None listed
Conditions
Brief summary
The primary purpose of this study is to evaluate the relative effectiveness of two of the best developed and most promising forms of therapy for problem gambling, namely face-to-face motivational interviewing combined with a self-instruction booklet and follow-up telephone ‘booster’ sessions (MI+W+B) and face-to-face cognitive behaviour therapy (CBT). Other aims are: a) to evaluate how effective gambling-related post-treatment text messaging is in preventing relapse and sustaining treatment gains at 12 months; b) to look at how other common issues such as mental health problems change following therapy; c) Identify which, if either, of the interventions is more effective for a variety of client groups including Maori and Pacific ethnic groups, and groups identified by the severity of their problem; and c) Identify the relationship between changes in other possible factors affecting response to treatment (e.g. mental health issues and alcohol or drug use) and gambling and problem gambling. The primary hypothesis is that CBT participants will show greater clinically meaningful reductions in gambling and problem gambling than MI+W+B participants at 12 months. Secondary hypotheses include that: 1. CBT and MI+W+B will be equivalent with respect to reductions in gambling and problem gambling at three months. 2. Participants allocated to the post-treatment text messaging conditions, in both the CBT and MI+W+B groups, will show greater clinically meaningful reductions in gambling and problem gambling at 12 months than those in the non-text messaging condition. 3. CBT participants will have greater reductions in depression and anxiety than MI+W+B participants at 12 months.
Interventions
This project is a single blind pragmatic randomised clinical trial (RCT) of two psychological interventions for problem gambling, with and without the addition of text-message support.
The interventions comprise:
Face-to-face Cognitive Behavioural Therapy (CBT), using a balanced and flexible application of cognitive restructuring and graded imaginal and live cue-exposure. Participants will receive up to ten face-to-face CBT sessions over a 12 week period. The approximate duration of each CBT ses
This project is a single blind pragmatic randomised clinical trial (RCT) of two psychological interventions for problem gambling, with and without the addition of text-message support. The interventions comprise: Face-to-face Cognitive Behavioural Therapy (CBT), using a balanced and flexible application of cognitive restructuring and graded imaginal and live cue-exposure. Participants will receive up to ten face-to-face CBT sessions over a 12 week period. The approximate duration of each CBT session will be 60 to 90 minutes. The therapy incorporates imaginal and real-life cue-exposure to gambling triggers and habituation/urge extinction. It also includes interventions directed towards understanding randomness and erroneous beliefs, awareness of inaccurate perceptions, and cognitive correction to erroneous perceptions. Regular homework sessions will also take place, focusing both on behavioural and cognitive goals, and recorded in diaries. This will be discussed in face-to-face sessions and progress reinforced. Face-to-face Motivational Interviewing (MI) plus a cognitive behavioural self-instructional workbook (W) and follow-up telephone booster sessions (B). Participants will receive one face-to-face motivational interview session structured to encourage clients to build a commitment to change by emphasising the reasons why change is desirable. The approximate duration of The MI session will be 60 to 90 minutes. Interviews end with a summary of participants’ stated reasons for changing and specific therapeutic goals. Participants will be given a self-help workbook based on a cognitive–behavioral model of problem gambling and relapse prevention techniques. The content of the workbook includes the following sections: Self-assessment, goal setting, strategies, maintenance and other resources for additional support. In addition, they will receive five follow-up motivational booster telephone sessions of 10-15 minutes duration at approximately one, two, four, eight and 12 weeks. These sessions will focus on motivation of, and reinforcement for, behaviour change through the use of the workbook. The CBT and MI interventions will be delivered by specialised problem gambling counselors at a problem gambling service. Half of the participants in the MI condition and half in the CBT condition will also be allocated to receive weekly text messages (an average of two a week) from the 12 week assessment until the 12 month assessment. Message content will be influenced by messaging that has been effective in alcohol and smoking reduction/cessation programmes and the growing literature on mobile health. The messages will be designed to sustain therapeutic gains and facilitate ongoing behaviour change including relapse prevention and recovery. Messages will be tailored to be consistent with each of the two treatment approaches. MI participants will receive messages that encourage self-reflection on treatment goals and workbook use. CBT participants will receive encouragement for using cognitive and behavioural strategies.
Sponsors
Professor Max Abbott
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Minimum age of 18 years Self-perception of having a gambling problem Willing to read materials related to the study (to ensure reading ability), Willing to participate in counselling and other treatment components (including owning a mobile phone with ability to receive text messages), Willing to have counselling sessions recorded, and provide follow-up data on gambling.
Exclusion criteria
Exclusion criteria will be the presence of active psychosis or active suicidal intent.
Outcome results
None listed