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Systematic Review
What is the clinical effectiveness of e-therapy for the treatment of patients with substance use disorders and other addictions?
Evidence on e-therapy for the treatment of substance use disorders and other addictions was from a small number of systematic reviews (SRs) and randomized controlled trials (RCTs). Findings consistently showed that therapist-guided e-therapy was superior to no treatment and wait list in reducing alcohol consumption or cannabis use, and the effect was small. Therapist-guided e-therapy was found to be equivalent to no treatment and wait list for patients with gambling addiction. With respect to substances, evidence was limited to the treatment of problematic alcohol and cannabis use and it is therefore unclear if the results generalize to the misuse of other substances. The evidence on gambling was limited to those who participated in online video poker.
Evidence on therapist-guided e-therapy for the treatment of adults with substance use disorders was based on a small number of SRs and RCTs. The accuracy of estimates from SRs was affected by the heterogeneity in the e-therapy treatments, lack of details on the components of e-therapy strategies, and undetermined amount and type of therapist support (e.g., telephone, email). Together with the lack of details on synchronicity of therapist contact in the included SRs, this is a major limitation that affects the precision of the findings. In most studies, the use of a waitlist as a comparator instead of an active treatment comparator might have led to an overestimate of the treatment effect of etherapy. Since the included studies either did not include or did not perform subgroup analyses based on a military, paramilitary, or veteran population, the generalizability to this population is unclear. Additionally, it is unclear whether the results of the studies generalize to a population using substances other than cannabis or alcohol, as they were the only substances examined in the included studies.