Face-to-face interventions for people experiencing problem gambling are effective, but only 8–17% of those with gambling problems will seek professional help (Productivity Commission, 2010).

The high-cost of face-to-face interventions and the low uptake of these services suggests that they may only have a limited impact on reducing gambling problems in the community. In this context, online and telephone delivery of mental health interventions, referred to as “e-mental health”, can provide an appropriate, cost-effective alternative for people affected by problem gambling.

The evidence suggests that greater availability of e-mental health interventions could lead to more people with gambling problems seeking help, and ultimately to a reduction in gambling problems across the population.

What is e-mental health? 

E-mental health broadly refers to digital platforms that support a therapeutic exchange and can be delivered across a range of digital platforms, either in a one-to-one or one-to-many setting. E-mental health can be delivered through: 

• email;
• chat and instant messaging;
• video counselling;
• online information;
• online screening;
• forums and message boards;
• online self-directed programs; and 
• talk-based telephony.

E-mental health works well when delivered as part of an integrated service option, which can include multiple online options, or when blending online options with offline gambling help and allied health services.

Benefits and limitations of e-mental health interventions for problem gamblers

There is growing evidence for the efficacy of e-mental health services across all addictive behaviours, including alcohol, drugs and gambling (Gainsbury & Blaszczynski, 2011). Access to e-mental health interventions has grown significantly over recent years as information technology has progressed.

A growing number of people affected by problem gambling report a strong preference for e-mental health over direct contact with a treatment agency (Cunningham, Hodgins, & Toneatto, 2008). They also report being more likely to seek help over the telephone or internet than attend face-to-face treatment (Hing, Russel, Gainsbury, & Blaszczynski, 2015). E-mental health interventions allow problem gamblers to self-manage their gambling in a setting that can be anonymous, private, convenient and immediate. They provide access to support and treatment services that are:

• easy to access¹;
• responsive;
• able to be self-managed; and 
• can minimise feeling of shame and stigma.

There is currently limited but promising evidence in favour of e-mental health interventions for problem gambling. Program evaluations are therefore crucial to help determine which treatment options are the most effective and for whom. However, the speed at which new technologies and e-mental health interventions are being developed and delivered means that there is often a delay between the introduction of new technologies and interventions, and the time it takes to complete evaluations.

Keeping in mind the limited evidence base, e-mental health, as part of a range of service options, may encourage more people affected by problem gambling to access support and treatment. Combining e-mental health programs with traditional supports appears to have the greatest potential for powerful and targeted interventions.

For a range of related resources, visit the Australian Gambling Research Centre website(link is external).

References

Cunningham, J., Hodgins, D., & Toneatto, T. (2008). Problem gamblers’ interest in self-help services. Psychiatric services, 59(6), 695–696.

Eysenbach, G. (2005). The law of attrition. Journal of Medical Internet Research, 7(1).

Gainsbury, S., & Blaszczynski, A. (2011). A systematic review of Internet-based therapy for the treatment of addictions. Clinical Psychology Review, 31(3), 490–498.

Hing, N., Russell, A. M. T., Gainsbury, S. M., & Blaszczynski, A. (2015). Characteristics and help-seeking behaviors of internet gamblers based on most problematic mode of gambling. Journal of Medical Internet Research, 17(1), e13. doi:10.2196/jmir.3781

Productivity Commission. (2010). Gambling, Report no. 50. Canberra.

^{1 Being able to access help, support or information or resources anytime, anywhere, is the most commonly cited reason for choosing online over telephone or face-to-face counselling.}