Nonuse of Blended Web-Based and Face-To-Face Cognitive Behavioral Therapy for Alcohol Use Disorder: Qualitative Study

Area of Science:

• Digital Health
• Mental Health Interventions
• Behavioral Science

Background:

• Social studies on digital health often focus on the digital divide, assuming non-use stems from lack of access.
• In Denmark, high internet and computer access suggest non-use of digital health tools is not due to access limitations.
• Previous research on internet-based alcohol use disorder (AUD) treatment has not explored reasons for preferring face-to-face over blended formats.

Purpose of the Study:

• To investigate why patients with AUD do not use blended face-to-face and internet-based cognitive behavioral therapy (bCBT).
• To explore patient-identified reasons for preferring traditional face-to-face treatment over bCBT for AUD.

Main Methods:

• Qualitative study involving 11 Danish AUD patients who opted out of bCBT.
• Individual, semistructured interviews conducted via cell phone.
• Thematic analysis of transcribed interviews to identify reasons for non-use.

Main Results:

• Reasons for preferring face-to-face treatment were primarily personal, not related to digital health literacy.
• Key themes included the need for in-person sessions, preference for verbal communication, desire for immediate feedback, and feeling more empowered in face-to-face settings.
• Participants perceived bCBT as impersonal, preferring direct therapist interaction with non-verbal cues.

Conclusions:

• Personal factors significantly influence the choice between face-to-face and blended AUD treatment.
• Designing digital health interventions requires considering patient preferences for personal connection and direct communication.
• The impersonal nature of bCBT and the value placed on non-verbal communication are critical factors for AUD patients.