Cognitive-behavioural therapy for concerned significant others of people with problem gambling

Today we published a study protocol for a randomised wait-list controlled trial in BMJ Open. The study is important since about 2.3% of the adult population in Sweden are considered to suffer from problem gambling. However, 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 and analysis

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.

Ethics and dissemination

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.


This work was supported by Svenska Spels’s Independent Research Council and the Swedish Research Council for Health, Working Life and Welfare (FORTE 2013-1765).

Data sharing statement

On completion, the data set generated in this trial will be published in a data repository (eg, Dryad or figshare), accompanied by script files to reproduce the statistical analyses.

Read the full paper:

Magnusson, K., Nilsson, A., Hellner Gumpert, C., Andersson, G., & Carlbring, P. (2015). Internet-delivered cognitive-behavioural therapy for concerned significant others of people with problem gambling: study protocol for a randomised wait-list controlled trial. BMJ Open, 5(12). doi:10.1136/bmjopen-2015-008724