Evaluating the efficacy of dynamic group psychotherapy for problem gambling: a qualitative study with transcripts from a brief cycle of online group psychotherapy sessions

Introduction: Problem gambling, exacerbated by the COVID-19 pandemic which limited access to traditional therapeutic interventions, necessitates innovative treatment approaches. This qualitative study examines the efficacy of dynamic group psychotherapy through online sessions, aiming to enhance standard gambling addiction treatments. It evaluates therapeutic factors and the group climate established through the online medium, assessing their impact on therapeutic relationships and member dynamics. Methods: Conducted in collaboration between the University of Padua and a Northeast Italy Health Unit, the study enrolled individuals in ongoing gambling addiction treatments. Ten online group psychotherapy sessions utilized mediatory objects to promote therapeutic engagement and dialogue. The methodological framework relied on thematic analysis of session transcripts to explore emergent themes, participants dynamics, and therapeutic processes initiated by the facilitators and adopted by the group. Results: The online setting fostered a cohesive, supportive group climate, with occasional disruptions that resolved rapidly, enhancing group intimacy. Participants valued the online modality for its flexibility and the safe interpersonal distance it offered, facilitating open sharing. Mediatory objects triggered reflective processes on cognitive styles and personal resources leading to cognitive schema adjustments and more adaptive thinking. The shared structuring of the intervention by the entire care team facilitated the activation of significant therapeutic processes, with the group taking an active role in its therapeutic journey.Discussion: Findings suggest online group psychotherapy as an effective complement to in-person sessions in gambling addiction treatment, highlighting its potential to overcome accessibility barriers. The integration of mediatory objects in online settings enhanced patient engagement and therapeutic outcomes, supporting the broader acceptance of online psychotherapeutic models. This approach suggests a promising pathway to improve treatment access and adherence for problem gambling and beyond, addressing mental health challenges in the digital era.