Introducing internet-delivered cognitive behavioral therapy for problematic alcohol use within an employee assistance program: perspectives of employees, employers and assessment psychologists

Abstract Background Employee assistance programs (EAP’s) are resources where employers can receive help when encountering substance abuse among their employees. Such help often entails in-person counselling delivered within the EAP. Internet-delivered cognitive behavior therapy (ICBT), shown to have a robust evidence base and currently being implemented in various health care settings, could potentially serve as an alternative to in-person counselling in EAP’s. However, until now, no studies have investigated ICBT in an EAP context. Methods The present qualitative study examined experiences of therapist-guided ICBT for employees with problematic alcohol use delivered within an EAP in Sweden. Interviews were conducted with the employees receiving the ICBT ( n = 7), with each employee’s employer representative ( n = 6), and with psychologists ( n = 3) involved in the recruitment and referral of employees to ICBT. The interviews were analyzed for each of these three categories (employees, employer representatives, psychologists) using thematic analysis. Results Most employees found ICBT useful and reported that their awareness of the negative consequences of excessive drinking had increased during treatment, in parallel with acquisition of tools to reduce their alcohol consumption. Perceived advantages included ICBT anonymity and flexibility, as well as the therapist guidance provided. Although employer representatives expressed some initial skepticism towards using the online delivery format to address alcohol problems, they mainly found ICBT beneficial. The psychologists appeared hesitant to recruit employees to ICBT as they either deemed alcohol problems of employees to be too severe for ICBT or stated that employees had psychiatric comorbidity leading to more complex needs. Conclusions ICBT for problematic alcohol use appeared beneficial for employees when delivered within an EAP. However, there was initial skepticism among employer representatives and psychologists were hesitant to recommend ICBT. Clinical trials registration NCT06774716, 2022-05-10.