GamblingLess: A Randomised Trial Comparing Guided and Unguided Internet-Based Gambling Interventions.

Area of Science:

• Psychology
• Behavioral Science
• Digital Health

Background:

• Internet-based interventions are increasingly used for gambling disorder.
• Evidence on the added value of therapist guidance in these digital programs is limited.

Purpose of the Study:

• To compare the effectiveness of an online self-directed cognitive-behavioral gambling program with and without therapist guidance.
• To investigate the impact of guidance on gambling symptom severity, urges, frequency, expenditure, psychological distress, quality of life, and help-seeking.

Main Methods:

• A two-arm, parallel-group randomized trial with pragmatic features was conducted.
• 206 gamblers were randomized into either an unguided or guided intervention group.
• Outcomes were assessed at 8 weeks, 12 weeks, and 24 months post-baseline.

Main Results:

• Both guided and unguided interventions led to significant improvements in gambling symptom severity, urges, frequency, expenditure, and psychological distress.
• The guided intervention showed additional improvements in urges and frequency, and a greater rate of clinically significant change (77% vs. 61%).
• Participants in both groups demonstrated substantial recovery rates, with 69% showing clinically significant improvement.

Conclusions:

• Online cognitive-behavioral gambling interventions are effective, with or without therapist guidance.
• Therapist guidance may offer additional benefits, particularly for reducing urges and frequency.
• Further research is needed to determine when and for whom human support is most valuable in digital gambling interventions.