Protocol: Mindfulness as an add-on intervention in treatment for problem gambling – a randomized control trial and a qualitative analysis in clinical settings in Sweden (Preprint)

BACKGROUND Problem gambling is a common behavioral addiction with deteriorating effects on mental health, social relationships and financial situation of affected individuals. The condition can be treated, but treatment seeking is often low, and few specific therapeutic methods have been researched in clinical trials. OBJECTIVE This protocol paper presents a study aiming to test whether mindfulness, as an add-on to treatment as usual in clinical settings, can improve gambling behavior and mental health, compared to a waitlist group which receives the active intervention later. METHODS Patients already enrolled to some extent in a treatment setting will be randomized to receive either an eight-week, weekly group mindfulness intervention (intervention group) or to be placed on a waiting list for two months, after which they also undergo the intervention. Problem gambling, depressive and anxiety symptoms are assessed at baseline, after the intervention group’s end of treatment, and three and 12 months after end of treatment. Patient satisfaction with the intervention will be assessed post-treatment. The study is followed by a qualitative interview study assessing lived experience, effects and challenges in mindfulness treatment for problem gambling. RESULTS Results will be presented in two separate publications. One quantitative paper will address gambling behavior as the primary outcome and depressive and anxiety symptoms as secondary outcomes. One qualitative paper will describe results of a content analysis of a number of relevant features of the intervention. CONCLUSIONS There is need for more effective interventions against problem gambling, and user acceptability is important to assess. This study will add to the treatment literature in problem gambling, and through the qualitative paper, it will deepen the understanding of favorable and challenging features of mindfulness for patients with problem gambling. CLINICALTRIAL The present study has been pre-registered at clinicaltrials.gov, clinicaltrials identifier NCT06561139.