Internet-based interventions for problem gambling: Scoping review [open access article]

Background: This study seeks to give an overview of academic research on internet-based interventions that are used to address problem gambling. The rate of treatment seeking has been demonstrated to be low across several research environments. This is in part because of the systemic barriers that treatment seekers face to accessing traditional face-to-face treatment. Making treatment resources for problem gambling available through the internet is one way to reduce the impact of those systemic barriers. The use of internet-based resources to address problem gambling has been growing, and a field of research evaluating it has developed as well. However, little has been done to summarize this collection of research. Access full article

Citation: Van der Maas, M., Shi, J., Elton-Marshall, T., Hodgins, D. C., Sanchez, S., Lobo, D. S., Hagopian, S., Turner, N. E. (2019). JMIR Mental Health, 6(1), e65. DOI: 10.2196/mental.9419

 

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Can a brief telephone intervention for problem gambling help to reduce co-existing depression? A three-year prospective study in New Zealand [subscription access article]

Ranta, J., Bellringer, M., Garrett, N. et al. (2018). Journal of Gambling Studies. Retrieved from link.springer.com/article/10.1007/s10899-018-9783-x

Abstract: Problematic gambling and depression commonly co-exist, with limited research indicating that depression and/or psychological distress appear to reduce with brief interventions for problem gambling. The present study was designed to examine the effect, over 36 months, of a brief problem gambling intervention on depression in a population of people seeking help for gambling issues. One-hundred and thirty-one participants were recruited from adult (18+ years) gambler callers to the New Zealand national gambling helpline. They received a manualised version of the helpline’s brief intervention, and were assessed at baseline, 12 and 36 months. Overall, problem gambling severity reduced from a score of 17 (using the Problem Gambling Severity Index) at baseline to a score of 7.5 at 36 months. The percentage of participants with depression reduced from 74% at baseline to 41% at 36 months. For both problem gambling and depression, the greatest reduction was in the first 12 months. Multiple logistic regression analyses at baseline showed an association between problem gambling and depression. Repeated measures logistic regression indicated that reduced problem gambling severity reduced depression and that there was no independent time effect taking place (i.e. the decreased depression was not due to natural recovery). Thus a single brief telephone intervention for problem gambling substantially reduced the prevalence of depression. This has clinical and public health implications with a benefit being that people with depression and co-existing gambling problems may not necessarily need additional treatment for depression if they receive treatment for their gambling issues. View article details, references and access options

Therapist-delivered and self-help interventions for gambling problems: A review of contents (open access article)

Simone Rodda, Stephanie S. Merkouris, Charles Abraham, David C. Hodgins, Sean Cowlishaw & Nicki A. Dowling. (2018). Journal of Behavioral Addictions
doi: 10.1556/2006.7.2018.44

Abstract: Background and aims
To date, no systematic approach to identifying the content and characteristics of psychological interventions used to reduce gambling or problem gambling has been developed. This study aimed to develop a reliable classification system capable of identifying intervention characteristics that could, potentially, account for greater or lesser effectiveness.

Discussion: This research provides a tool that allows systematic identification of intervention characteristics, thereby enabling consideration, not only of whether interventions are effective or not, but also of which domain-relevant characteristics account for greater or lesser effectiveness. The taxonomy also facilitates standardized description of intervention content in a field in which many diverse interventions have been evaluated.

Conclusion: Application of this coding tool has the potential to accelerate the development of more efficient and effective therapist-delivered and self-directed interventions to reduce gambling problems. Full article

Player Behavioral Tracking and Personalized Feedback in Online Gambling: Implications for Prevention and Treatment of Problem Gambling (full text)

Edgerton, J. D., Biegun, J., & Roberts, L. W.

In recent years, participation in online gambling has been growing at a significant rate, as have concerns over its connection to problem gambling. The relationship between online access and problem gambling is complex. On one hand the nature of online gambling appears to invite potential for problematic gambling; on the other hand it is also well-suited to the incorporation of sophisticated RG tools that can help prevent excessive gambling. This article provides a brief overview of research on the efficacy of several increasingly available RG tools – limit-setting, in game “pop-up” messages and player behavioral tracking and personalized feedback – and the potential of these tools, used in concert, to increase gambler’s self-awareness and self-monitoring to reduce risk across a broad spectrum of gambling involvement. In addition to weighing the growing evidence for the preventative utility of such RG strategies, we also consider the burgeoning interest in their therapeutic/clinical potential, both as part of self-guided or therapist-assisted online interventions and as adjunct to conventional in-person clinical services. We conclude that, limitations notwithstanding, the evidence for online RG tools that incorporate player behavioral tracking and personalized feedback is quite encouraging when it comes to reducing problem gambling risk; and that, although less far along, research on the treatment potential of interventions incorporating such technology is also promising and merits further study.

Latest Developments in Treatment for Disordered Gambling: Review and Critical Evaluation of Outcome Studies – Open Access

Yakovenko, I., & Hodgins, D. C.

Purpose of review: Over the last decade, treatments for disordered gambling have developed rapidly. The goal of this paper is to review and to critically evaluate the literature published on the treatment of disordered gambling in the past 3 years. Important findings are emphasized and accompanied by the authors’ personal observations on controversial results or hypotheses of interest. Recent findings: Cognitive-behavioral interventions have been evaluated in treatment of Hong Kong Chinese individuals as well as in combination with mindfulness-based approaches. Personalized-feedback interventions have received increased attention, with brief treatments demonstrating overall efficacy. Pharmacological treatments continue to receive only limited support. On the other hand, web-based treatments appear to show promise. Summary: Cognitive-behavioral and brief treatments remain the most empirically supported approaches, but new inventive combinations of treatments such as web-based therapies are emerging. Future research could benefit from diversification of types of treatments evaluated as well as an examination of what is considered “evidence-based.”

Yakovenko, I., & Hodgins, D. C. (2016). Latest Developments in Treatment for Disordered Gambling: Review and Critical Evaluation of Outcome Studies. Current Addiction Reports, 1–8. http://doi.org/10.1007/s40429-016-0110-2

Practical Treatments Considering the Role of Sociocultural Factors on Problem Gambling

Reviews of problem gambling (PG) literature increasingly recognize the ways in which different ethnic groups are affected by gambling behaviors, yet discourse, which considers sociocultural factors within PG, remains limited. Literature on this topic is influenced by large inconsistencies amongst research studies, overlapping terminology, and variability in the validity of research studies, making conclusions difficult to draw. Despite these discrepancies, this paper explores how sociocultural factors influence PG among diverse cultural groups and provides specific practical implications for treating PG disorders in culturally diverse populations. Notable factors that exacerbate PG behavior cross-culturally include substance abuse, low socioeconomic status, lack of social activities, and geographic location. Culturally sensitive treatment options such as Motivational Interviewing and Cognitive Behavioral Therapy have been identified as effective treatments for PG with culturally diverse populations. This paper extends current thought by providing practical treatment recommendations that consider the subtle nuances of diverse populations. It explains how treatment providers and behavioral addiction professionals can increase their understanding and skills when conceptualizing PG clients from a diverse background.

Treating Problem Gambling Samples with Cognitive Behavioural Therapy and Mindfulness-Based Interventions: A Clinical Trial

The problem gambling (PG) intervention literature is characterised by a variety of psychological treatments and approaches, with varying levels of evidence (PGRTC in Guideline for screening, assessment and treatment in problem and pathological gambling. Monash University, Melbourne, 2011). A recent PG systematic review (Maynard et al. in Res Soc Work Pract, 2015. doi:10.1177/1049731515606977) and the success of mindfulness-based interventions to effectively treat disorders commonly comorbid with PG suggested mindfulness-based interventions may be effective for treating PG. The current study tested the effectiveness of three interventions to treat PGs: 1. case formulation driven Cognitive Behaviour Therapy (CBT); 2. manualised CBT; and 3. mindfulness-based treatment. All three interventions tested returned large effect size improvements in PG behaviour after seven sessions (Cohen’s d range 1.46–2.01), at post-treatment and at 3 and 6-month follow-up. All of the interventions were rated as acceptable by participants at post-treatment. This study suggests that the mindfulness-based and TAU interventions used in the current study appear to be effective at reducing PG behavior and associated distress and they also appear to generalise to improvements in other measures such as quality of life-mental functioning and certain mindfulness facets more effectively than the manualised form of CBT utilised used here. Secondly, a brief mindfulness intervention delivered after psycho-education and a brief CBT intervention may be a useful supplement to traditional CBT treatments by addressing transdiagnostic processes such as rumination and thought suppression. Thirdly, CBT interventions continue to report effectiveness in reducing PG behaviour and associated distress consistent with the prevailing literature and clinical direction.