Social rank and compassion: How insecure striving, social safeness and fears of compassion mediate the relationship between masculinity, depression and anxiety.

OBJECTIVE: Traditional masculinity norms displayed by men attempt to signal a dominance or 'toughness' to others; however, traditional masculine norms are associated with a range of mental health difficulties, including depression and anxiety. Based on social rank theory, we tested the mediating role of insecure striving, social safeness and fears of compassion on the relationship between masculinity, anxiety and depression. We also examined whether compassionate goals were negatively correlated with masculine norm adherence. DESIGN: We used a cross-sectional survey design recruiting 844 men, aged 18-60 years (M = 34.0, SD = 14.4). RESULTS: Our results replicated previous findings with masculine norms significantly associated with depression and anxiety. Extending on previous work, we found insecure striving, social safeness and fears of compassion fully mediated these relationships for anxiety and partially for depression. This relationship was strongest for the masculinity subtypes of self-reliance and emotional control. Compassionate goals were negatively associated with masculine norm adherence. CONCLUSIONS: Social rank theory offers a helpful explanatory framework to understand the links between traditional masculinity and mental health, highlighting the importance of social safeness and insecure striving for men.

Making Connections that Count - a Case Study of the Family Referral Service in Schools Program on the Central Coast, New South Wales, Australia.

Introduction: Adverse childhood experiences (ACEs) are associated with health and social problems in later life, with an early intervention highly desirable for better outcomes. Description: The Family-Referral-Services-In-Schools (FRSIS) is an early-intervention case management program for children and families with complex unmet needs, providing access to family support, housing, mental health care, and/or drug and alcohol services. The in-school trial setting was aimed at improving service uptake which was low in its community counterpart. Discussion: FRSIS was a well-regarded intervention that reduced barriers to access for vulnerable families. The school setting and non-government agency service provision led to increased acceptability and trust. The program reached 5% of the student population. Support was tailored to family need, which was often complex and involved both children and caregivers. Initially, the multi-agency partnership and governance oversight group championed the service and enabled the pilot to be established, however funding uncertainty and competing priorities saw leadership support ebb away despite operational success. Conclusion: The FRSIS model breaks down numerous barriers to accessing care for vulnerable families by its generalist nature and tailored approach and represents a high-trust approach to brokering appropriate care. Consistency in leadership support was a missed opportunity for program sustainability.

Psychometric Evaluation of a New Digitally Animated Child Self-Report Assessment Instrument: The Interactive Child Distress Screener.

The present study aimed to provide the first psychometric evaluation of the newly developed, digitally animated assessment instrument: the Interactive Child Distress Screener (ICDS). The latent factor structure of the novel ICDS was first established using exploratory factor analysis (EFA) on 15 pairs of animated items using a community sample (N = 266) of child-parent dyads. EFA results support a two-factor structure representing two broad domains of internalizing and externalizing difficulties (r = .52) and comprised 12 items. The reliability of the factors was strong with ordinal alpha and omega coefficients above .84 and .87, respectively, for each of the subscales. Convergent validity for the overall sample was supported with established child and parent-reported measures of internalizing and externalizing problems; however, the ICDS factors demonstrated convergence greater in magnitude with other child-reported measures such as the Me and My School Survey. Satisfaction and utility ratings by children indicated that the digital format was highly acceptable.

Parental Adjustment Scale: Validation of a brief, five-item measure of parental adjustment for use with families of typically developing children and children with developmental and/or intellectual disabilities in Australia.

BACKGROUND: Explores the validity of the five-item parental adjustment scale, a subscale of the previously validated Parenting and Family Adjustment Scales. AIM: The aim was to assess the factor structure and convergent validity of a measure of parental adjustment within parents of typically developing children and parents of childiren with developmental and/or intellectual disabilities. METHODS AND PROCEDURES: Cross-sectional survey data was analysed from Australian parents of children aged 2-12 years who were typically developing children (N = 683) and had developmental and/or intellectual disabilities (N = 756). Confirmatory factor analyses and multi-group structural equation modelling examined if the factor structure performed similarly across the two populations. Convergent validity was assessed. OUTCOMES AND RESULTS: The confirmatory factor analysis supported the hypothesised one-factor structure for the parental adjustment scale in both populations. Partial measurement invariance confirmed that the scale was structurally consistent within both parent groups. The convergent validity was supported by significant correlations with the DASS-21 in the disability population and the K10 in the typically developing population. CONCLUSIONS AND IMPLICATIONS: This brief, easily administered, five-item scale demonstrates strong potential in assessing parental adjustment, within both parents of typically developing children and parents of children with developmental and/or intellectual disabilities.

Predicting positive outcomes and successful completion in an online parenting program for parents of children with disruptive behavior: An integrated data analysis.

Online delivery of parenting support is steadily increasing, yet the factors that influence program engagement and efficacy are still understudied. This study used an integrated data analysis approach to identify family and program-related factors that influence outcomes. We combined individual data from seven published efficacy trials of the web-based version of the Triple P-Positive Parenting Program. Data were analyzed for 985 families with children aged between 2 and 12 years (M = 4.87; SD = 2.14) using a Latent Change Score approach. At post-intervention, sociodemographic factors were not predictive of changes in child behavior problems, while parents of boys and those with higher education showed greater improvements in dysfunctional parenting. Parents who were initially more confident in their parenting showed more overall gains while parents with more initial adjustment difficulties showed less improvement. Only the effect of baseline child behavior problems on changes in dysfunctional parenting was moderated by treatment condition. At follow-up, program variant and completion were the primary outcome predictors, with completion found to be related to initial parenting confidence, internet usage and program variant. The implications of these findings for reaching and retaining parents in online programs across all phases of the engagement process are discussed.

The Relations of Parental Autonomy Support, Parental Control, and Filial Piety to Chinese Adolescents' Academic Autonomous Motivation: A Mediation Model.

This study attempted to examine the mediating role of filial piety in the relationships between parental autonomy support and control and Chinese adolescents' academic autonomous motivation. A set of questionnaires were administered to 492 adolescent students at two senior high schools in Fuzhou, China. Confirmatory Factor Analysis and Structural Equation Modeling were employed to analyze the data. The results showed that reciprocal filial piety (RFP) fully mediated the relationships of parental autonomy support and behavioral control with adolescents' academic autonomous motivation. RFP did not significantly mediate the relationship between psychological control and academic autonomous motivation. Comparatively, authoritarian filial piety (AFP) did not play a significant mediating role in the relationship between the three parenting dimensions and adolescents' academic autonomous motivation. The findings provide a new perspective for understanding the relationship between parenting behaviors and Chinese adolescents' academic autonomous motivation.

Collective Impact Approaches to Promoting Community Health and Wellbeing in a Regional Township: Learnings for Integrated Care.

This Perspective Paper explores the challenges of implementing local initiatives guided by the tenets of the Collective Impact (CI) approach. As such, it draws implications of CI for integrated health and social care efforts to improve and sustain health and social outcomes within a community-wide context, based on our efforts to deploy a CI intervention in the regional town of Muswellbrook, New South Wales (NSW) Australia. A program of health and wellbeing activities providing mental health and wellness messages and activities was implemented in the township over 2 years by the Family Action Centre (FAC), University of Newcastle, Australia. A key takeaway was the importance of authentic community engagement and active involvement as opposed to mere consultation.

Compassion-Focused Technologies: Reflections and Future Directions.

Compassion is a prosocial motivation that is critical to the development and survival of the human species. Cultivating compassion involves developing deep wisdom, insight, and understanding into the nature and causes of human suffering; and wisdom and commitment to take positive action to alleviate suffering. This perspective piece discusses how compassion relates to the context of modern technology, which has developed at a rapid pace in recent decades. While advances in digital technology build on humankind's vast capacity to develop practical tools that promise to enrich our lives and improve our social connections, in reality the effects are often far from benign. The motives underlying the development of many contemporary digital platforms seem rooted in competitiveness and capitalism; while modern social media and online platforms are having a profound and pervasive impact on the mental health and wellbeing of humans around the globe. Nonetheless, digital technology holds considerable potential to promote compassionate insight, wisdom, and prosocial behavior. We reflect on the current state of technology within human society and examine the notion of compassionate technologies; discuss how contemporary paradigm shifts such as the inclusive design movement may be harnessed to build tools and platforms that promote collective good and increase prosocial behavior; and highlight examples of initiatives that are harnessing modern technology to advance democracy, collective knowledge, and personal freedoms and agency.

Co-design and qualitative validation of animated assessment item content for a child-reported digital distress screener.

PURPOSE: The Interactive Child Distress Screener (ICDS) is a novel, digital screening tool that is currently under development and aims to broadly assess self-reported emotional and behavioural distress in children aged five to 11 years. This study implemented a generative participatory codesign and iterative refinement process to qualitatively validate the content of 30 animated assessment items developed for the ICDS by assessing their acceptability and accuracy from the child's perspective. METHODS: The participants (N = 62) were five to 11-year-old children. Individual interviews were conducted with each child to determine acceptability and validity of animated items and facilitate the co-design refinement process of the animated assessment items. RESULTS: Twenty-two out of 30 (73%) items met ≥80% satisfaction and accuracy consensus in their original format, six items (20%) required one round of refinement before meeting consensus, and two items (7%) required two rounds of refinements. Combined acceptability of animated items was high, ranging from 4.1 to 5 out of 5 across all items. CONCLUSION: Participants were able to accurately identify and understand socio-emotional and behavioural constructs when depicted as animated items. Acceptability was high, even in first iterations when accuracy of understanding required refinement. This study highlighted the importance and benefits of iterative participatory design methodology in ensuring assessment items developed for children are understood, accepted and likely to be effective in obtaining accurate self-report.

The efficacy and acceptability of the Triple P: Positive Parenting Program with Turkish parents.

AIM: To evaluate the effectiveness of Group Teen Triple P with parents who have behaviorally disturbed adolescents. METHODS: The research was conducted in an experimental manner. The sample was 76 parents who were grouped as 38 cases and 38 controls with a block randomization method. Data were collected using the Family Background Questionnaire, General Health Questionnaire (GHQ-12), Strengths and Difficulties Questionnaire (SDQ), Conflict Behavior Questionnaire (CBQ), and Parent Satisfaction Questionnaire. Group Teen Triple P Program was implemented with the case group for 8 weeks. Data were collected immediately after the program and again after 3 months. Data were evaluated using variance analysis, t test, χ2 test, multivariate analysis of covariance, and analysis of covariance test. RESULTS: It was found that participation in Group Teen Triple P resulted in the improvement of parental mental health, decreased problematic behavior of the adolescents, and fewer problems between adolescents and their parents. CONCLUSION: Group Teen Triple P should be made available to more parents of adolescents in Turkey.

Comparing apples and pears: misleading conclusions about the population mental health impact of a parenting programme, a commentary on Marryat, Thompson and Wilson (2017).

BACKGROUND: The article by Marryat, Thompson and Wilson (2017) in BMC Pediatrics presents an evaluation of the implementation of the Triple P system as a public health intervention conducted by the Glasgow City Council and NHS Greater Glasgow and Clyde. DISCUSSION: Unfortunately, the conclusions drawn are questionable for multiple reasons. The lack of a controlled design precludes defensible conclusions about intervention effects free from routine threats to internal validity. There was a substantial mismatch between the intervention sample and the population sample assessed. The article's title and abstract leave readers with the mistaken impression that the children assessed for outcome were suitably representative of intervention families, when in fact many of the children in the intervention families were missing from the teacher-report outcome assessment (a single questionnaire), and many or most of the children in the teacher-report outcome assessment belonged to families who had never received the intervention. Although Triple P targets parent-child relations and child behavioural and emotional problems at home, Marryat et al. narrowly defined mental health impact as child difficulties in nursery or preschool, while not reporting data from practitioners and parents in the same evaluation that did not support the authors' conclusion. The paper was further diminished by a number of misleading statements and factual errors related for example to other research on Triple P. Studying the extent to which child mental health functioning at home can generalise to school settings is an important topic of inquiry in relation to parenting support interventions, but unfortunately the Marryat et al. article did not move this area forward.

Human evolution and culture in relationship to shame in the parenting role: Implications for psychology and psychotherapy.

OBJECTIVES: There is considerable evidence that early parenting has profound effects on a range of physiological and psychological maturation processes. Furthermore, psychotherapy often addresses some of the distortions and developmental difficulties that have arisen from early childhood. While research has focused on obvious candidates such as abuse and neglect, this paper reviews some of the core themes related to a less investigated area, specifically parental shame on child development. Role shame sensitive parenting styles will be explored against an evolutionary background that contrasts early human and modern human rearing contexts. We also outline a study examining the role of shame in psychological controlling and dysfunctional parenting styles, its relationship to different dimensions of shame and fears of compassion. DESIGN: An online survey was conducted containing self-report measures of dysfunctional parenting styles, three dimensions of shame (external, internal, and reflected), fears of compassion, mental health indices, and a measure of psychological flexibility. METHODS: An online survey was accessed by 333 parents (306 being female) with a child between the ages of 3-9 years. RESULTS: Two hierarchical multiple regressions indicated support for our two primary hypotheses, with shame explaining significant variance in both psychological controlling and dysfunctional parenting styles over and above that explained by psychological inflexibility, parental mental health, and fears of compassion. Additionally, results from standard multiple regressions indicated that fears of compassion account for significant variance in external shame, as well as internal and reflected shame. CONCLUSIONS: Recommendations for future research include focusing on parental motivation in order to help support parents and children are provided. PRACTITIONER POINTS: Shame is a major factor for how parents engage in parenting practices and respond to their children Practitioners need to be sensitive to the shame parents can experience and asses for it Assessing shame-threat in parenting and shifting to compassionate motivation can lead to more responsive and positive parenting.

The 'Flow' of compassion: A meta-analysis of the fears of compassion scales and psychological functioning.

This meta-analysis examined the associations between the fears of compassion and mental health. We extracted 19 studies reporting 154 effect sizes (Pearson's r) from 22 independent samples published during the last seven years, with data from 4723 participants. All studies used the Fears of Compassion Scales (FCS), which includes three subscales; fears of compassion for self, for others, and receiving from others. Specific mental health outcomes included: depression; anxiety; distress; and well-being, as well as the psychological vulnerability factors of self-criticism and shame. The overall association between the three FCS subscales and mental health difficulties was .49, .30 and .48 for fears of self-compassion, fears of compassion for others, and fears of compassion from others, respectively. Across mental health domains and vulnerability factors, pooled effect sizes ranged between r = .13 and .55 (in absolute value), with the strongest associations found between the mental health variables of shame, self-criticism, and depression, and the FCS subscales of fears of self-compassion and fears of receiving compassion. Moderator analyses were also conducted, including, age, gender, publication status, and sample (clinical vs. non-clinical). Overall, clinical populations demonstrated significantly stronger associations between mental health difficulties and fears of self-compassion, relative to non-clinical populations.

Towards Scalable, Integrative Assessment of Children's Self-Regulatory Capabilities: New Applications of Digital Technology.

The assessment of self-regulation in children is of significant interest to researchers within education, clinical and developmental psychology, and clinical neuroscience, given its importance to adaptive functioning across a wide range of social, educational, interpersonal, educational and health domains. Because self-regulation is a complex, multidimensional construct, a range of assessment approaches have been developed to assess its various components including behavioural, cognitive and emotional domains. In recent years, digital technology has been increasingly used to enhance or supplement existing measurement approaches; however, developments have predominantly focused on translating traditional testing paradigms into digital formats. There is a need for more innovation in digital psychological assessments that harness modern mechanisms such as game-based design and interactivity. Such approaches have potential for the development of scalable, adaptable universal approaches to screening and assessment of children's self-regulatory capabilities, to facilitate early identification of difficulties in individuals and also guide planning and decision-making at a population level. We highlight a novel, innovative digital assessment tool for children called Rumble's Quest, a new measure of children's socio-emotional functioning that shows promise as an integrative assessment of well-being and self-regulation, and which incorporates both self-report and direct assessment of cognitive self-regulation. This tool is scalable, can be integrated into normal classroom activities, and forms part of a comprehensive prevention support system that can be used to guide stakeholders' decision-making regarding early intervention and support at the individual, classroom, school and community level. We finish by discussing other innovative possibilities for psychological assessment with children, using new and emerging technologies and assessment approaches.

Exploring scale validity and measurement invariance of the Toronto Mindfulness Scale across levels of meditation experience and proficiency.

OBJECTIVES: The Toronto Mindfulness Scale (TMS) is a widely used instrument of state mindfulness. Research suggests the interpretation and functioning of mindfulness scale items may differ as a function of meditation experience, and thus, establishing invariance across experience levels is essential. METHODS: Five hundred and five meditation practitioners (32.7% male, 33.3% female, and 34.1% unspecified) with an average age of 42.37 years (SD = 12.70) completed the TMS online. RESULTS: Results support at least partial invariance across subgroups based on years of mindfulness meditation experience and self-reported proficiency. Construct validity of the Decentering subscale was also supported; however, the Curiosity subscale did not meet validity expectations, as it required additional model modifications to yield good fit, and means were not sensitive to differences in group experience or proficiency. CONCLUSIONS: Our findings suggest further review of the TMS Curiosity items may be warranted to determine its suitability for use within mindfulness assessment.

Do Parents Benefit From Help When Completing a Self-Guided Parenting Program Online? A Randomized Controlled Trial Comparing Triple P Online With and Without Telephone Support.

In response to recent increases in the dissemination of Web-based parenting supports, an important consideration is whether the core benefits of self-directed participation in online parenting interventions are counterbalanced by issues such as high dropout and noncompletion rates commonly reported within the Internet intervention literature. This study outlines a randomized controlled trial of Triple P Online, a Web-based variant of the Triple P-Positive Parenting Program, delivered with varied levels of support scaffolding. Participants were 183 parents of children between 1 and 8 years of age with concerns about their child's behavior and at least one area of disadvantage or family difficulty. Participants were randomized to self-directed Triple P Online, telephone-supported Triple P Online, or a wait-list control. Primary outcomes measured at baseline, postintervention, and 5-month follow-up were negative parenting styles and child behavior problems. Secondary outcomes included parent confidence, anger, and adjustment; relationship quality; program engagement; and parent satisfaction. Self-directed participants showed short-term treatment effects, including reductions in overall negative parenting and frequency of child behavior problems, while practitioner support led to greater improvements in negative parenting and intensity of difficult child behaviors. Participants in the supported condition were also more likely to complete modules and reported greater program satisfaction. At follow-up, 50% of outcomes for the self-directed condition were significantly better than the control, while 94% of outcomes were significantly better than the control in the practitioner-supported condition. Although self-directed online approaches to parenting intervention are promising, this research highlights how minimal support can improve effective engagement and enhance outcomes for families.

The Interactive Child Distress Screener: Development and Preliminary Feasibility Testing.

BACKGROUND: Early identification of child emotional and behavioral concerns is essential for the prevention of mental health problems; however, few suitable child-reported screening measures are available. Digital tools offer an exciting opportunity for obtaining clinical information from the child's perspective. OBJECTIVE: The aim of this study was to describe the initial development and pilot testing of the Interactive Child Distress Screener (ICDS). The ICDS is a Web-based screening instrument for the early identification of emotional and behavioral problems in children aged between 5 and 12 years. METHODS: This paper utilized a mixed-methods approach to (1) develop and refine item content using an expert review process (study 1) and (2) develop and refine prototype animations and an app interface using codesign with child users (study 2). Study 1 involved an iterative process that comprised the following four steps: (1) the initial development of target constructs, (2) preliminary content validation (face validity, item importance, and suitability for animation) from an expert panel of researchers and psychologists (N=9), (3) item refinement, and (4) a follow-up validation with the same expert panel. Study 2 also comprised four steps, which are as follows: (1) the development of prototype animations, (2) the development of the app interface and a response format, (3) child interviews to determine feasibility and obtain feedback, and (4) refinement of animations and interface. Cognitive interviews were conducted with 18 children aged between 4 and 12 years who tested 3 prototype animated items. Children were asked to describe the target behavior, how well the animations captured the intended behavior, and provide suggestions for improvement. Their ability to understand the wording of instructions was also assessed, as well as the general acceptability of character and sound design. RESULTS: In study 1, a revised list of 15 constructs was generated from the first and second round of expert feedback. These were rated highly in terms of importance (mean 6.32, SD 0.42) and perceived compatibility of items (mean 6.41, SD 0.45) on a 7-point scale. In study 2, overall feedback regarding the character design and sounds was positive. Children's ability to understand intended behaviors varied according to target items, and feedback highlighted key objectives for improvements such as adding contextual cues or improving character detail. These design changes were incorporated through an iterative process, with examples presented. CONCLUSIONS: The ICDS has potential to obtain clinical information from the child's perspective that may otherwise be overlooked. If effective, the ICDS will provide a quick, engaging, and easy-to-use screener that can be utilized in routine care settings. This project highlights the importance of involving an expert review and user codesign in the development of digital assessment tools for children.

Attitudes Toward e-Mental Health Services in a Community Sample of Adults: Online Survey.

BACKGROUND: Despite evidence that e-mental health services are effective, consumer preferences still appear to be in favor of face-to-face services. However, the theory of planned behavior (TPB) suggests that cognitive intentions are more proximal to behavior and thus may have a more direct influence on service use. Investigating individual characteristics that influence both preferences and intentions to use e-mental health services is important for better understanding factors that might impede or facilitate the use of these services. OBJECTIVE: This study explores predictors of preferences and intentions to access e-mental health services relative to face-to-face services. Five domains were investigated (demographics, technology factors, personality, psychopathology, and beliefs), identified from previous studies and informed by the Internet interventions model. We expected that more participants would report intentions to use e-mental health services relative to reported preferences for this type of support and that these 5 domains would be significantly associated with both intentions and preferences toward online services. METHODS: A mixed sample of 308 community members and university students was recruited through social media and the host institution in Australia. Ages ranged between 17 and 68 years, and 82.5% (254/308) were female. Respondents completed an online survey. Chi-square analysis and t tests were used to explore group differences, and logistic regression models were employed to explore factors predicting preferences and intentions. RESULTS: Most respondents (85.7%, 264/308) preferred face-to-face services over e-mental health services. Relative to preferences, a larger proportion of respondents (39.6%, 122/308) endorsed intentions to use e-mental health services if experiencing mental health difficulties in the future. In terms of the 5 predictor domains, 95% CIs of odds ratios (OR) derived from bootstrapped standard errors suggested that prior experience with online services significantly predicted intentions to use self-help (95% CI 2.08-16.24) and therapist-assisted (95% CI 1.71-11.90) online services in future. Being older predicted increased intentions to use therapist-assisted online services in future (95% CI 1.01-1.06), as did more confidence using computers and the Internet (95% CI 1.06-2.69). Technology confidence was also found to predict greater preference for online services versus face-to-face options (95% CI 1.24-4.82), whereas higher doctor-related locus of control, or LOC (95% CI 0.76-0.95), and extraversion (95% CI 0.88-1.00) were predictive of lower likelihood of preferring online services relative to face-to-face services. CONCLUSIONS: Despite generally low reported preferences toward e-mental health services, intentions to access these services are higher, raising the question of how to best encourage translation of intentions into behavior (ie, actual use of programs). Strategies designed to ease people into new Internet-based mental health programs (to enhance confidence and familiarity) may be important for increasing the likelihood that they will return to such programs later.

Can the Perceived Barriers to Psychological Treatment Scale be used to investigate treatment barriers among females with disordered and non-disordered eating behaviours?

There is a lack of psychometrically sound instruments to assess treatment barriers among individuals with disordered eating behaviours. This study examined the factor structure and psychometric properties of the Perceived Barriers to Psychological Treatment scale (PBPT; Mohr et al., 2010) among a sample of individuals with disordered eating behaviours. Participants were 708 females aged 14 years and older who completed an online survey. The sample was randomly divided in two for the conduct of exploratory (EFA) and confirmatory (CFA) factor analyses. EFA suggested a seven-factor structure retaining 24 of the original 27 items (variance explained = 60%, α = 0.91). Factors were stigma, participation restrictions, negative evaluation of treatment, lack of motivation, emotional concerns, access restrictions, and time constraints. To assess clinical sensitivity, we conducted a secondary EFA utilising only clinical cases from this sample, which supported the solution but suggested retaining 25 of the original 27 items (variance explained = 58%, α = 0.89). The 25-item, seven-factor solution was further supported by CFA with an independent sample. Construct validity was also supported. The study suggests that the instrument will provide clinicians and researchers with a valid and reliable method of assessing treatment barriers in disordered eating samples.

Internet-Based Delivery of Cognitive Behaviour Therapy Compared to Monitoring, Feedback and Support for Problem Gambling: A Randomised Controlled Trial.

The aim of this study was to investigate the efficacy of an Internet-based cognitive behavioural therapy program (I-CBT) for the treatment of problem gambling, when compared to a waitlist control and an active comparison condition consisting of monitoring, feedback, and support (I-MFS). Participants (N = 174) were randomly allocated to the three conditions. Variables of interest were gambling outcome and related mental health measures. Participants in the active conditions (I-CBT and I-MFS) completed six online modules. Both I-CBT and I-MFS conditions resulted in significant treatment gains on gambling severity. However, I-CBT was also associated with reductions in a range of other gambling-related and mental health outcomes. Compared with I-MFS, I-CBT produced greater effects across seven outcomes measures, relating to gambling urges, cognitions, stress, and life satisfaction. I-CBT participants also rated the program as significantly more satisfactory. Treatment gains observed for both active conditions were found to be stable through to 12 month follow up. The results indicate that the benefits of I-CBT were more than simply the non-specific effects of engaging in online treatment or receiving motivation, feedback, and support. Online treatments for gambling may be a valuable tool in increasing help-seeking and treatment engagement in this population, and be integrated as part of stepped care approaches to treatment.