Case study of A Pilot Online Treatment Service for Problem Gambling

Abstract

Objective: Most people with gambling-related problems do not seek treatment. Possible barriers to seeking treatment include stigma, travel distance, and competing obligations (e.g., childcare). Online group therapy may help reduce some of these barriers. Method: The current paper presents a small case study to assess the feasibility of an 8-week online group therapy program. This program called Skills for Change Online was designed as an introduction to treatment using a cognitive behavior therapy approach. It includes teaching coping skills, mindfulness, dealing with erroneous beliefs and emotions. Sixteen people consented to participate in the study, three were included in the group, but only two participants completed the treatment. The group was evaluated using a longitudinal case study design (pre-test, post-test, with a 1-year follow-up). In addition, 8 waitlist controls completed the follow-up up survey. Measures included the Problem Gambling Screening Index (PGSI), Mindfulness Attention Awareness Scale (MAAS), Random Events Knowledge Test (REKT), Perceived Social Support (PSS), Kessler Psychological Distress Scale (K6), and Quality of Life (QLI). Results: Both participants reported increases in their MAAS (d =.56), and REKT scores (d =1.06), and decreases in problem gambling, and gambling craving (d =-0.30) after treatment. In addition, both participants had clinically significant decreases in PGSI scores dropping from a severe problem gambling to a moderate level of gambling problems. These positive outcomes were sustained according to a 12-month follow-up survey. Participants provided feedback during treatment, that the treatment services were helpful but also discussed technological challenges involved in online group therapy. A group of participants who were not included in the treatment showed less overall improvement in gambling, mindfulness based on the MAAS and knowledge of random chance based on the REKT. Conclusion: The results are encouraging. However, the sample is very small and there is a need for further research with larger samples and randomized controlled designs. The difficulties of running on-line groups are discussed.

Operational status of mental health, substance use, and problem gambling services: A system‐level snapshot two years into the COVID‐19 pandemic

“…And yet, we know that there are significant disparities in accessibility of virtual services among historically-excluded and underserved populations. 11,23 Indeed, clinicians and researchers have been sounding the alarm about inequity in access to virtual care prior to, during and in the aftermath of the pandemic. 10,25,40,48 The digital divide results in virtual services increasing accessibility among some groups-particularly among urban, higher income, women 41 -while exacerbating inequities among other groups-e.g., people experiencing poverty and homelessness.…”

“…due to gender‐sexual identity, legal issues, homelessness, and ABI) were modified and virtual. And yet, we know that there are significant disparities in accessibility of virtual services among historically‐excluded and underserved populations 11,23 . Indeed, clinicians and researchers have been sounding the alarm about inequity in access to virtual care prior to, during and in the aftermath of the pandemic 10,25,40,48 .…”

“…8 At the same time, the pandemic would also leave widespread service disruptions in its wake: lockdowns, physical distancing requirements, staffing shortages, and rapid shifts in service delivery modalities (e.g., the shift to virtual delivery models) which would reduce the availability and accessibility of community-based mental health and addiction services. 3,9 While pre-pandemic research examined differences between virtual and in-person therapies, 10,11 the onset of COVID saw a tidal wave of new research on this topic. The pandemic-related challenges to mental health and addictions needs and services would be a serious concern for populations facing social and health vulnerabilities in particular, given higher needs and…”