“The program has received very positive feedback from the clients”
It all begins with an idea.
Finnish treatment provider Peluuri was an early adopter of online treatment. Back in 2007, Peluuri started providing a bespoke version of our online treatment to people struggling with gambling problems in Finland. The journey began with a single therapist and has now expanded to a team of six. In total, 2684 clients have completed the program. We’ve talked to Peluuri about their experiences of working with the treatment program and the changes they have seen over the years.
What’s your experience working with the treatment program?
The program complements our other services very well. It allows clients to participate from anywhere, and it is provided to clients free of charge. The high level of anonymity and the low threshold are other important factors.
The collected data is very important for us. It is an essential part of our information production, reportage and communication.
Have the characteristics of clients seeking help changed over the years?
Young men, aged 18 to 34, constitute the largest demographic group seeking help from Peluuri. The characteristics of players have largely remained consistent over the years.
In recent years, we have noticed that players seek help earlier. Previously, the average duration before seeking help was 7-9 years, but now it has decreased to 4-6 years. The acceleration of problems can be attributed to the faster and more addictive nature of games, coupled with easy access to money. While physical AGMs used to be the primary cause of issues in the past, nowadays, online casinos—especially online slots—are the predominant contributors. There has been a significant rise in mobile gambling.
Today, clients have way better access to equipment and to the internet, facilitating a smoother experience with the treatment program. In the early days, some clients had to use computers in public libraries or workplaces to complete the modules, which, of course, was not the optimal situation.
Has clients’ attitudes toward online treatment changed over the years?
We haven't seen any notable change in clients’ attitudes, but there seems to be an overall positive change in perception toward online treatment. Maybe because it is a more common and accessible form of treatment now.
How does working with online treatment differ from working with ”traditional treatment”?
For some clients, sharing personal matters is more comfortable over the phone than in face-to-face conversations.
In 2013, we conducted a small pilot with 17 clients in the Gambling Clinic, where we applied the online treatment during face-to-face meetings. Both clients and therapists provided positive feedback, and we observed no significant differences in outcomes.
How do you reach and guide clients into the treatment program?
Clients discover the program through various channels, including the Peluuri helpline/chat, Peluuri's webpage, Google, or referrals from professionals and collaborators. An introduction, featuring a video about the program, is available on the Peluuri webpage. We don’t market the program actively, as the demand already exceeds our capacity to accommodate more clients.
What does your process look like when a client wants to participate in the treatment program?
The client completes and submits the application, available on peluuri.fi.
Upon acceptance, the client is placed in the queue. The client receives a confirmation email along with information about their queue status.
While in the queue, the client receives regular emails about their position and information on reducing gambling harm. Information about alternative forms of treatment and support is also provided during this time.
Upon entering the program, the client receives an email requesting registration.
After registration, the assigned therapist contacts the client to schedule the first call. The client works with the same therapist throughout the entire program.
The program spans over 8 weeks (1 week per module), with weekly assignments and 30-45 minute phone calls with the assigned therapist.
After completing all eight modules, the client receives 1-3 follow-up calls. Two follow-up surveys are completed at 6 and 12 months after program completion.
How do the clients experience the treatment program?
The clients are content with both the program and the content. Typically, clients who initiate the program are highly motivated. However, the long queues and waiting times can be frustrating for them.
Participating in the program is straightforward. Clients have the flexibility to choose both the time and place that suit them for completing the self-study modules, and the client and therapist collaboratively agree on a convenient time for their weekly phone calls. The program has received very positive feedback from the clients, with many clients emphasising the significance of the phone calls with their therapists.
Are there specific elements in the treatment program that hold extra value for you?
The surveys play a crucial role in evaluating and analysing the program's impact, serving as evidence of its effectiveness. Additionally, they provide us with valuable data concerning problem gamblers and gambling problems.
The program provides a structured framework for the client-therapist interaction, ensuring a systematic process. With that being said, the structure is still flexible enough to be tailored to each client's needs. The educational components serve as a solid foundation for meaningful conversations between client and therapist.
Research studies
Two studies have been conducted on Peluuri’s version of the online treatment program. Find them here:
https://akjournals.com/view/journals/2006/11/1/article-p75.xml
”Now I can help clients no matter where they are, while I can work remotely myself.”
Can online treatment be particularly suitable for people with gambling problems? Yes, it is undoubtedly a good complement to traditional treatment to reach out and ensure that more people receive timely treatment, says Pia Norgren, licensed psychologist, specialist in addiction psychology, and co-owner of IBT Uppsala. Pia uses our online treatment for gambling problems to treat clients throughout Sweden. We spoke with Pia to learn more about how it's going and why she chose to work with online treatment.
Why did you want to start treating gambling problems online?
I wanted access to a structured treatment for gambling problems and to reach more clients. Now I can help clients no matter where they are, while I can work remotely myself.
I feel that online treatment suits people with gambling problems particularly well. They are used to sitting at the computer, and I find that it's almost easier for them to engage in treatment in this format compared to meeting physically and doing assignments with pen and paper.
Very few seek help for their gambling problems through the municipality. They don't want to go there and ask for treatment. There is a significant shame associated with gambling problems – in that case, it can be a good alternative to receive treatment digitally and more anonymously. I have weekly video calls with the clients I treat, where we go through and discuss the tasks the client has done independently during the week. That meeting is needed and important.
How does online treatment differ from "traditional treatment"?
The fact that there is a set treatment structure with ready-made content makes it easier to maintain a thread in the treatment. It's easier to stick to the topic when you have a structure to follow. In traditional treatment, it can be easy to get lost in something else happening at the moment.
For clients with severe comorbidity, online treatment may not be as suitable. However, I can imagine a combination where part of the treatment occurs face-to-face, while online treatment is used as a supplement to address the addiction.
What advantages do you see in using online treatment with a structured format?
First and foremost, I have access to modern tools that are in line with the times to effectively reach more people. For example, I don't have to prepare assignments and send them with clients.
I like that the treatment includes many educational components. Relapse prevention is not really a treatment but more of an education. In online treatment, the client can absorb the knowledge on their own and at their own pace, giving us more room to focus on the core issues during our conversations.
I can follow the client's work in the treatment and see how he or she has answered the various tasks. During our video calls, I use the client's answers as a basis for the conversation. It makes it easy to start a conversation where the client can then speak freely.
What trends do you see for online treatment in the future?
I think there are too few treatment options for addiction in general. I have worked with clients who are criminally involved. They are difficult to reach, and not all therapists want to work with them. Moreover, it may be that you can't even meet them. Being able to work digitally with them would have been very good.
How is the collaboration with Sustainable Interaction?
Great! I have received quick feedback on questions, and everything has been straightforward.
Sustainable Care delivers online solution for treating gambling problems to French Arpej
We are both grateful and proud to announce our partnership with the French association Arpej and SOS Joueurs for the establishment of the first French online therapy for gamblers. This collaboration will provide SELF (French Online Care) treatment adapted to the characteristics of French-speaking players facing gambling problems.
We are both grateful and proud to announce our partnership with the French association Arpej and SOS Joueurs for the establishment of the first French online therapy for gamblers. This collaboration will provide SELF (French Online Care) treatment adapted to the characteristics of French-speaking players facing gambling problems.
Sustainable Care is the designers and creators behind the online treatment, which includes a secure platform for managing and administering clients and therapists, and an evidence-based treatment program with eight modules, each targeting a different aspect of gambling addiction and treatment.
Based on methods such as Motivational Interviewing (MI) and CBT (Cognitive Behavioral Therapy), the treatment combines information, questions, interactive exercises and a forum for peer support. The closed system allows for efficient client-therapist contact and is designed to let clients progress at their own pace.
–We’ve been working with online treatment for many years now and have seen firsthand the positive impact our model has on individuals participating in the treatment. This positive effect is further supported by the extensive research conducted on our treatment, says Johan Brandsten, CEO of Sustainable Interaction.
– This will be the first online therapeutic program for treating excessive gamblers in France. We’ve adapted the treatment program for the French market in collaboration with Armelle ACHOUR, Director of the remote resource center, Thierry Ventre, Doctor addictologist and Jean-Michel Costes, researcher attached to Concordia University in Montreal, says Emmanuel BENOIT, Managing Director of ARPEJ and SOS.
– When making these adaptations, we’ve been sensitive to the existing structure of the treatment program and the experiences that have already been gained. We would like to express our gratitude to Sustainable Interaction for their collaboration, Emmanuel concludes.
Johan Brandsten, CEO
Criminal sanctions clients in Finland receive online treatment for gambling problems
Peluuri has been running the Peli poikki online treatment program since 2007. After learning from their experiences and looking into their evaluations of the program’s effectiveness, we felt that the program would be very suitable for criminal sanctions clients. We also got very good feedback from Peluuri about the program and working with Sustainable Interaction.
Hi, Sofia! You offer online treatment for gambling problems to criminal sanctions clients all over Finland, could you tell us more about that?
Sofia Holmberg, project manager at RETS
Studies show that prisoners are 5 to 10 times more likely to have gambling problems compared to the rest of the population. By addressing problem gambling among criminal sanctions clients, we aim to reduce recidivism and individual and societal harms caused by gambling.
In 2019 the Finnish Criminal Sanctions Agency started strengthening their services for community sanctions clients with gambling problems by cooperating with Gambling Clinic in the Helsinki Metropolitan area. In a pilot project, community sanctions officers in Southern Finland were trained to identify signs of gambling problems among their clients and refer them to the Peluuri’s Peli poikki online treatment program as needed. The results of the pilot showed the importance of addressing gambling problems among community sanctions clients.
And now you’re building on that in a new project?
As a continuum to the pilot project, RETS (RETS Crime-Free Life Support Foundation) started the RISERaPeli-project in October 2021. In the project we will develop our version of the Peli poikki program to meet the needs of criminal sanctions clients who gamble at a problematic or high-risk level.
Within the project, you’ll continue training criminal sanctions officers to identify signs of gambling problems?
Yes. In collaboration with the Criminal Sanctions Agency we aim to train all criminal sanctions officers to identify signs of problematic gambling behaviour. According to a Finnish study, 85% of prison workers felt that problem gambling is a serious concern among criminal sanctions clients. They also felt that their knowledge to provide help for clients with gambling problems were insufficient. So there’s really a great need.
What challenges do you think the online treatment program will help you solve?
In 2019 the average daily number of criminal sanctions clients was higher than the number of inmates in Finland. Working online gives us the possibility to intervene quickly and provide help with a very flexible schedule to be able to prevent gambling problems from escalating. We can reach all clients regardless of where they are located and what type of community sanction they are serving.
Why did you choose Sustainable Interaction’s online treatment program?
Peluuri has been running the Peli poikki online treatment program since 2007. After learning from their experiences and looking into their evaluations of the program’s effectiveness, we felt that the program would be very suitable for criminal sanctions clients. We also got very good feedback from Peluuri about the program and working with Sustainable Interaction.