An randomised control trial of a cognitive behavioural therapy mobile health app [Manaaki] aimed at reducing gambling symptom severity and supporting people experiencing gambling problems.

INTERVENTION: A BESPOKE DESIGNED MOBILE APP Involves an intervention app that has an evidence based CBT program embeded within it comprising of six modules, a shared forum, a webchat component and a diary. The Modules are: 1. KNOWING MYSELF (and my gambling): Designed to provide personalised feedback, goal setting, and understanding of gambling motivations, triggers, and/or consequences 2. GETTING READY (to make changes): Designed to enhance readiness and confidence to gamble less, helping to shape my thoughts and values to help make change 3. TAKING CONTROL (right now): Designed to identify strategies that can be used to “contain” the gambling in the short-term, directs to other useful tools such as venue exclusions. 4. TAKING ACTIONS (that last) : Designed to identify strategies and skills that can be used to ensure longer-term success in gambling less. Activating personal strengths and resources and enhancing belief for successful change 5. MANAGING URGES (to cope with real situations): Designed to cope with gambling urges and cravings 6. CHANGE FOR GOOD (and building a new future): Relapse prevention strategies designed to prevent gambling relapses in the future. Participants can navigate through the modules and module subtopics in the order that they find appropriate. Each subtopic can take between 10mins to 30 minutes to work through. Each module has a mix of short and long subtopics and the participant is prompted to take time to absorb and put into practice some of the skills before moving to the next module, although they are not stopped from moving on. The SHARED FORUM: peer support is an important element in gambling addiction recovery. This tool allows the user to share experiences with other intervention participants, much like they might do if they participated in a face-to-face group session. The CHAT FEATURE: connects the user to the national gambling helpline chat service which is a 24/7 service staffed by professional councillors. The DIARY: is a personalised tool that the user can capture their journey as they journey to being gambling harm free. The user can post the outcomes from their module activity or record positive thoughts and reminders. PROCEDURE: All eligible participants will be informed of the study requirements and consent within the app. Baseline data will be collected and this will generate a randomised outcome to either Intervention or Control. DOSE: this is a pragmatic trial and as such participants in the intervention arm can use the app for as much or as little as they want over the 12 week study period. Participants decide where they wish to start and as they progress suggestions will be provided on strategies to develop or additional learning elsewhere in the app that they might find useful. MEASURES: measures will be collected at 4, 8 and 12 weeks. App analytics will be utilised to capture frequency of use and time using the app, navigation journey and modules/subtopic completions, event capture if data entered, and use of the support tools such as the chat function. LOCATION: this is a national study and participants can use the app where and whenever they wish. PERSONALISATION: Throughout the app, the participant’s name is used i.e. So, [John] … , to provide a more tailored feel to the intervention. Summaries and interpretations are also based on their participant’s responses to the Modules and subtopics so that the participant receives information relevant to them. Notifications are also personalised with the participant’s name and where appropriate uses a greeting that is appropriate to the participant and linked to their demographics.