Randomized Trial of Brief Motivational Treatments for Pathological Gamblers: More Is Not Necessarily Better

Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 10/2009; 77(5):950-60. DOI: 10.1037/a0016318
Source: PubMed


The efficacy of brief treatments for media-recruited pathological gamblers was tested in a randomized clinical trial design (N = 314). Two self-directed motivational interventions were compared with a 6-week waiting list control and a workbook only control. Brief motivational treatment involved a telephone motivational interview and a mailed self-help workbook. Brief motivational booster treatment involved a telephone motivational interview, a workbook, and 6 booster telephone calls over a 9-month period. Primary outcomes were gambling frequency and dollar losses. As hypothesized, brief and brief booster treatment participants reported less gambling at 6 weeks than those assigned to the control groups. Brief and brief booster treatment participants gambled significantly less often over the first 6 months of the follow-up than workbook only participants. However, the workbook only participants were as likely to have significantly reduced their losses over the year and to have not met criteria for pathological gambling. Contrary to the hypothesis, participants in the brief booster treatment group showed no greater improvement than brief treatment participants. These results provide further support for the value of brief motivational treatments for pathological gambling.

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    • "In light of the dearth of research on this topic, and to advance the literature with a view towards informing clinical practice, more research is required to elucidate the nature and impact of participant goal selection in the treatment of gambling disorders. In this paper, we examined the nature and impact of goal selection in archival data from a randomized controlled trial (RCT) of a brief motivational intervention for pathological gambling (Hodgins et al. 2009). This paper is only the second in the literature to report the dynamics of goal selection in pathological gambling over the course of treatment. "
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    ABSTRACT: The present study of recovery from cannabis use disorders was undertaken with 2 primary objectives that address gaps in the literature. The first objective was to provide an exploratory portrait of the recovery process from cannabis use disorders, comparing individuals who recovered naturally with those who were involved in treatment. The second objective was to explore systematically the similarities and differences between abstinence and moderation recoveries. Adults who have recovered from a cannabis use disorder were recruited in the (N = 119). The abstinence and treatment-assisted participants exhibited higher levels of lifetime cannabis problem severity than the moderation and natural recovery participants, respectively. As well, cognitive factors were identified as the most useful strategies for recovery (e.g., thinking about benefits and negative consequences of cannabis), followed by behavioral factors (e.g., avoidance of triggers for use and high-risk situations). Findings lend further support to the effectiveness of cognitive, motivational, and behavioral strategies as helpful actions and maintenance factors involved in the recovery process. The findings also generally support the idea that cannabis use disorders lie on a continuum of problem severity, with moderation and natural recoveries more likely to occur at the lower end of the continuum and abstinence and treatment-assisted recoveries more likely to occur at the upper end. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Psychology of Addictive Behaviors 07/2015; 29(3). DOI:10.1037/adb0000097 · 2.09 Impact Factor
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    • "We propose to collect a sample of 180 participants and we estimate (based upon Hodgins et al., 2009) that we will successfully follow about 153 participants at three months. This number will ensure a heterogeneous sample of individuals that will provide a valid assessment of the perceived value of different components of the SCTs. "
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    ABSTRACT: Background Gambling disorders affect about one percent of adults. Effective treatments are available but only a small proportion of affected individuals will choose to attend formal treatment. As a result, self-directed treatments have also been developed and found effective. Self-directed treatments provide individuals with information and support to initiate a recovery program without attending formal treatment. In previous research we developed an telephone-based intervention package that helps people to be motivated to tackle their gambling problem and to use basic behavioral and cognitive change strategies. The present study will investigate the efficacy of this self-directed intervention offered as a free online resource. The Internet is an excellent modality in which to offer self-directed treatment for gambling problems. The Internet is increasingly accessible to members of the public and is frequently used to access health-related information. Online gambling sites are also becoming more popular gambling platforms. Method/Design A randomized clinical trial (N=180) will be conducted in which individuals with gambling problems who are not interested in attending formal treatment are randomly assigned to have access to an online self-directed intervention or to a comparison condition. The comparison condition will be an alternative website that offers a self-assessment of gambling involvement and gambling-related problems. The participant’s use of the resources and their gambling involvement (days of gambling, dollars loss) and their gambling problems will be tracked for a twelve month follow-up period. Discussion The results of this research will be important for informing policy-makers who are developing treatment systems. Trial registration ISRCTN06220098
    BMC Public Health 01/2013; 13(1):10. DOI:10.1186/1471-2458-13-10 · 2.26 Impact Factor
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    • "The results of these studies were promising, yielding, at least, shortterm improvements and advantages over control conditions. The study of media-recruited participants concerned about their gambling (Hodgins et al., 2009) is particularly relevant to this report. That study analyzed three experimental conditions: a workbook, the workbook and a brief (10 min) telephone motivational interview, and the previous conditions with an added six booster calls. "
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    ABSTRACT: Two studies conducted in Massachusetts and Nevada evaluated the efficacy of a self-help toolkit for problem gambling. Individuals concerned about gambling-related problems, in response to public notices and newspaper advertisements, volunteered for a randomized trial of the self-help toolkit, Your First Step to Change: Gambling. Participants were randomly assigned to 1 of 3 conditions: (a) a printed toolkit, (b) the toolkit and a brief guide to the toolkit's content, or (c) assignment to a wait-list condition. Participants, 145 in Massachusetts and 170 in Nevada, reported their gambling behavior, beliefs and attitudes about chance, and recent and planned help seeking at baseline, 88% at 1 month later, and 79% at 3 months later. Findings for the complete and intent-to-treat analyses at both sites indicated that participants significantly improved. At the end of the study period, significantly more toolkit recipients than control group participants reported recently abstaining from gambling. Minimally invasive, self-directed resources like this self-help toolkit can assist remediating gambling-related problems among gamblers who do not engage in formal treatment.
    American Journal of Orthopsychiatry 04/2012; 82(2):278-89. DOI:10.1111/j.1939-0025.2012.01157.x · 1.36 Impact Factor
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