Randomized controlled trial of an Internet intervention for problem gambling provided with or without access to an Internet intervention for co-occurring mental health distress

Abstract

Background and aimsThe current randomized controlled trial tested whether there was benefit to providing an online gambling intervention and a separate self-help mental health intervention for anxiety and depression (i.e. MoodGYM) (G + MH), compared to only a gambling intervention (G only) among people with co-occurring gambling problems and mental health distress. The primary outcome of interest was improvement in gambling outcomes. Secondary analyses also tested for the impact of the combined intervention on depression and anxiety outcomes.MethodsParticipants who were concerned about their gambling were recruited to help evaluate an online intervention for gamblers. Those who met criteria for problem gambling were randomized to receive either the G only or the G + MH intervention. Participants were also assessed for current mental health distress at baseline, with three quarters (n = 214) reporting significant current distress and form the sample for this study. Participants were followed-up at 3- and 6-months to assess changes in gambling status, and improvements in depression and anxiety.ResultsFollow-up rates were poor (47% completed at least one follow-up). While there were significant reductions in gambling outcomes, as well as on measures of current depression and anxiety, there was no significant difference in outcomes between participants receiving the G only versus the G + MH intervention.Discussion and conclusionThere does not appear to be a benefit to providing access to an additional online mental health intervention to our online gambling intervention, at least among participants who are concerned about their gambling.Trial registration: ClinicalTrials.govNCT02800096; Registration date: June 14, 2016.

GamblingLess: A Randomised Trial Comparing Guided and Unguided Internet-Based Gambling Interventions

“…This pattern of results was replicated when using ITT analyses and after controlling for other help-seeking. These findings are consistent with previous promising results resulting from other PSD internet-based therapeutic interventions for gambling [ 30 , 31 , 32 , 33 , 34 ]. Moreover, almost 70% of participants reported recovery or improvement on gambling symptom severity at the 24 month evaluation period.…”

“…Almost all participants were classified in the problem gambling category of the PGSI. This demographic and gambling profile is consistent with that reported in previous studies evaluating internet-based therapeutic interventions [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ] and is very similar to gamblers using the national online gambling service [ 43 , 44 ]. These findings may indicate that young males are attracted to online modalities, in preferences to other service modalities, such as face-to-face counselling.…”

“…Despite evidence of their efficacy in other fields, there is a paucity of research investigating the effectiveness of internet-based therapeutic interventions for the treatment of problem gambling. A limited number of recent randomised trials have, however, found that PSD iCBT for problem gambling is effective in improving gambling and psychological outcomes up to 12 months following treatment [ 29 , 30 , 31 , 32 , 33 , 34 ], although some have found no differences compared to a no intervention control group [ 31 ] or brief online personalised feedback [ 34 ]. Moreover, adding a separate mental health [ 33 ] or alcohol use intervention [ 32 ] to iCBT has not improved outcomes.…”

Developing and testing the effectiveness of a novel online integrated treatment for problem gambling and tobacco smoking: a protocol for an open-label randomized controlled trial

“…Numerous articles support the efficacy of these CBT/MI strategies for the treatment of problem gambling, tobacco use, and addictive behaviours more broadly [17,55]. In the gambling literature, approaches aimed at targeting both problem gambling and alcohol use [56] or mental health difficulties [57] were shown to have no significant difference in outcomes between the separate and integrated treatment interventions; however, a limitation to both trials relied on a more sequential approach to treatment and lacked a stronger integrated component. Given CBT/MI's emphasis on general coping skill development, we posit that it is an ideal framework for an integrated intervention for co-occurring problem gambling and tobacco use.…”

Developing and Testing the Effectiveness of a Novel Online Integrated Treatment for Problem Gambling and Tobacco Smoking: A Protocol for an Open Label Randomized Controlled Trial

“…Numerous articles support the e cacy of these CBT/MI strategies for the treatment of problem gambling, tobacco use, and addictive behaviours more broadly. 17,55 In the gambling literature, approaches aimed at targeting both problem gambling and alcohol use 56 or mental health di culties 57 were shown to have no signi cant difference in outcomes between the separate and integrated treatment interventions; however, a limitation to both trials relied on a more sequential approach to treatment and lacked a stronger integrated component. Given CBT/MI's emphasis on general coping skill development, we posit that it is an ideal framework for an integrated intervention for co-occurring problem gambling and tobacco use.…”