title: Internet-delivered cognitive-behavioural therapy for concerned significant others of people with problem gambling: study protocol for a randomised wait-list controlled trial.
abstract: BACKGROUND
  About 2.3% of the adult population in Sweden are considered to suffer from problem gambling, and it is estimated that only 5% of those seek treatment. Problem gambling can have devastating effects on the economy, health and relationship, both for the individual who gambles and their concerned significant other (CSO). No empirically supported treatment exists for the CSOs of people with problem gambling. Consequently, the aim of this study is to develop and evaluate a programme aimed at CSOs of treatment-refusing problem gamblers. The programme will be based on principles from cognitive behavioural therapy (CBT) and motivational interviewing. To benefit as many CSOs as possible, the programme will be delivered via the internet with therapist support via encrypted email and short weekly conversations via telephone.
  
  
  METHODS
  This will be a randomised wait-list controlled internet-delivered treatment trial. A CBT programme for the CSOs of people with problem gambling will be developed and evaluated. The participants will work through nine modules over 10 weeks in a secure online environment, and receive support via secure emails and over the telephone. A total of 150 CSOs over 18 years of age will be included. Measures will be taken at baseline and at 3, 6 and 12 months. Primary outcomes concern gambling-related harm. Secondary outcomes include the treatment entry of the individual who gambles, the CSO's levels of depression, anxiety, as well as relationship satisfaction and quality of life.
  
  
  BACKGROUND
  The protocol has been approved by the regional ethics board of Stockholm, Sweden. This study will add to the body of knowledge on how to protect CSOs from gambling-related harm, and how to motivate treatment-refusing individuals to seek professional help for problem gambling.
  
  
  BACKGROUND
  NCT02250586.
authors.affiliation: Department of Clinical Neuroscience, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Kristoffer
authors.identifier: http://orcid.org/0000-0003-0713-0556
authors.initials: K
authors.lastname: Magnusson
authors.affiliation: Department of Clinical Neuroscience, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Nilsson
authors.affiliation: Department of Clinical Neuroscience, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Clara
authors.initials: C
authors.lastname: Hellner Gumpert
authors.affiliation: Department of Clinical Neuroscience, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Stockholm, Sweden Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Andersson
authors.affiliation: Department of Psychology, Stockholm University, Stockholm, Sweden.
authors.forename: Per
authors.identifier: http://orcid.org/0000-0002-2172-8813
authors.initials: P
authors.lastname: Carlbring
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology / Q000628:therapy; D002985:Clinical Protocols; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000209:etiology / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005715:Gambling / Q000523:psychology* / Q000628:therapy; D006801:Humans; D020407:Internet; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D010549:Personal Satisfaction; D057566:Self Report; D018454:Spouses / Q000523:psychology*; D017216:Telemedicine / Q000379:methods*; D055815:Young Adult
keywords: cognitive behavior therapy; concerned significant other; pathological gambling; randomized controlled trial