Internet-based delivery of cognitive behaviour therapy compared to monitoring, feedback and support for problem gambling: a randomised controlled trial

The aim of this study was to investigate the efficacy of an Internet-based cognitive behavioural therapy program (I-CBT) for the treatment of problem gambling, when compared to a waitlist control and an active comparison condition consisting of monitoring, feedback, and support (I-MFS). Participants (N = 174) were randomly allocated to the three conditions. Variables of interest were gambling outcome and related mental health measures. Participants in the active conditions (I-CBT and I-MFS) completed six online modules. Both I-CBT and I-MFS conditions resulted in significant treatment gains on gambling severity. However, I-CBT was also associated with reductions in a range of other gambling-related and mental health outcomes. Compared with I-MFS, I-CBT produced greater effects across seven outcomes measures, relating to gambling urges, cognitions, stress, and life satisfaction. I-CBT participants also rated the program as significantly more satisfactory. Treatment gains observed for both active conditions were found to be stable through to 12 month follow up. The results indicate that the benefits of I-CBT were more than simply the non-specific effects of engaging in online treatment or receiving motivation, feedback, and support. Online treatments for gambling may be a valuable tool in increasing help-seeking and treatment engagement in this population, and be integrated as part of stepped care approaches to treatment