Effectiveness of a web-based self-help tool to reduce problem gambling: A randomized controlled trial
Background: Problem gambling constitutes a public health concern that is associated with mental illnesses, substance use, and financial difficulties. The past-year prevalence of problem gambling worldwide averages 2.3%. As most problem gamblers commonly avoid traditional counselling services due to perceived stigma and their preference for self-reliance, treatment accessibility could potentially be improved through web-based interventions.
Methods: This randomized controlled trial evaluated the effectiveness of a web-based self-help intervention (Win Back Control) relative to an active control condition consisting of a self-help manual for problem gambling. We recruited 360 problem gamblers and randomly allocated them to Win Back Control (n = 185) or a self-help manual condition (n = 175). The primary outcome was the number of days of gambling in the last 30 days. Secondary outcomes included other gambling related variables, changes in gambling-related problems (Problem Gambling Severity Index, Gambling Symptom Assessment Scale), use of alcohol and cigarettes, and psychopathological comorbidity measured at post-treatment and 6 month follow-up. All analyses were conducted according to the intention-to-treat principle.
Results: The number of days of gambling over the last 30 days decreased significantly for both conditions (F=13.06, P < 0.001), with no significant difference between the two conditions. However, participants in the Win Back Control condition decreased more their money spent (P = 0.001) and gambling minutes (P < 0.001) at week 8 and 6 months follow up. Moreover, they improved significantly more according to the Gambling Symptom Assessment Scale (F=3.18, P = 0.042) and their cigarette use over the last 30 days at the 6 month follow-up (F=19.34, P = 0.039).
Conclusion: Participants in the Win Back Control condition practiced safer gambling and improved overall more than participants in the active self-help manual control condition. Win Back Control seems to be an effective treatment option for problem gamblers. Disclosure of interest: This project is co-financed by the 16 SOS-Spielsucht-Cantons, Health Promotion Switzerland, and the Canton of Zurich. The authors declare no conflicts of interest.