{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:39:30Z","timestamp":1790357970444,"version":"4.1.0"},"reference-count":86,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,12,21]]},"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      The prevalence of disordered gambling worldwide has been estimated at 2.3%. Only a small minority of disordered gamblers seek specialist face-to-face treatment, and so a need for alternative treatment delivery models that capitalise on advances in communication technology, and use self-directed activity that can complement existing services has been identified. As such, the primary aim of this study is to evaluate an online self-directed cognitive\u2013behavioural programme for disordered gambling (G\n                      <jats:sc>ambling<\/jats:sc>\n                      L\n                      <jats:sc>ess:<\/jats:sc>\n                      F\n                      <jats:sc>or<\/jats:sc>\n                      L\n                      <jats:sc>ife).<\/jats:sc>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>\n                      The study will be a 2-arm, parallel group, pragmatic randomised trial. Participants will be randomly allocated to a pure self-directed (PSD) or guided self-directed (GSD) intervention. Participants in both groups will be asked to work through the 4 modules of the G\n                      <jats:sc>ambling<\/jats:sc>\n                      L\n                      <jats:sc>ess<\/jats:sc>\n                      programme over 8\u2005weeks. Participants in the GSD intervention will also receive weekly emails of guidance and support from a gambling counsellor. A total of 200 participants will be recruited. Participants will be eligible if they reside in Australia, are aged 18\u2005years and over, have access to the internet, have adequate knowledge of the English language, are seeking help for their own gambling problems and are willing to take part in the intervention and associated assessments. Assessments will be conducted at preintervention, and at 2, 3 and 12\u2005months from preintervention. The primary outcome is gambling severity, assessed using the Gambling Symptom Assessment Scale. Secondary outcomes include gambling frequency, gambling expenditure, psychological distress, quality of life and additional help-seeking. Qualitative interviews will also be conducted with a subsample of participants and the Guides (counsellors).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study has been approved by the Deakin University Human Research and Eastern Health Human Research Ethics Committees. Findings will be disseminated via report, peer-reviewed publications and conference presentations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.anzctr.org.au\/Trial\/Registration\/TrialReview.aspx?id=368996\" ext-link-type=\"uri\">ACTRN12615000864527<\/jats:ext-link>\n                      ; results.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-014226","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T20:20:10Z","timestamp":1487967610000},"page":"e014226","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["GAMBLINGLESS: FOR LIFE study protocol: a pragmatic randomised trial of an online cognitive\u2013behavioural programme for disordered gambling"],"prefix":"10.1136","volume":"7","author":[{"given":"S S","family":"Merkouris","sequence":"first","affiliation":[{"name":"School of Psychology, Deakin University, Geelong, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S N","family":"Rodda","sequence":"additional","affiliation":[{"name":"School of Psychology, Deakin University, Geelong, Victoria, Australia"},{"name":"Turning Point, Eastern Health, Fitzroy, Australia"},{"name":"Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia"},{"name":"Auckland University of Technology, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Austin","sequence":"additional","affiliation":[{"name":"School of Psychology, Deakin University, Geelong, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D I","family":"Lubman","sequence":"additional","affiliation":[{"name":"Turning Point, Eastern Health, Fitzroy, Australia"},{"name":"Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Harvey","sequence":"additional","affiliation":[{"name":"School of Medicine, Flinders University, Adelaide, Australia"},{"name":"School of Medicine, Deakin University, Geelong, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Battersby","sequence":"additional","affiliation":[{"name":"School of Medicine, Flinders University, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Centre for Addiction and Mental Health, Toronto, Ontario, Canada"},{"name":"Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Psychology, University of Toronto, Toronto, Ontario, Canada"},{"name":"Research School of Population Health, Australian National University, Canberra, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Lavis","sequence":"additional","affiliation":[{"name":"School of Medicine, Flinders University, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Smith","sequence":"additional","affiliation":[{"name":"School of Medicine, Flinders University, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N A","family":"Dowling","sequence":"additional","affiliation":[{"name":"School of Psychology, Deakin University, Geelong, Victoria, Australia"},{"name":"Melbourne Graduate School of Education, University of Melbourne, Parkville, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,2,23]]},"reference":[{"key":"2025121513334655000_7.2.e014226.1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (APA). 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