Avoid alcohol training in treatment for problem drinkers

The aim of the study is to examine the effectiveness of CBM Avoid Alcohol training as an adjunct to a cognitive behavioral treatment (TAU) in an outpatient treatment setting. The TAU consists of a structured, online CBT program in which the participant and the therapist communicate asynchronously, via the Internet only or a face-to-face CBT group or individual therapy. A treatment regarding CBM Avoid Alcohol training is added to the TAU. Patients will be randomised to a CBM Avoid Alcohol training or to a CBM placebo training. All participants receive pictures of alcoholic beverages and soda drinks, that are tilted to the left or right. They are instructed to approach one type of tilt (e.g., tilted left) by pushing a certain key (and the picture grows bigger) and avoid the other type of tilt (e.g., tilted right) by another key (and the picture shrinks). Participants in the experimental group (AAT-training) avoid alcoholic pictures and approach soda drinks, while participants in the control group (placebo training) approach and avoid those pictures equally often.

1. A higher percentage of participants reaching the guidelines for low risk drinking in the AAT training condition compared to those in the AAT placebo condition.

2. Improvement of health status and depression, anxiety and stress symptoms in participants in the AAT training condition compared to those in the placebo condition.

3.The added effect on treatment outcome is mediated by a change in approach bias.

- Intake procedure Treatment as usual (demographic characteristics, TLFB, MAP-HSS, DASS-21, 5-items OCDS, CIDI)

- Pre-assessment training (TLFB, VAS, DMQ-r, Drinking refusal self-efficacy, AAT)

- Post- assessment training (TLFB, VAS, AAT and CSQ)

- Posttest and follow-up Treatment as usual (TLFB, MAP-HSS, DASS-21, 5-items OCDS)

The CBM training will start simultaneously with the goal setting assignment in the TAU (web-based treatment or face-to face treatment for alcohol abuse).

The training consists of a pre- and postassessment and 8 training sessions.

Condition 1: TAU + AAT training

Condition 2: TAU + placebo AAT