University of Calgary, Calgary, Canada.
Centre for Addiction and Mental Health, Toronto, Canada.
J Gambl Stud. 2019 Jun;35(2):635-651. doi: 10.1007/s10899-019-09830-7.
Self-directed treatments for gambling disorder have been developed to attract individuals who are reluctant to seek formal treatment. Self-directed treatments provide individuals with information and support to initiate a recovery program without attending formal treatment. In this study, an online version of a previously evaluated telephone-based intervention package is compared to a brief online normative feedback intervention called Check Your Gambling. In a randomized controlled trial design, participants with gambling problems who were not interested in formal treatment (N = 181) were recruited through media announcements. After a baseline telephone assessment, participants were assigned to have access to either the brief Check Your Gambling, or the extended self-management tools intervention. Follow-up assessments were conducted at 3, 6, and 12 months post baseline by blinded interviewers. Participant nominated collaterals were contacted to validate self-reported gambling involvement. The follow-up rate at 12 months was 78%. Participants in both conditions showed significant reductions in days of gambling and problem severity but no differences between conditions were found, contrary to the primary hypothesis. Lack of previous treatment for gambling and higher baseline self-efficacy predicted fewer days of gambling in both conditions. Self-efficacy increased over time but did not appear to mediate changes in gambling. Participants who were most engaged in the extended online program showed better outcomes. Those with low engagement showed a slower trajectory of change but equivalent improvements by 12 months. The extended online intervention was not associated with better outcomes than the brief Check Your Gambling intervention. Future research needs to explore the attractiveness, uptake, and effectiveness of online interventions with and without therapist support to understand their potential role in gambling disorder treatment systems.Trial Registration ISRCTN06220098.
自我指导的赌博障碍治疗方法旨在吸引那些不愿意寻求正规治疗的个体。自我指导的治疗方法为个体提供信息和支持，以便在不参加正规治疗的情况下启动康复计划。在这项研究中，将比较一种先前评估过的基于电话的干预方案的在线版本和一种称为“检查您的赌博”的简短在线规范反馈干预措施。采用随机对照试验设计，通过媒体公告招募对正规治疗不感兴趣的有赌博问题的参与者（N=181）。在基线电话评估后，将参与者分配至接受简短的“检查您的赌博”或扩展的自我管理工具干预。通过盲法访谈者在 3、6 和 12 个月的基线后进行随访评估。联系参与者提名的陪衬者以验证自我报告的赌博参与情况。12 个月的随访率为 78%。两种情况下的参与者在赌博天数和问题严重程度上都显著减少，但与主要假设相反，两种情况下均未发现差异。缺乏以往的赌博治疗和较高的基线自我效能感预测两种情况下的赌博天数更少。自我效能感随时间增加，但似乎不会影响赌博行为的变化。在扩展的在线计划中最投入的参与者表现出更好的结果。那些投入度低的参与者变化轨迹较慢，但到 12 个月时，改善情况相当。与简短的“检查您的赌博”干预相比，扩展的在线干预并未带来更好的结果。未来的研究需要探讨有和没有治疗师支持的在线干预措施的吸引力、采用率和有效性，以了解它们在赌博障碍治疗系统中的潜在作用。试验注册 ISRCTN06220098。
