The Use of a Smartphone Application to Complete Therapeutic Homework in Cognitive-Behavioral Therapy for Gambling Disorder: a Pilot Study of Acceptability and Feasibility

Abstract

The efficacy of cognitive-behavioral therapy (CBT) is limited by clients’ failure to complete homework assignments. Widespread growth in smartphone use and application (app) software provides the potential to enhance the homework completion. In this pilot study, we examined the demographics of clients who declined to use an app to complete homework in CBT for gambling disorder. We also systematically collected information on what clients liked and disliked about an app to complete homework and compared their homework completion and treatment attendance with an archival, matched sample of 15 clients who completed homework using hardcopy. Clients who declined to use the app to complete homework were socioeconomically disadvantaged. Almost all clients who rated the app agreed or strongly agreed that they enjoyed using it. Clients who used the app to complete homework attended a similar number of treatment sessions but completed more homework than clients who used hardcopy. For individuals with access to smartphones, these results support the acceptability and feasibility of a smartphone app to complete therapeutic homework in CBT for gambling disorder and allow us to make several recommendations for future randomized controlled trials. These studies should allow clients to customize the frequency of homework reminders and to complete homework over multiple log-ins to the app. However, the implementation of smartphone-based healthcare interventions may not enhance the accessibility of care for individuals from socioeconomically disadvantaged backgrounds.