Projects
Family Reinforcement and Contingency Management for Gambling (FRCM-Gam): A feasibility and acceptability study
It is a common belief that there is not much we can do in situations where an individual with a gambling problem is unadmitted or resistant to change until they admit they have a problem and agree to accept help. Such beliefs can add to families’ feelings of helplessness and powerlessness about their ability to encourage the gambler to change their behaviour. Research has clearly shown that families can play an important role in motivating a non-treatment-seeking or unadmitted individual with an addiction, to reduce their harmful behaviour and to seek help. Drawing on previous research, we have developed an intervention for individuals concerned about an unadmitted or treatment-refusing family member or friend engaged in harmful gambling. This study aims to conduct a pilot randomised control trial of this intervention. Thirty family members or friends of a non-help-seeking heavy gambler will be randomised to the intervention or treatment as usual control. Randomisation will be blocked to increase the likelihood of equal group sizes, using a standard permutated block algorithm in which block sizes are randomly chosen from 2, 4, and 6 to protect concealment. Outcomes will comprise the participants’ well-being and the heavy gamblers’ behaviour including help-seeking. Early results are encouraging and indicate the intervention can successfully encourage the gambler to enter treatment.
Development of a therapist-assisted AI chatbot to facilitate help-seeking and engagement with cognitive behaviour therapy for problem gambling.
While cognitive behaviour therapy (CBT) is an effective intervention for individuals experiencing gambling disorders, help-seeking rates remain low. The challenge is to create opportunities and to intervene earlier in the problem gambling trajectory before gambling disorder has become established or entrenched. Each State and Territory has gambling help websites and national and local gambling help phone lines that are typically accessed when someone seeks information or help when the gambler or significant other is experiencing significant distress at gambling losses. We believe that AI technology supported by a gambling therapist may offer a 24-hour anonymous bridge between those engaged in harmful gambling behaviours and triage the level of help they require. Through partnership between SALHN, Flinders University and the University of California, our team has won two research grants from the SA Department for Human Services totalling more than $120,000. We are nearing the completion of phase one of this project and about to embark on phase two. The phase one feasibility trial involves the co-design, development, and initial testing of our therapist-assisted AI chatbot named ‘Gabi’, among 40 SA gamblers using an uncontrolled pre-post design. Phase two will be informed by the results from phase one and previous research from our unit that has shown engagement with homework predicts outcomes for individuals receiving CBT for gambling disorder. This second study will comprise a randomised control trial (RCT) to answer the research question, “Does a therapist-assisted AI chatbot increase patients’ engagement in CBT homework and subsequent clinical outcomes for individuals receiving CBT for gambling disorder?”
Collaboration with the University of Indonesia Department of Psychiatry
In 2021 we began a collaboration with addiction clinicians/researchers at the University of Indonesia. Gambling disorder (GD) has become a wide concern in Indonesia, and our collaboration has led to the development of culturally sensitive internet-delivered CBT treatment (iCBT). We are currently working on a non-randomised pilot and feasibility study that will recruit 20 people with GD. All participants will receive the iCBT intervention through self-learning videos and guided weekly group sessions. The effectiveness of the intervention will be assessed at baseline (week 0), post-treatment completion (week 10), and 6 weeks post-treatment (week 16). The outcomes measured will be the change in gambling symptoms, gambling urges, cognitive distortions, readiness to change, emotional problems, and quality of life of the participants. The study’s results will indicate the acceptability of the intervention and the feasibility of a subsequent conclusive trial. The delivery of iCBT may help to address the issue of treatment access in an extensive geographical region and provide immediate implications as a treatment resource for GD in practice.
