Acceptability of cognitive-behaviour therapy via the Internet for cessation of benzodiazepine use

Long-term use of benzodiazepines remains common, and conveys significant risk. Providing psychological intervention in association with gradual dose reduction increases cessation rates above dose reduction alone, but appropriate psychological support is difficult to obtain. This study was undertaken to assess the outcomes of an uncontrolled case series of an Internet-based cognitive-behaviour therapy for benzodiazepine cessation.

Users of benzodiazepines for >3 months who wanted to reduce or cease benzodiazepines participated in the trial. They completed online assessments and accessed 13 newsletters on managing withdrawal symptoms and developing alternate ways to cope with life events. Therapist assistance was provided by email. Follow up was at 3 and 6 months and feedback was obtained via comments and emails.

Program ratings and emailed comments of the program were positive. Thirty-two people registered for the program and 14 (44%) completed a 6 month follow up. Of these, eight (57%) reduced weekly intake by at least half, including five (36%) who ceased use. Shorter duration of use and birth outside Australia predicted greater percentage reductions at 3 months, while being living with a partner and being in paid employment predicted reductions at 6 months.

While results were encouraging, controlled research is required to confirm the efficacy of the program, and engagement of both users and prescribers needs further attention.