Table 6 Certainty in evidence (GRADE) for psychosocial interventions
| Â | Â | Psychosocial interventions | Cognitive behavioural therapy | Contingency management | Community reinforcement | Motivational interviewing | Family-oriented approach | Mentoring | Coping skills | Cue exposure | Implementation intentions | Home visit | Controlled drinking |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Risk of bias | Meta-analyses (AMSTAR) | Very low | Moderate | Low | Moderate | Adolescent moderate; others low | High | Low | Low | Low | Moderate | Moderate | High |
RCTs | NR | High | High | High | High | NR | Low | Very low | Very high | Low | High | Low | |
Inconsistency | Meta-analyses | Not consistent | Incomparable (population, time) | Consistent | NA (single study) | Adolescent consistent; others not | NA (single study) | NA (single study) | NA (single study) | NA (single study) | NA (single study) | Consistent | NA (single study) |
Heterogeneity of RCTs | High | Moderate | High | NR | Moderate adolescent, NR others | Very high | Low | NR | Moderate-high | Low | Low | Very low | |
Indirectness | AUD and emerging adults only | Moderately applicable | Applicable | Limited applicability | Applicable | Under 18Â years only | Under 18Â years only | Applicable (AUD) | Applicable (AUD) | Applicable | AUD and pregnant women | Applicable (AUD) | |
Imprecision | Confidence interval | Moderate | Wide | Very wide | Wide | Moderate | Mixed | Small | Very wide | Moderate | Small | Very wide | Very wide |
Sample size | Less than 100 | Hundreds | Less than 100 | Hundreds | Adolescents thousands; others NR | Hundreds | Thousands | Less than 100 (intervention) | Less than 100 | Thousands | Hundreds | Less than 100 | |
Small study effect (number of studies) | NR | NR | NR | No (2) | No (3), NR (3) | No (1) | NR (2) | NR (1) | Yes (1) | No (1) | NR (2) | No (1) | |
Other | NA | NA | NA | Large effect, long-term | Sub-group differences; short timeframe | NA | Long-term | NA | NA | Short timeframe | NA | Long-term | |
Overall | Very low | Very low | Very low | Low | Adolescents—moderate; others—very low | Very low | Moderate | Very low | Very low | Moderate | Very low | Low | |