Evaluating the effectiveness of an online self-directed intervention for problem gambling

Abstract

It has been estimated that close to a million Australians engage with a gambling activity at least weekly, with close to a quarter being classified as problem gamblers. Unfortunately, traditional face-to-face therapies for problem gambling are underutilized suggesting they may not meet the needs of a proportion of individuals with gambling-related problems. The evolution of Internet communication systems has fostered potential treatment mediums, including Internet-based therapy. Internet-based therapy involves the delivery of treatment programs via the Internet, and can be provided in conjunction with clinician assistance. Past literature suggests that Internet-based interventions have resulted in positive treatment outcomes for numerous psychological disorders. The current thesis reviewed evidence for the efficacy of Internet-based therapy and conducted an RCT comparing two interventions; a online self-directed intervention for problem gamblers, with and without the addition of a one-off motivational interviewing (MI) telephone call. Randomly allocated participants (N = 126) were provided access to an online self-directed program, based on CBT and MI principles, for a duration of 6 weeks, and were followed up on 4 separate occasions (immediately post-treatment, 1-, 3- and 6-month follow-up). There was a significant reduction in gambling symptomology at post-treatment for both groups, with those in the iCBT + MI group producing superior outcomes compared to the iCBT-alone group, at post-treatment, with effects deteriorating at follow-up. The proposed study was the first empirical evaluation of using an online self-directed program for problem gambling in Australia and preliminary findings suggest that this can be seen as an advantageous treatment option to target this clinical population. Nonetheless, it is imperative that this Internet-based treatment program be tested in a second RCT against waitlist controls, in order to further establish its efficacy.