Web-based interventions have the potential to reduce the treatment gap for problem gambling. In the past years, several web-based help options were made available to the public. However, only few studies were conducted to test their effects. This study investigated the efficacy of two interventions for problem gamblers provided online by the German Federal Center for Health Education (BZgA). The first intervention is the guided program "Check Out" (CO), the second is email counselling (EC). A web-based randomized controlled trial with follow-up surveys after 3, 6 and 12 months was conducted. Participants were allocated to CO, to EC or to a waitlist (WL). Outcomes were the degree of problem gambling according to the Problem Gambling Severity Index, the number of days gambled in past 30 days, the highest stake during the past 30 days and the subjective well-being (WHO-5). 167 individuals were included in the trial. In comparison to the WL at the 3 months follow-up, participants of CO showed significant improvements with moderate to strong effect sizes in all outcomes. Strongest effects were found in the problem gambling severity (d = 0.91; p = 0.023), followed by the well-being (d = 0.70; p = 0.011), the gambling days (d = 0.59; p = 0.001) and the highest stake (d = 0.55; p = 0.012). Improvements were sustained until last follow-up. Compared to the WL, users of EC had beneficiary results in the problem gambling severity (d = 0.74; p = 0.022). No significant effect differences were found between CO and EC. However, according to process evaluation, users of CO reported a significantly stronger working alliance than users of EC (d = 0.70; p = 0.019) and used the intervention considerably longer (d = 0.84; p = 0.004). CO helps treatment-seeking individuals to sustainably reduce their gambling behavior and to increase their general well-being. Compared to EC, CO seems a better support option, since its effects include a wider range of outcomes. Possible reasons are the more engaging program structure and elements of CO, as well as the closer interaction between client and counselor.

Ziel: Überprüfung der Effektivität einer auf Motivational Interviewing (MI) basierenden Intervention im Online-Chat unter jungen Alkohol- und Cannabiskonsumenten mit ambivalenter Änderungsmotivation. Methodik: Randomisiert-kontrollierte Online-Studie mit Nachbefragungen nach einem und nach drei Monaten. Die Rekrutierung erfolgte über die Selbsttests auf der Website drugcom.de und schloss nur Personen mit problematischem Alkohol- oder Cannabiskonsum ein. Teilnehmer der Interventionsgruppe nahmen am privaten MI-Chat teil. Mitglieder der Kontrollgruppe erhielten im Chat lediglich Sachinformationen über den zuvor genutzten Selbsttest. Ergebnisse: 302 Personen wurden randomisiert und in die ITT-Auswertung einbezogen. Es zeigten sich keine Gruppenunterschiede im Konsum von Alkohol (p ≥ 0.224), Cannabis (p = 0.537) oder in der Änderungsmotivation nach RCQ (p = 0.469). Beide Gruppen senkten ihren Alkoholkonsum im Studienverlauf signifikant und zeigten Verbesserungen der Änderungsbereitschaft. Schlussfolgerungen: Die beschriebene Chat-Intervention erzielt keine Verhaltensänderung bei ambivalent eingestellten Konsumenten. Online-Interventionen für diese Zielgruppe sollten womöglich länger und verbindlicher gestaltet werden.

The intervention helped ameliorate symptoms of work-related stress and burnout. Although limited by a small sample size, the study suggests that the program provides effective support for affected individuals. However, further studies with bigger sample sizes should be conducted to examine the effects of such programs more precisely.

BackgroundTrials demonstrate the effectiveness of web-based interventions for cannabis-related disorders. For further development of these interventions, it is of vital interest to identify user characteristics which predict treatment response.MethodsData from a randomized factorial trial on a web-based intervention for cannabis-users (n = 534) was reanalyzed. As potential predictors for later treatment response, 31 variables from the following categories were tested: socio-demographics, substance use and cognitive processing. The association of predictors and treatment outcome was analyzed using unbiased recursive partitioning and represented as classification tree. Predictive performance of the tree was assessed by comparing its cross-validated results to models derived with all-subsets logistic regression and random forest.ResultsGoal commitment (p < .001), the extent of self-reflection (p < .001), the preferred effect of cannabis (p = .005) and initial cannabis use (p = .015) significantly differentiate between successful and non-successful participants in all three analysis methods. The predictive accuracy of all three models is comparable and modest.ConclusionsParticipants who commit to quit using cannabis, who at least have moderate levels of self-reflection and who prefer mild intoxicating effects were most likely to respond to treatment. To predict treatment response on an individual level, the classification tree should only be used as one of several sources of information.Trial registration: http://www.isrctn.com/ISRCTN99818059

Hintergrund: Im Zuge der Ausweitung von Glücksspielangeboten im Internet gewinnen auch webbasierte Angebote der Suchtprävention weiter an Bedeutung. Interaktiven Angeboten kommt hierbei eine besondere Rolle zu, da sie die Anpassung präventiver Inhalte an die Situation und Bedürfnisse der Nutzer erlauben. Um der Verbreitung problematischen Glücksspielverhaltens vorzubeugen, entwickelte die Bundeszentrale für gesundheitliche Aufklärung (BZgA) im Jahr 2007 mit „Check dein Spiel“ (CDS) ein entsprechendes Angebot im Internet. Ziele: Dieser Beitrag gibt einen Überblick über die interaktiven Inhalte der Webseite und erläutert, wie diese in der Prävention und Frühintervention bei problematischem und pathologischem Glücksspielverhalten eingesetzt werden. Zunächst wird hierbei der datenbankbasierte Selbsttest dargestellt, bei dem Glücksspielteilnehmende eine individuelle Rückmeldung über das eigene Glücksspielverhalten erhalten können. Darüber hinaus wird das strukturierte mehrwöchige Beratungsprogramm von CDS beschrieben und über die Erfahrungen mit dem Programm seit seinem Online-Start berichtet.