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Cognitive Behaviour Therapy for Problem Gamblers: A Clinical Outcomes Evaluation

Published online by Cambridge University Press:  25 March 2013

Barry Tolchard  and
Malcolm W. Battersby
Barry Tolchard*
Affiliation:
School of Health, University of New England, Armidale, New South Wales, Australia
Malcolm W. Battersby
Affiliation:
Flinders Human Behaviour & Health Research Unit, School of Medicine, Flinders University, Adelaide, South Australia, Australia
*
Address for correspondence: School of Health, University of New England, Armidale NSW 2351, Australia. Email: barry.tolchard@une.edu.au
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Abstract

Cognitive-Behaviour Therapy (CBT) is considered the number one non-pharmacological treatment for a number of mental and psychological disorders (Tolin, 2010; Stuhlmiller & Tolchard, 2009). While CBT with problem gamblers has shown promise, the quality of the research in this area is lacking. One area of concern is that across the many trials and reports using CBT with gamblers no single unified approach has been used and so comparison across studies is limited. Similarly, translation of the CBT research into clinical practice is almost entirely absent (Walker, 2005). This article will explore the concepts of CBT with problem gamblers and identify common elements across all reported approaches. A unified model of CBT with problem gamblers will be suggested and the direct clinical application of this model described from a state-wide gambling service in Australia (Flinders Approach) with 205 problem gamblers. The results indicate that the Flinders Approach is successful in treating gamblers considered to be at the severest end of the experience, with a 69% completion rate. Implications for future research in which this model may be tested against other therapies and pharmacological treatments will be discussed.

Keywords

cognitive-behaviour therapypathological gamblingproblem gamblingclinical evaluationassessment

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Type
Standard Papers
Information
Behaviour Change , Volume 30 , Issue 1 , April 2013 , pp. 12 - 23
Copyright
Copyright © The Authors 2013

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References

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorder (4th ed.). Washington, DC: Author.Google Scholar
Baldo, V., Cristofoletti, M., Majori, S., Cibin, M., Peron, C., Dal Zotto, A., . . . Zampieri, N. (2006). Relationship between pathological gambling, alcoholism and drug addiction. Annali di Igiene, 18, 147–53.Google ScholarPubMed
Battersby, M.W., Oakes, J., Tolchard, B., Forbes, A., & Pols, R.G. (2008). Cognitive behavioural treatment for problem gamblers. In Zangeneh, M.A., Blaszczynski, A. & Turner, N.E. (Eds.), The pursuit of winning (pp. 179–197). New York: Springer.Google Scholar
Battersby, M.W., Thomas, L.J., Tolchard, B., & Esterman, A. (2002). The South Oaks Gambling Screen: A review with reference to Australian use. Journal of Gambling Studies, 18, 257–271.Google Scholar
Beck, A.T., Steer, R.A., & Brown, G. (1985). Beck Anxiety Checklist. Unpublished manuscript, University of Pennsylvania.Google Scholar
Beck, A.T., Ward, C., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.CrossRefGoogle ScholarPubMed
Ben-Tovim, D., Esterman, A., Tolchard, B., & Battersby, M.W. (2001). The Victorian Gambling Screen: Project report. Melbourne, Australia: Victorian Research Panel.Google Scholar
Blaszczynski, A., & Nower, L. (2002). A pathways model of problem and pathological gambling. Addiction, 97, 487–499.CrossRefGoogle ScholarPubMed
Brewer, J., Grant, J.E., & Potenza, M.N. (2008). The treatment of pathologic gambling. Addictive Disorders & Their Treatment, 7 (1), 1–13.Google Scholar
Churchill, S. (1894). Gambling and betting. Nibet & Co.: London.Google Scholar
Echeburua, E., Baez, C., & Fernandez-Montalvo, J. (1996). Comparative effectiveness of three modalities in the psychological treatment of pathological gambling. Behavioural and Cognitive Psychotherapy, 24, 51–72.Google Scholar
Elliot Stanford & Associates. (1998). Evaluation of the Gamblers Rehabilitation Fund. Adelaide, Australia: Department of Human Services.Google Scholar
Foa, E.B., Liebowitz, M.R., Kozak, M.J., Davies, S., Campeas, R., Franklin, M.E., . . . Tu, X. (2007). Randomized, placebo-controlled trial of exposure and ritual prevention, Clomipramine, and their combination in the treatment of obsessive-compulsive disorder. Focus, 5, 368–380.CrossRefGoogle Scholar
Forsyth, J. P., Barrios, V., & Acheson, D.T. (2006). Exposure therapy and cognitive interventions for anxiety disorders: Overview and newer third-generation perspectives. In Richard, D.C.S. & Lauterbach, D. (Eds.), (Handbook of exposure therapies (pp. 61–108): Oxford: Elsevier.Google Scholar
Gooding, P., & Tarrier, N. (2009). A systematic review and meta-analysis of cognitive-behavioural interventions to reduce problem gambling: Hedging our bets? Behaviour Research and Therapy, 47, 592–607.CrossRefGoogle ScholarPubMed
Goodyear-Smith, F., Arroll, B., Kerse, N., Sullivan, S., Tse, S., Shepherd, R., Rossen, F., & Perese, L. (2006). Primary care patients reporting concerns about their gambling frequently have co-occurring lifestyle and mental health issues. British Medical Council Family Practice, 7, 25–30.Google Scholar
Grant, J.E., Donahue, C.B., Odlaug, B.L., & Kim, S.W. (2011). A 6-month follow-up of imaginal desensitization plus motivational interviewing in the treatment of pathological gambling. Annals of Clinical Psychiatry, 23 (3), 3–10.Google Scholar
Griffiths, M., Wardle, H., Orford, J., Sproston, K., & Erens, B. (2010). Gambling, alcohol, consumption, cigarette smoking and health: Findings from the 2007 British Gambling Prevalence Survey. Addiction Research & Theory, 2, 208–223.Google Scholar
Hodgins, D., & el-Guebaly, N. (2010). The influence of substance dependence and mood disorders on outcome from pathological gambling: Five-year follow-up. Journal of Gambling Studies, 26 (1), 117–127.Google Scholar
Hollon, S.D., Stewart, M.O., & Strunk, D. (2005). Enduring effects for cognitive behavior therapy in the treatment of depression and anxiety. Annual Review of Psychology, 57, 283–315.Google Scholar
Kaminer, Y., & Haberek, R. (2004). Pathological gambling and substance use. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 1326–1327.Google Scholar
Kim, S.W., Grant, J.E., Eckert, E.D., Faris, P.L, & Hartman, B.K. (2006). Pathological gambling and mood disorders: Clinical associations and treatment implications. Journal of Affective Disorders, 92, 109–116.Google Scholar
Ladouceur, R., & Lachance, S. (2006). Overcoming pathological gambling: Therapist guide. New York: Oxford University Press.Google Scholar
Ladouceur, R., Sylvain, C., Boutin, C., Lachance, S., Doucet, C., Leblond, J., & Christian, J. (2001). Cognitive treatment of pathological gambling. Journal of Nervous and Mental Disease, 189, 774–780.CrossRefGoogle ScholarPubMed
Lesieur, H.R., & Blume, S.B (1987). The South Oaks Gambling Screen (SOGS): A new instrument for the identification of pathological gamblers. The American Journal of Psychiatry, 144, 1184–1188.Google Scholar
Marks, I.M., Hallam, R.S., Connolly, J., & Philpott, R. (1977). Nursing in behavioural psychotherapy. London: Royal College of Nursing.Google Scholar
McConaghy, N., Armstrong, M. S., Blaszczynski, A., & Allcock, C. (1983). Controlled comparison of aversive therapy and imaginal desensitization in compulsive gambling. British Journal of Psychiatry, 142, 366–372.Google Scholar
Mundt, J.C., Marks, I.M., Shear, M.K., & Greist, J.H. (2002). The work and social adjustment scale: A simple measure of impairment in functioning. The British Journal of Psychiatry, 180, 461–464.CrossRefGoogle Scholar
Olatunji, B., Cisler, J., Brett, J., & Deacon, B. (2010). Efficacy of cognitive behavioral therapy for anxiety disorders: A review of meta-analytic findings. Psychiatric Clinics of North America, 33 (3), 557–577.Google Scholar
Pallesen, S., Mitsem, M., Kvale, G., Johnsen, B.H., & Molde, H. (2005). Outcome of psychological treatments of pathological gambling: A review and meta-analysis. Addiction, 100, 1412–1422.CrossRefGoogle ScholarPubMed
Pallesen, S., Molde, H., Arnestad, H. M., Laberg, J. C., Skutle, A., Iversen, E., . . . Holsten, F. (2007). Outcome of pharmacological treatments of pathological gambling: A review and meta-analysis. Journal of Clinical Psychopharmacology, 27, 357–364.Google Scholar
Petry, N.M. (2005). Pathological gambling: Etiology, co-morbidity, and treatment. Washington, DC: American Psychological Association.Google Scholar
Petry, N.M., Ammerman, Y., Bohl, J., Doersch, A., Gay, H., Kadden, R., Molina, C., & Steinberg, K. (2006). Cognitive-behavioural therapy for pathological gambling. Journal of Consulting & Clinical Psychology, 74, 555–567.CrossRefGoogle Scholar
Productivity Commission. (2010). Gambling (Report no. 50). Canberra, Australia: Author.Google Scholar
Quilty, L., Watson, C., Robinson, J., Toneatto, T., & Bagby, R. (2011). the prevalence and course of pathological gambling in the mood disorders. Journal of Gambling Studies, 27 (2), 191–201.Google Scholar
Riley, B., Smith, D., & Oakes, J. (2011). Exposure therapy for problem gambling in ruralcommunities: A program model and early outcomes. Australian Journal of Rural Health, 19, 142–146.Google Scholar
Rosenthal, R.J. (2008). Psychodynamic psychotherapy and the treatment of pathological gambling. Revista Brasileira de Psiquiatria, 30 (Suppl. 1), 41–50.Google Scholar
Sabura, A.J., de Lisle, S.M., & Dowling, N.A. (2011). Mindfulness-based cognitive therapy for problem gambling. Clinical Case Studies, 10, 210–228.Google Scholar
Slutske, W.S. (2006). Natural recovery and treatment-seeking in pathological gambling: Results of two U.S. national surveys. American Journal of Psychiatry, 163, 297–302.Google Scholar
Stuhlmiller, C., & Tolchard, B. (2009). Computer-assisted CBT for depression and anxiety: Increasing accessibility to evidence-based mental health treatment. Journal of Psychosocial Nursing and Mental Health Services, 47 (7), 32–40.Google Scholar
Thomas, S.A., Merkouris, S.S., Radermacher, H.L., Dowling, N.A., Misso, M.L., Anderson, C.J., & Jackson, A.C. (2011). Australian guideline for treatment of problem gambling: An abridged outline. Medical Journal of Australia, 195 (11/12), 664–665.Google Scholar
Tolchard, B., & Battersby, M.W. (1996). The effect of treatment of pathological gamblers referred to a behavioural psychotherapy unit: II outcome of three kinds of behavioural intervention. Paper presented at the 7th Annual Conference of the National Association for Gambling Studies, Adelaide.Google Scholar
Tolchard, B., & Battersby, M.W. (2000). Nurse behavioural psychotherapy and pathological gambling: An Australian perspective. Journal of Psychiatric and Mental Health Nursing, 7, 335–342.Google Scholar
Toneatto, T., & Brennan, J. (2002). Pathological gambling in treatment-seeking substance abusers. Addictive Behaviors, 27, 465–469.Google Scholar
Toneatto, T., Cunningham, J., Hodgins, D., Adams, M., Turner, N., & Koski-Jannes, A. (2008). Recovery from problem gambling without formal treatment. Addiction Research & Theory, 16, 111–120.Google Scholar
Toneatto, T., & Gunaratne, M. (2009). Does the treatment of cognitive distortions improve clinical outcomes for problem gambling? Journal of Contemporary Psychotherapy, 39 (4), 221–229.Google Scholar
Tolin, D. (2010). Is cognitive–behavioral therapy more effective than other therapies?: A meta-analytic review. Clinical Psychology Review, 30 (6), 710–720.Google Scholar
Volberg, R.A. (2004). Fifteen years of problem gambling prevalence research: What do we know? Where do we go? Electronic Journal of Gambling Issues, 10, 1–9. Retrieved July 2, 2007, from http://www.cgr.org/Files/Google Scholar
Walker, M. (2005). Problems in measuring the effectiveness of cognitive therapy for pathological gambling. Journal of Gambling Studies, 21, 79–90.CrossRefGoogle ScholarPubMed