Rolvien L, Buddeberg L, Gehlenborg J, Borsutzky S, Moritz S. A Self-Guided Internet-Based Intervention for the Reduction of Gambling Symptoms: A Randomized Clinical Trial. JAMA Netw Open. 2024;7(6):e2417282. doi:10.1001/jamanetworkopen.2024.17282
This single-center randomized clinical trial assessed the effectiveness of a self-guided internet-based intervention for gambling. Secondary aims included understanding which intervention components drove effectiveness. Researchers recruited 243 adults aged 18 to 75. All spoke German and wanted help for gambling. Participants were randomly assigned to the intervention group (n = 119) or a wait-listed control group (n = 124). People with serious mental illnesses or suicidal thoughts were excluded. The program (Restart) included 12 interactive online modules. These modules used text, videos, and audio to teach strategies rooted in cognitive behavioral therapy, mindfulness, and metacognitive training. Participants set their own pace but were encouraged to complete about two modules per week, spending 30–60 minutes per module. The program featured four fictional characters with gambling problems to make the material relatable. It also included access to a mobile app called Cogito, which offered self-help exercises for gambling and depression. Results showed the intervention significantly reduced gambling behavior and depressive symptoms compared with the control group. The effect was moderate for gambling symptoms (Cohen’s d = 0.59) and small for depression (d = 0.33). Participants did not show major changes in gambling-related thoughts. Although 78.6% completed the study, actual use of the program was brief. On average, participants spent 61 minutes and completed about 4.5 modules. Those with upfront positive expectations benefited more, suggesting expectations improved outcomes. The study concluded that even limited use of the self-guided program can reduce gambling problems. Future research should include long-term follow-up and more active comparison groups.