ICBTG in Routine Care (iCBTG)

Implementation of Internet-based Cognitive Behavior Therapy for Problem Gambling in Routine Addiction Care: A Feasibility Study

Problem gambling (PG) is a major public health concern worldwide. As awareness of PG has risen, treatment demand is increasing, and internet interventions is a promising alternative for providing fast, evidence-based treatment at scale, to a low cost. This article presents the protocol of an open label, uncontrolled pilot and feasibility trial of a novel internet-delivered cognitive behavioral treatment, conducted in regular addiction care with adult treatment-seeking patients (max N=25) with problematic gambling. Weekly measures of gambling symptoms and gambling will serve as outcome measures. Study results will further guide the development of the intervention and its implementation into regular addiction care.

Study Overview

• Status: Completed
• Conditions: Gambling Disorder; Problem Gambling
• Intervention / Treatment: Behavioral: iCBT

• Study Type: Interventional
• Enrollment (Actual): 23
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Sweden
  • Stockholm, Sweden, 117 61
    • eStöd

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion criteria:

• being at least 18 years old
• living in Sweden
• being able to read and write Swedish.
• having a total score of >= 3 on the Problem Gambling Severity Index (PGSI; Ferris & Wynne, 2001)
• having the ability to work with online treatment material by themselves (with support from a therapist)

Exclusion criteria:

• fulfilling criteria for ongoing manic episode
• currently undergoing a parallel CBT treatment for Gambling Disorder or problem gambling.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: NA
• Interventional Model: SINGLE_GROUP
• Masking: NONE

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

EXPERIMENTAL: iCBT for Gambling Disorder; Treatment will consist of a 1+10 module internet delivered CBT program targeting problem gambling, newly developed. A bottom-up procedure was used to develop the treatment protocol, inspired by Clark's (2004) method for developing novel CBT treatments. We developed a clinical model delineating what factors contribute to the persistence of problem gambling behavior, and aligned these with targeted treatment interventions; based on behavioral upon research on the learning and maintenance processes of gambling behavior (Ramnerö et al, in press), theoretical models of gambling and comorbidity (Blaszczynski & Nower, 2002); as well as qualitative interviews with treatment seeking gamblers with or without comorbidity.

Behavioral: iCBT; A newly developed iCBT protocol targeting problem gambling.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Gambling Symptom Assessment Scale (G-SAS)	Gambling symptoms	Past 7 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Gambling Time Line Follow Back (TLFB-G)	Gambling behavior	Past 7 days
The 9-item Patient Health Questionnaire (PHQ-9	Depressive symptoms	Past 2 weeks
The 7-item Generalised Anxiety Disorder scale (GAD-7)	Anxiety symptoms	Past 2 weeks
The Alcohol Use Disorders Identification Test (AUDIT)	Alcohol use	Past 12 months
The Drug Use Disorders Identification Test (DUDIT)	Drug use	Past 12 months
the 26-item World Health Organization Quality of Life-BREF (WHOQOL-BREF)	Quality of life	Past 2 weeks

Collaborators and Investigators

• Sponsor: Karolinska Institutet
• Investigators: Study Chair: Philip H Lindner, PhD, Karolinska Institutet

Publications and helpful links

General Publications

• Molander O, Lindner P, Ramnero J, Bjureberg J, Carlbring P, Berman AH. Internet-based cognitive behavior therapy for problem gambling in routine care: protocol for a non-randomized pilot and feasibility trial. Pilot Feasibility Stud. 2020 Jul 21;6:106. doi: 10.1186/s40814-020-00647-5. eCollection 2020.

Study record dates

Study Major Dates

• Study Start (ACTUAL): October 4, 2019
• Primary Completion (ACTUAL): February 9, 2021
• Study Completion (ACTUAL): February 9, 2021

Study Registration Dates

• First Submitted: April 28, 2019
• First Submitted That Met QC Criteria: May 9, 2019
• First Posted (ACTUAL): May 10, 2019

Study Record Updates

• Last Update Posted (ACTUAL): January 3, 2022
• Last Update Submitted That Met QC Criteria: December 11, 2021
• Last Verified: December 1, 2021

More Information

Terms related to this study

• Keywords: Gambling Disorder; Cognitive-behavioral therapy; Psychiatric comorbidity; Problem gambling; Internet intervention; Regular addiction care
• Additional Relevant MeSH Terms: Mental Disorders; Disruptive, Impulse Control, and Conduct Disorders; Gambling
• Other Study ID Numbers: 2019-0428

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No