GamblingLess: A pilot pragmatic randomised controlled trial evaluating the effectiveness of an online self-help cognitive behavioural program for the treatment of problem gambling

The aims of this project were to develop an online self-directed cognitive behavioural program for gambling (GAMBLINGLESS. FOR LIFE.) and employ a pragmatic trial design to investigate the effectiveness of this program delivered under guided self-directed conditions compared to pure self-directed conditions. A total of 206 participants were recruited into the pragmatic trial. These participants were mostly male, less than 40 years of age, born in Australia, and employed full-time. They most commonly reported having issues with EGMs, horse, harness or greyhound racing, and sports and events betting. Almost all users (96%) were classified in the problem gambling category using the Problem Gambling Severity Index. There were no statistically significant differences between the PSD and GSD conditions on almost all outcome measures at the 8- or 12-week evaluations. However, participants in the GSD group reported a significantly greater reduction in days gambled at the 12-week evaluation, and a higher rate of low-intensity help-seeking at the 8-week evaluation, than participants in the PSD. Moreover, at the 12-week evaluation, there was a medium effect size between the PSD and GSD groups on several measures, including gambling symptom severity, gambling urges, gambling expenditure, and quality of life; and a considerably higher proportion of GSD participants (62%) than PSD participants (35%) “recovered” on gambling symptom severity at the 12-week evaluation. There were also statistically significant improvements in gambling symptom severity, gambling urges, gambling frequency, and psychological distress within treatment groups at the 8- and 12-week evaluations. On gambling symptom severity, 50% of users recovered, 14% improved, 34% showed no real change, and 3% deteriorated; for psychological distress, 32% of users recovered, 15% improved, 45% experienced no real change, and 9% deteriorated. There were significant improvements in gambling expenditure and quality of life at the 8-week, but not the 12-week, evaluation. In contrast, there was no within-group improvement on help-seeking at either post-baseline evaluation.