A self-guided Internet-based intervention for individuals with gambling problems: study protocol for a randomized controlled trial

Lara Bücker, Stefan Westermann, Simone Kühn, Steffen Moritz, Lara Bücker, Stefan Westermann, Simone Kühn, Steffen Moritz

Abstract

Background: Only a small fraction of individuals with pathological or problematic gambling seek professional help despite available evidence-based treatments such as cognitive behavioral therapy (CBT). Anonymous Internet-based interventions may help to overcome treatment barriers. Results of a pilot study using an Internet-based intervention for depression in a sample of individuals with problematic or pathological gambling behavior show that both depressive and gambling-related symptomatology can be reduced with a generic depression program compared with a wait-list control group. Based on encouraging results of the pilot study, we developed a low-threshold, anonymous and cost-free online self-help program ("Restart") to test whether a program tailored to the needs of gamblers yields better results compared to the effects of the intervention evaluated in the pilot study. The online self-help program is based on CBT, targeting emotional problems and gambling-related symptoms and is accompanied by a smartphone application to sustain treatment benefits.

Method: A randomized controlled trial with two conditions (intervention group and wait-list control group), two assessment times (reassessment after 8 weeks) and a total of 136 participants is planned. The primary outcome will be change in pathological gambling measured with the Pathological Gambling Adaptation of Yale-Brown Obsessive-Compulsive Scale from pre to post intervention. The change in depressive symptoms (assessed with the Patient Health Questionnaire - 9 depression module) and gambling-related dysfunctional thoughts (assessed with the Gambling Attitudes and Beliefs Survey) will represent secondary outcomes. The intervention includes modules on debt management, impulse control, gambling-specific cognitive biases, self-esteem, social competence, sleep hygiene, mindfulness and positive activities.

Discussion: This study is one of the first investigations of Internet-based self-help programs in a sample of problematic gamblers. Self-guided Internet-based interventions represent a promising possibility to narrow the existing treatment gap while saving expensive and scarce resources (e.g., psychotherapists). The expected findings will add substantial knowledge in the development of effective Internet-based treatments for individuals with gambling problems. The empirical and clinical implications (e.g., broader use and promotion of such interventions in the future) and the limitations of the study will be discussed.

Trial registration: ClinicalTrials.gov, NCT03372226 . Registered on 13 December 2017.

Keywords: CBT; Internet-based self-help; Online intervention; Pathological gambling; Problematic gambling.

Conflict of interest statement

Ethics approval and consent to participate

The study has been approved by the German Society for Psychology (DGPs) (ID: SM 092017_amd_012014_2b). Electronic informed consent to participate in the study is being obtained from every participant.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Standard protocol items: recommendation for interventional trials (SPIRIT) timeline. PG-YBOCS, Pathological Gambling Adaption of Yale-Brown Obsessive-Compulsive Scale; SOGS, South Oaks Gambling Screen; PHQ-9, Patient Health Questionnaire-9; GABS, Gambling Attitudes and Beliefs Survey; WSQ, Web Screening Questionnaire

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