Internetbased treatment options for problem gambling A review

Internet-based treatment options for problem gambling: A review of existing evidence and models Sally Gainsbury (nee Monaghan) April 9 th, 2010 Alberta Gaming Research Institute’s 9 th Annual Conference Banff, Alberta centre for gambling education & research

Outline n Why consider Internet-based treatments n Internet therapy n Online interventions n Implementation issues Centre for Gambling Education & Research

Why consider a new form of treatment? n The majority of problem gamblers (90 -97%) do not engage in treatment n Annual cost of each pathological gambler = CAD$20, 000 -$56, 000 n Many individuals with gambling problems may benefit from largely self-guided lessintensive treatment interventions Centre for Gambling Education & Research

Advantages of online treatment n n n n User demand Increases treatment accessibility, availability and convenience Offers privacy and anonymity Relevant for at-risk population Adapted from existing treatment models Fits with stepped-care treatment model Cost-effective Empirical evaluations Centre for Gambling Education & Research

Internet Therapy n Online self-guided exercises n Therapist support n Empirically supported Centre for Gambling Education & Research

Norway - www. spillbehandling. no n 3 -month program conducted online with telephone support n Weekly assignments (CBT-based) n Online discussion forum Centre for Gambling Education & Research

Norway - www. spillbehandling. no n n n 2007 -2009: 90 clients (86% male, M age=36, M SOGS=11. 6), 38 completions, 18 no starts, 11 drop-outs Positive changes for gambling thoughts and behaviour, depression, anxiety and concentration Positive client feedback Centre for Gambling Education & Research

Finland: Addiction Link n n n Self-help resources & assessments Professional support & counselling Peer-support & discussion Approximately 170 visitors per day, 40, 000/month 12% of counselling for problem gambling Centre for Gambling Education & Research

Germany – Check Your Gambling www. spielen-mit-verantwortung. de n Personalised counselling - 4 week program n Automated self-test & relevant information n Local help options Centre for Gambling Education & Research

Germany – Check Your Gambling n 2007 -2009: 197 participants registered (12 -15/month) n 87% male, n mean age=34, n 64% first help seeking, n 95% pathological gamblers n n n 66% completed program Feedback: gambling diary, counsellor feedback and online chats sig. helpful Centre for Gambling Education & Research

United Kingdom - Gam. Aid n n Chat with online advisors (during service hours) Email advice Support, not treatment Online forums/discussion boards Centre for Gambling Education & Research

Australia – Gambling Help Online n n Live counselling 24/7 Email-based counselling Centre for Gambling Education & Research

Australia – Gambling Help Online n Since soft launch 31. 8. 09 4, 209 hits (3, 083 unique hits) n 197 live counselling requests n 28 unique email requests n 64% anonymous access n 58% contacts outside traditional business hours n 47% males n 84% gamblers n 78% metropolitan n Centre for Gambling Education & Research

Online interventions n Internet-based self-help treatment options n No “gold standard”: structure, components, time-frame n Evolve based on research & feedback Centre for Gambling Education & Research

Components of online interventions n Registration Allows progress to be tracked n Users can be contacted n May be anonymous n Facilitates research n Centre for Gambling Education & Research

Components of online interventions n Tailored normative feedback Stand-alone intervention or first step n Increases relevance of information n May motivate behavioural change n Cunningham, J. A. et al. (2009) Centre for Gambling Education & Research

Components of online interventions n Tailored content Personalised treatment n Tailoring based on age, gender, culture, form of gambling, stage of motivation & change, reasons for gambling n Centre for Gambling Education & Research

Components of online interventions n Behavioural tools Monitoring diaries n Analysis of behavioural patterns n Goal setting n Progress tracking n Centre for Gambling Education & Research

Components of online interventions n Interactive educational exercises Educational information n Cognitive strategies n Quizzes n Automated feedback n Multi-media n www. gambleaware. co. uk Centre for Gambling Education & Research

Components of online interventions n Motivational phases n Work with clients at various levels of readiness for change Centre for Gambling Education & Research

Components of online interventions n Online support groups and forums Adjunct to treatment or maintenance n Monitored n High traffic flow and activity n Centre for Gambling Education & Research

Know the Score n n n Launched by Responsible Gambling Council 109 University & college campuses Interactive PG awareness program On-campus staff n Website n Quiz n Facebook n Bluetooth texting n Blog n Centre for Gambling Education & Research

Check Your Gambling. Net n n Brief automated personalised feedback intervention Summary report Centre for Gambling Education & Research

Implementation issues n Internet access n Client suitability n Promotion & advertising n Attrition n Research Centre for Gambling Education & Research

Conclusions n n Growing support for Internet-based treatment Successful, accessible, cost-effective Providing brief treatment & support for those who would not seek traditional services Empirically verifiable Centre for Gambling Education & Research

Acknowledgments The presenter would like to thank the Centre for Addiction and Mental Health (CAMH) and the Ontario Problem Gambling Research Centre (OPGRC) for their support of this research Centre for Gambling Education & Research

Thank you n Questions, comments? Sally Gainsbury (nee Monaghan) Post-doctoral Research Fellow Centre for Gambling Education & Research Southern Cross University Lismore, Australia Email: smon 5844@uni. sydney. edu. au Centre for Gambling Education & Research