ICBTG in Routine Care

Study Overview
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Brief Summary
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Problem gambling (PG) is a major public health concern worldwide. As awareness of PG has risen, treatment demand is increasing, and internet interventions is a promising alternative for providing fast, evidence-based treatment at scale, to a low cost. This article presents the protocol of an open label, uncontrolled pilot and feasibility trial of a novel internet-delivered cognitive behavioral treatment, conducted in regular addiction care with adult treatment-seeking patients (max N=25) with problematic gambling. Weekly measures of gambling symptoms and gambling will serve as outcome measures. Study results will further guide the development of the intervention and its implementation into regular addiction care.

Official Title
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Implementation of Internet-based Cognitive Behavior Therapy for Problem Gambling in Routine Addiction Care: A Feasibility Study

Conditions
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Problem Gambling, Gambling Disorder

Intervention / Treatment
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* Behavioral: iCBT


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: being at least 18 years old living in Sweden being able to read and write Swedish. having a total score of >= 3 on the Problem Gambling Severity Index (PGSI; Ferris & Wynne, 2001) having the ability to work with online treatment material by themselves (with support from a therapist) Exclusion criteria: fulfilling criteria for ongoing manic episode currently undergoing a parallel CBT treatment for Gambling Disorder or problem gambling.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: iCBT for Gambling Disorder<br>Treatment will consist of a 1+10 module internet delivered CBT program targeting problem gambling, newly developed. A bottom-up procedure was used to develop the treatment protocol, inspired by Clark's (2004) method for developing novel CBT treatments. We developed a clinical model delineating what factors contribute to the persistence of problem gambling behavior, and aligned these with targeted treatment interventions; based on behavioral upon research on the learning and maintenance processes of gambling behavior (Ramnerö et al, in press), theoretical models of gambling and comorbidity (Blaszczynski & Nower, 2002); as well as qualitative interviews with treatment seeking gamblers with or without comorbidity. | Behavioral: iCBT<br>* A newly developed iCBT protocol targeting problem gambling.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Gambling Symptom Assessment Scale (G-SAS) | Gambling symptoms | Past 7 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Gambling Time Line Follow Back (TLFB-G) | Gambling behavior | Past 7 days | 
| The 9-item Patient Health Questionnaire (PHQ-9 | Depressive symptoms | Past 2 weeks | 
| The 7-item Generalised Anxiety Disorder scale (GAD-7) | Anxiety symptoms | Past 2 weeks | 
| The Alcohol Use Disorders Identification Test (AUDIT) | Alcohol use | Past 12 months | 
| The Drug Use Disorders Identification Test (DUDIT) | Drug use | Past 12 months | 
| the 26-item World Health Organization Quality of Life-BREF (WHOQOL-BREF) | Quality of life | Past 2 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Internet intervention, Gambling Disorder, Cognitive-behavioral therapy, Psychiatric comorbidity, Regular addiction care, Problem gambling