Randomized controlled trial of an online self-directed intervention for gambling problems with or without a motivational interview: 24-month follow-up

We previously reported on a randomized controlled trial of an online self-directed workbook for gambling problems delivered with or without a motivational interview (MI). The aim was to enhance workbook engagement and outcomes through the MI. Participants were randomized to the internet workbook only (IO) or internet workbook plus motivational interview (IMI). The current paper describes 24-month outcomes of that trial to examine the durability of changes observed during the original trial and whether the MI produced any long-term additional benefit. The follow-up sample (n = 134IO, 127 IMI) was 58% female with a mean age of 38.8 years. After 2 years, there remained no additional benefit of the MI; participants in both groups demonstrated sustained reductions in gambling severity, expenditures, and duration relative to baseline. At 24 months, 53% of participants were classified as improved and a further 16% reported at least 3 months of abstinence from gambling. The magnitude and trajectory of improvements were consistent with prior controlled studies of similar self-directed approaches. Our findings underscore the durability of improvements observed following participation in a self-directed gambling program, while also highlighting that the addition of a brief MI may not confer any long-term incremental benefit.