The treatment of gambling addiction in the US has experienced decades of stability, but recent pandemic-induced lockdowns have upset the balance. Kindbridge Research Institute Director Dr Nathan Smith discusses the effectiveness of telehealth as a treatment in a world still reeling from the effects of Covid.
Gambling disorder is a serious mental health condition and the only behavioral addiction currently recognized by the American Psychiatric Association.
Decades-long stability in the treatment of this disorder has been upset by covid-induced lockdowns, with populations becoming isolated for months at a time and succumbing to the stresses that follow.
The pandemic has created a seismic shift in societal factors that influence gambling disorder and treatment availability: Underlying risk factors were heightened, gambling availability changed drastically, and there was reduced access to treatment.
A number of studies have been conducted to consider the impact lockdowns have had on the uptake of online gambling, with the movement from retail to online betting, reduced access to treatment options and decreased quality of mental health all considered.
Tackling the reduction of access
The reduction in access to treatment is a clear issue, and one that must be addressed to prevent the continued decline in the conditions of those most at risk. Areas of effectiveness that have suffered the most have been aspects such as group therapy, which has not been offered in recent years due to it not complying with social distancing guidelines.
Findings from research suggest that traditional gambling treatment is not adequate due to its rigid structure and fragmentation in marginalized populations, meaning more emphasis must be placed on newer, alternative treatment like telehealth.
However, state regulations in the US currently make a transition to telehealth gambling services difficult. With lockdowns still relatively fresh in the minds of most, patients remain wary of seeking treatment for medical conditions and hospitals are more focused on reducing the spread of viruses, even at the expense of reduced social support for patients.
Telehealth as a solution
As in many aspects of life, the pandemic has asked us to reassess how we think about moving forward.
In the treatment of gambling addiction, telehealth has emerged as one of the leading candidates for solving the problems that have arisen. Telehealth offers a way to overcome the many increases in societal risk factors for gambling disorder, offering remote therapy that allows access to care when isolated.
We are in the midst of creating a sustainable framework for responsible gaming in the US, and Kindbridge is pioneering the creation of new treatment centers online, as well as different approaches to traditional treatment, which can be moved online on either a temporary or permanent basis.
For example, during a lockdown, an addiction recovery service using self-management and recovery training groups successfully transitioned from in-person treatment to telephone consultations with no change in treatment quality.
Care for non-opioid addictions is often found wanting, and this has only been exacerbated since the pandemic. A review of country-level briefing notes developed six months after Covid-19’s worldwide outbreak found eight countries advocated for increased telehealth solutions to addiction care.
Although the issues of social isolation and increased screen time remain, online delivery, as a treatment modality, increases overall efficiency and administrative compliance.
Another potential benefit of telehealth treatment is the ability to integrate other app-based tools for gambling treatment in combination with more traditional methods.
One such tool is ecological momentary intervention, which deliver brief interventions electronically to a person’s phone. In a feasibility trial, using ecological monitoring intervention techniques on smartphones was able to reduce gambling episodes by 71%, craving occurrences by 72%, and craving intensity by 5.4%.
The road ahead
We are traversing unknown territory in a lot of respects. The availability of gambling in the US is now higher than it has ever been, while access to new kinds of treatment is also at a level higher than previously seen.
The emergence of online treatment is a huge positive. The guiding hand of online treatment providers, and their expertise of essential tools like telehealth, will be vital in the months and years to come, as the industry looks to establish sustainable, workable practices in responsible gambling.