Contingency Management as an Adjunct Treatment for Rural and Remote Disordered Gamblers

Piloting the Addition of Contingency Management to Best Practice Counselling as an Adjunct Treatment for Rural and Remote Disordered Gamblers

The purpose of this project is to pilot contingency management as an adjunct treatment to counselling as usual using internet delivered video-conferencing applications for remote disordered gamblers. This project further investigates the impact of adding contingency management to counselling to improve counselling attendance and retention and uses internet-delivered approaches to assist rural and remote disordered gamblers gain access to counselling treatments.

Study Overview

• Status: Recruiting
• Conditions: Gambling Disorder
• Intervention / Treatment: Behavioral: Contingency Management; Behavioral: Cognitive Behavioural Therapy

Detailed Description

The chosen methodology is a randomised clinical trial where participants are allocated into one of two conditions; Contingency Management and Cognitive Behavioural Therapy (CM+), or Cognitive Behavioural Therapy alone (CBT) for the treatment of disordered gambling. Participants will experience a battery of tests pre- and post-treatment examining clinical, psychological, and behavioural issues, including co-morbid substance use. Alberta Rural Development Network (ARDN) affiliates will be provided with information regarding how participants can access the Qualtrics study site (e.g., an on-line survey hosting company) and will be individually directed to the study site by the principal investigator to complete the consent form and the base-line assessments. Counselling will be provided free of charge using Skype or Facetime video-conferencing internet applications. Participation in each condition will last 14 weeks: 12 weeks for treatment, and 2 weeks of assessments (one week prior to treatment and one week post treatment). Pre-treatment assessments (including demographic information) will take approximately 30-45 minutes, as will the post-treatment assessments. The progress check-ups by the Principal Investigator will take 5 to 10 minutes. A subset of treatment seekers, counsellors, and community/project stakeholders (e.g., ARDN affiliates) will also be chosen to participate in qualitative interviews to explore their experiences as well as their perceptions regarding the utility of the program for residents of rural and remote areas. The qualitative interviews will take approximately 30-60 minutes.

• Study Type: Interventional
• Enrollment (Estimated): 54
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Darren R Christensen, PhD; Phone Number: 403-329-5124; Email: darren.christensen@uleth.ca
• Study Contact Backup: Name: Chad Witcher, PhD; Phone Number: 403-332-4439; Email: chad.witcher@uleth.ca

Study Locations

• Canada
  • Alberta
    • Lethbridge, Alberta, Canada, T1K 3M4
      • Recruiting
      • University of Lethbridge
      • Contact: Chad Witcher, PhD; Phone Number: 403-332-4439; Email: chad.witcher@uleth.ca
      • Contact: Darren R Christensen, PhD; Phone Number: 4033295124; Email: darren.christensen@uleth.ca

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 70 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• capable of providing written consent,
• received a diagnosis of gambling disorder (American Psychiatric Association, 2013),
• gambled within the last month,
• live in a rural or remote location, and
• speak English

Exclusion Criteria:

• Medically unmanaged psychiatric or neurological disorder(s) except for disordered gambling

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Contingency Management; This is a treatment where participants earn points for treatment attendance and for providing evidence of gambling abstinence. These points are added to study accounts that can be redeemed for goods and services available at a variety of on-line businesses (e.g., Amazon, Walmart, etc.). Submission of evidence of gambling behaviour or non-attendance at an on-line counselling session re-sets subsequent points to the starting level. The CM procedure is implemented as part of the CBT counselling session.	Behavioral: Contingency Management; In addition to Cognitive Behavioural Therapy, this intervention uses small incentives to reinforce study attendance and gambling abstinence.
Active Comparator: Cognitive Behavioural Therapy; CBT is currently considered "best practice" for the treatment of problem gambling, as noted in the National Health and Medical Research Council (Australia) endorsed Clinical Guidelines for problem and pathological gambling treatment (Problem Gambling Research and Treatment Centre, 2011). CBT is typically a semi-structured approach for delivering cognitive behavioural therapy addressing the participant's experiences, thoughts, and emotions relating to their gambling and substance use. Techniques include psychoeducation, behavioural interventions, and cognitive strategies. Participants are expected to attend on-line counselling sessions three times a week for approximately 12 weeks. All participants will receive individual counselling from an experienced counsellor/therapist.	Behavioral: Cognitive Behavioural Therapy; This intervention uses psychoeducation, behavioural strategies, and cognitive restructuring to assist the participant in their efforts to become abstinent from gambling.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Gambling Abstinence	The total number of sessions that a participant provided evidence of gambling abstinence in the study	12 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Session Attendance	The total number of sessions that a participant attended the study	12-weeks
Study Retention	The total number of weeks that a participant attended the study	12-weeks

Collaborators and Investigators

• Sponsor: University of Lethbridge
• Collaborators: Rural Development Network
• Investigators: Principal Investigator: Darren R Christensen, PhD, University of Lethbridge

Publications and helpful links

General Publications

• Christensen DR, Witcher CSG, Leighton T, Hudson-Breen R, Ofori-Dei S. Piloting the addition of contingency management to best practice counselling as an adjunct treatment for rural and remote disordered gamblers: study protocol. BMJ Open. 2018 Apr 3;8(4):e018804. doi: 10.1136/bmjopen-2017-018804.

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2016
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: November 1, 2016
• First Submitted That Met QC Criteria: November 2, 2016
• First Posted (Estimated): November 3, 2016

Study Record Updates

• Last Update Posted (Actual): May 11, 2026
• Last Update Submitted That Met QC Criteria: May 6, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Contingency Management; Internet; Rural; Gambling Disorder
• Additional Relevant MeSH Terms: Mental Disorders; Disruptive, Impulse Control, and Conduct Disorders; Behavior; Risk-Taking; Gambling; Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities; Cognitive Behavioral Therapy
• Other Study ID Numbers: 2016-080

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Only the research team will have access to the individual participant data