A randomised control trial comparing face-to-face with online problem gambling treatment

The primary aim of the current study is to examine different ways of delivering psychological treatments for problem gambling. Namely, the study aims to compare face-to-face treatment, online self-directed treatment, and a hybrid that has both face-to-face and online components. The delivered treatment is a cognitive therapy focusing on helping the participant understand what motivates their gambling, and then deconstructing their erroneous beliefs about their preferred form of gambling, followed by teaching them skills to make better decisions in the future. While face-to-face cognitive therapy is well researched and a supported treatment for problem gambling, preliminary evidence suggests that it may be delivered efficaciously online. The research will be completed at the University of Sydney’s Gambling Treatment and Research Clinic, which comprises of three locations: o Mallett St- Level 2, Brain and Mind Centre, 94 Mallett St, Camperdown, NSW, 2050 o Parramatta- Level 4, 20-22 Macquarie St, Parramatta, 2150 o Campbelltown- 171-179 Queen St, Campbelltown, 2560 The current study will be administered as a randomised control outcome trial, with participants randomly allocated to one of the three treatment conditions: 8 sessions of face-to-face cognitive therapy (FTF) administered by registered and intern psychologists who have had extensive training in problem gambling treatment; 8 sessions of online self-directed cognitive therapy (OSD); and a combined model (FTF/OSD), where participants would receive 2 sessions of FTF cognitive therapy combined with 6 sessions of OSD cognitive therapy.These sessions, each lasting from 45 min to 1 hour, will run over a period of 8-weeks and those allocated to receive online therapy will have access to these clinicians if they require further support. The treatment that will be examined will be based on a variety of cognitive therapy which was developed at the Gambling Treatment and Research Clinic by current deputy director, Dr Fadi Anjoul. The therapy focuses on helping the participant understand what motivates their gambling, and then deconstructing their erroneous beliefs about their preferred form of gambling, followed by teaching them skills to make better decisions in the future. The participants in the study will be recruited from consecutive clients presenting to the University of Sydney’s Gambling Treatment and Research Clinic for assistance with a gambling problem. In all treatment conditions, the client will receive a psychotherapeutic intervention covering comparable modules of cognitive therapy. Included modules will be: 1) problem basis of gambling; 2) automatic tendencies; 3) theory of winning; 4) randomness; 5) return to player percentage and negative expectancy; 6) futility of gambling; 7) turning-off gambling; and 8) self-management training. Once participants have successfully completed all therapeutic modules, they will then be asked to attend a face-to-face assessment session where a trained clinician will conduct a clinical assessment and administer the outcome measures again, and enquire as to whether the participant has consulted any other health professionals regarding their gambling or any related distress. Those not responding or completing treatment will be offered an alternative treatment and be classified as treatment failures for the purpose of the study. Participants will then be contacted via phone at three month following the completion of treatment for a follow-up assessment. At this three-month follow-up, participants will be offered one of the alternative treatments if further treatment is deemed to be necessary. Finally, participants will also be conducted via phone at 6 months for a final follow-up.