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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    • "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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    ABSTRACT: This literature review summarizes recent empirical research on the reasons disordered gamblers try, through treatment or otherwise, to resolve or reduce their gambling problems. Relevant databases and bibliographies were searched for English-language studies, published since 1998, that asked gamblers themselves about motivators for action. Found were ten studies addressing reasons for trying to resolve or reduce gambling problems, five addressing reasons for seeking help and four addressing reasons for requesting self-exclusion from casinos. Help-seeking occurred largely in response to gambling-related harms (especially financial problems, relationship issues and negative emotions) that had already happened or that were imminent. Resolution was often motivated by the same kinds of harms but evaluation/decision-making and changes in lifestyle or environment played a more prominent role. Self-exclusion was motivated by harms, evaluation/decision-making and a wish to regain control. Awareness and educational materials could incorporate messages that might encourage heavy gamblers to make changes before harms became too great. Intervention development could also benefit from more research on the motivators leading to successful (vs. failed) resolution, as well as on the ways in which disordered gamblers are able to overcome specific barriers to seeking help or reaching resolution.
    Journal of Gambling Behavior 09/2009; 26(1):1-33. DOI:10.1007/s10899-009-9151-y · 1.28 Impact Factor
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