Clinical consensus statements on change techniques for gambling treatment: A Delphi study with clinicians.

Abstract

Background and aims: The active ingredients of psychological gambling treatments remain unclear, with research identifying effective change techniques only emerging. This study aimed to identify clinical consensus statements on effective change techniques for gambling treatment according to Australian and New Zealand gambling clinicians. Identification of promising change techniques can inform the development of optimised interventions.

Methods: A panel of 68 clinicians participated in a two-round Modified Delphi study. Panellists rated the effectiveness of 19 change techniques for reducing gambling severity, expenditure and frequency. Consensus criteria for effectiveness and ineffectiveness were defined a priori. Panellists were also asked to provide culturally relevant considerations and adaptations when using change techniques with culturally diverse, linguistically diverse and Indigenous populations. Responses were analysed through a thematic analysis.

Results: Clinical consensus was reached on the effectiveness of 10 change techniques: relapse prevention, goal setting, motivational enhancement, information provision, cognitive restructuring, financial regulation, information gathering, plan social support, problem solving, and decisional balance. There was no consensus that any technique was ineffective, however social comparison received the lowest ratings. Panellists also identified four key themes of considerations when working with culturally diverse, linguistically diverse and Indigenous populations.

Discussion and conclusions: This is the first Delphi study to explore clinician perspectives on change technique effectiveness. Ten change techniques were identified as likely to be effective. Findings can inform the selection of promising change techniques for inclusion in gambling treatment programs and expedite optimised intervention development by focussing research efforts on change techniques most likely to be effective.