Category: Addictive Behaviors
The failure to complete homework assignments is related to poorer outcomes in CBT for disordered gamblers. Widespread use of smartphones and application (app) software provides potential to enhance the completion of homework. To date, no studies have investigated whether smartphone apps are an acceptable, feasible, and efficacious means for completing homework in CBT with disordered gamblers.
Participants were 10 clients who completed homework using a smartphone app, a historical sample of 10 clients, matched on therapist, who completed homework using hardcopy assignments, and four advanced clinical psychology doctoral student therapists. The mean age of the clients was 49.20 years (SD = 13.83) and 55% were female. The sample of clients was diverse with 55% identifying as African American and 45% identifying as Caucasian. They endorsed an average of 6.80 (SD = 2.42) DSM-5 criteria for disordered gambling.
Hardcopy assignments from a gambling-focused CBT were adapted for an Android/Apple-compatible smartphone app. Content of the four homeworks was identical between the hardcopy and app versions. Homework assignments focused on decisional balance, triggers and consequences to gambling, healthy alternatives, and relapse prevention. Clients using the app were reminded to complete these weekly assignments by a notification system that alerted them three days per week within nine hour periods.
At intake and post-treatment, clients completed measures of disordered gambling symptomatology, frequency of gambling, and dollars wagered in the past 30 days. Clients and therapists rated the acceptability of the app post-treatment.
Five clients using the app and six using paper-and-pencil completed treatment. The five clients who completed treatment using the app “agreed” or “strongly agreed” they enjoyed using it. Three therapists “agreed” that they enjoyed using the app, and one therapist was “neutral.” Compared to those who completed the hardcopy homework (M = 1.80, SD = 1.75), the app clients completed a greater number of the homework assignments (M = 2.20, SD = 1.62). Interestingly, the app clients attended slightly fewer sessions (M = 4.00, SD = 1.80 vs. M = 3.50, SD = 1.90). On average, clients who used either form of homework experienced a reduction in disordered gambling symptoms.
Our results provide initial evidence that using smartphone apps to complete homework assignments do not detract from gambling-focused CBT. Rather, they may enhance their completion. These results are consistent with previous research that apps lead to greater homework completion and a reduction in psychological symptoms (Mansson et al., 2013). However, additional research is imperative for optimizing these apps for completing homework assignments in gambling-focused CBT.
Rory Pfund– Graduate Student, University of Memphis, Memphis, Tennessee
Samuel Peter– University of Memphis
Abigail Armstrong– University of Memphis
James Whelan– University of Memphis
Kenneth Ward– University of Memphis
Andrew Meyers– University of Memphis