Internet-based versus synchronous cognitive behavioral therapy for gambling disorder: Study protocol for a...

Area of Science:

• Psychiatry
• Behavioral Science
• Digital Health

Background:

• Gambling Disorder (GD) has low help-seeking rates and high attrition despite effective treatments.
• Internet-based cognitive behavioral therapy (iCBT) may overcome access barriers, but asynchronous vs. synchronous formats require more evidence.
• Current research lacks direct comparisons between asynchronous and synchronous CBT for GD.

Purpose of the Study:

• To outline a randomized controlled trial (RCT) protocol comparing asynchronous therapist-guided iCBT ("SpilleFri") with synchronous CBT (sCBT) for adults with GD.
• To evaluate the non-inferiority of asynchronous iCBT compared to sCBT in treating Gambling Disorder.
• To explore secondary outcomes including gambling behavior, psychological distress, and relationship quality.

Main Methods:

• A non-inferiority RCT will randomize 150 adult patients diagnosed with GD to either "SpilleFri" (asynchronous iCBT) or sCBT (in-person or video).
• The primary outcome is the change in GD severity (NODS) from baseline to 3 months post-treatment.
• Data collection occurs at 8 time points, including 12-month follow-up, with non-inferiority tested using mixed linear models.

Main Results:

• This section is not applicable as the abstract describes a study protocol, not results.
• The study aims to determine if asynchronous iCBT is non-inferior to sCBT for GD treatment.
• Exploration of process variables and moderators of treatment response is planned.

Conclusions:

• This trial addresses a critical gap by comparing asynchronous and synchronous CBT formats for GD.
• If non-inferior, "SpilleFri" (asynchronous iCBT) could provide a scalable, flexible, and resource-efficient GD treatment option.
• Findings may inform stepped-care models and improve access to evidence-based interventions for Gambling Disorder.