol misuse. • Resources on anger, cognitive coping, sleep, and worry were used the most. • Most patients read the stories and were satisfied with them. • Large improvements in alcohol use, depression, and cravings. • Adding treatment components was not detrimental to outcomes.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.008 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it