A study comparing two interventions to support people concerned about a friend or family member’s gambling problem, and their effects on help-seeking and wellbeing.

What is the intervention Helping Others Promote Engagement in Gambling Support (HOPE-Gam) is a brief, manualised, structured behavioural intervention grounded in learning theory and contingency management principles. It is designed for concerned significant others (CSOs) of people with gambling problems, with the aim of increasing treatment engagement by the person with gambling problems. The intervention teaches CSOs to modify their own responses to gambling-related behaviours in ways that reduce reinforcement for gambling and increase reinforcement for non-gambling and help-seeking behaviours. HOPE-Gam is delivered in five graded components: Preparation: Psychoeducation on gambling disorder, cognitive behavioural therapy (CBT), and treatment options, with coaching on how to present treatment opportunities and facilitate rapid access. Contingency management: Identification of maintaining reinforcers of gambling and development of alternative, incompatible behaviours. Operant conditioning strategies: Training in reinforcing non-gambling behaviours and withdrawing reinforcement for gambling. Behavioural agreements: Development of agreed behavioural expectations to support positive change. Involving others: Inclusion of additional supports where earlier strategies are insufficient. The intervention includes explicit emphasis on facilitating timely access to treatment services when the gambler expresses willingness to engage. Who delivers it and their relevant expertise The intervention is delivered by clinicians with Master’s-level qualifications in psychology, cognitive behavioural therapy, or psychotherapy. Delivery may also involve postgraduate clinical trainees working under structured supervision from senior clinicians. All therapists are trained in the HOPE-Gam manual and receive ongoing clinical supervision to ensure fidelity. How it is delivered The intervention is delivered as individual therapy sessions to CSOs (not the gambler) in-person or via telehealth. Sessions are therapist-led, structured, and guided by a treatment manual. Between-session tasks (home practice activities) are assigned and reviewed collaboratively. These activities typically require approximately 30 minutes per week of worksheet completion and monitoring activities, although participants are also encouraged to apply the behavioural strategies during naturally occurring interactions with the person experiencing gambling problems. Activities may include completing a gambling behaviour monitoring diary, completing the 5-Ws worksheet, identifying incompatible activities and desired behaviours, and recording reinforcement strategies used. How often and for how long Participants receive up to six sessions, each lasting approximately 30-60 minutes. Sessions are typically delivered weekly over six weeks but may be flexibly scheduled over a period of up to three months depending on participant need and availability. Where it is delivered The intervention is delivered through a specialist gambling treatment service within the Southern Adelaide Local Health Network (SALHN). Adherence and fidelity monitoring Participant adherence will be supported through attendance at sessions, completion of between-session practice tasks, and collaborative goal setting. Intervention fidelity will be ensured through manualised delivery, clinician training and supervision, audio-recording of sessions (with consent), and the use of adherence checklists with random fidelity auditing.