Presented at the 6th International Gambling Conference in February 2016. Presented by Magnus Eidem

1. A telephone and Internet based
treament program in Norway
Magnus Eidem
Magnus.eidem@sykehuset-innlandet.no

3. Background
• Funded by the Norwegian Ministry of Health
(The National Action Plan against Problem Gambling)
• 2006: Developed the program, treatment manual &
website design
• Project launched November 2007
• Aim to make it easier to seek help, reach out to more
problem gamblers
• Only 10% of gamblers seek treatment
– Due to shame, denial, social inhibition, inconvenience

4. Advantages of Internet therapy
• Cost-effective
• High accessiblity (24/7)
• Lower threshold for treatment seeking?
- March 2009: No longer need referrals to participate in treatment
(Many problem gamblers do not seek treatment due to shame, denial, inconvenience, geography etc)

5. Why online treatment?
• Many people live far from treatment services in Norway, we
aim to make it easier to seek help and increase number of
problem gamblers who receive treatment
• Stigma about seeking help
• Reach out to ”new groups” of problem gamblers, such as
online gamblers
• Give the problem gambler more flexibility in treatment,
reduce time and money commitment

6. Treatment
• Participants sign up through the website
• Treatment lasts for approximately three months
• Weekly telephone meetings between the client and
the therapist
• Client assignments provide the structure and content
for the telephone meetings
• The assignments are based on cognitive behaviour
therapy

7. Assignment 1
Assignment 1
Sign up through
the website
Sign up through
the website
Telephone
meeting
Telephone
meeting
Client interview
Client interview
Open user
account
Open user
account
Screening
SCL-90R, GBQ,
SOGS-R
Screening
SCL-90R, GBQ,
SOGS-R
Assignment 9
Assignment 9
Consultation
Consultation
Consultation
Consultation
Re-test
+ summary
Re-test
+ summary
Make appointment for client interview
Basics, background, demographic, gambling
history, information, motivation,
expectations.
Clients sign consent form / program start
(www.spillbehandling.no)
3months3months
Online
Discussion
Forum
Online
Discussion
Forum
Consultation
Consultation
Screening feedback

8. Instruments
• SOGS-R
• GBQ
– Luck/Perseverance
– Illusion of control
• SCL-90
– 9 symptom scales
– (somatization, obsessive-compulsive, interpersonal
sensitivity, depresson, anxiety, hostility, fobic anxiety,
paranoid ideation, psychotisism)

9. The 9 client assignments
• Motivation / goals
• Readiness to change (the stages) – pros & cons
• Analyzing gambling situations
• High-risk situations, identify erroneous thoughts
• Flashcard & notebook (Self-help tools used in treatment)
• Financial situation and challenges
• Self-disclosure
• Relationships, trust and honesty
• Maintaining abstinence, what to do instead of gambling?

10. • 900 have signed up
• About 1/3 completion rate
• Majority of «drop outs» did not start at all
• 80% men, 20 % women
• Age 16 – 69
• Main problem: Online Casino (Internet slotmachines)
• Other games: Sportsbetting, VLT , Poker,
Horse betting, Daytrading, MMORPG

12. Aim of the present study
• To conduct a pilot study with a preliminary
description and evaluation of this novel
treatment approach in terms of its
effectiveness

13. Conclusion
• Reduction in symptoms of pathological gambling
maintained after 3-6 months after treatment
completion
• Reduction in symptoms of genereal psychological
distress
• Fewer cognitive distortion related to gambling after
treatment

14. Test / re-test SCL 90 R
“Description and pre-post evaluation of an internet based treatment program for pathological gambling in Norway”
(Myrseth, Brunborg, Eidem, Pallesen) The International Journal of Gambling Studies, 2013.

15. • The project has been a success!
• We have reached out to problem gamblers that
because of geographical challenges didn’t seek help
• We have made it easier to seek help
So far…

16. Future goals
• Continiue to run treatment program
• Update website / new platform
• Develop an APP to help more high risk players
• Adopt other kind of problem gaming (MMORPG’s)

17. Future research directions
• Include control/comparison
group to control for non-
spesific treatment effects
• Comparison of face-to-face
vs. Internet delivered
treatment
• More outcome measures
• Longer follow-up