Web-Based Intervention and Email-Counseling for Problem Gamblers: Results of a Randomized Controlled Trial
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.
KeywordsPathological gambling Problem gambling Gambling disorder Counseling Email Prevention
The authors thank all counselors of CDS involved in the study: Ilka Andersen, Evi Schunack, Ingrid Lechner and Reglinde Schöbl.
Benjamin Jonas conceived and coordinated the study, supervised the data collection and conducted the analysis. Benjamin Jonas, Fabian Leuschner, Anna Eiling, Christine Schoelen, Renate Soellner and Peter Tossmann drafted the manuscript. All authors approved the final version of the manuscript.
The study was funded by the BZgA on behalf of the German Federal Ministry of Health.
Compliance with Ethical Standards
Conflict of interest
Benjamin Jonas, Fabian Leuschner, Anna Eiling and Peter Tossmann work for Delphi Gesellschaft, which developed “Check Out” on behalf of the Federal Centre for Health Education (BZgA).
All procedures performed in this study were approved by the ethics committee of the Department of Applied Human Sciences at the University of Magdeburg-Stendal, Germany, (reference number 4973-60) and were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Before the study, individuals were comprehensively informed about the study. Individuals willing to participate gave their informed consent by checking an “I agree to participate” checkbox (see manuscript for details).
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