This study will determine the effectiveness of three different treatment strategies in
reducing gambling behaviors in pathological gamblers.
Pathological gambling is a chronic disorder in which a person is unable to control the urge
to gamble. People who are pathological gamblers constantly think about gambling, and they
may feel restless when not able to gamble. A pathological gambler's addiction to the thrill
of gambling may lead to serious relationship, career, and debt problems. The number of
pathological gamblers in the United States is steadily growing, leading to significant
financial, psychological, and public health consequences. However, studies examining the
effectiveness of treatments for pathological gamblers are limited. Forms of psychotherapy,
such as cognitive behavioral therapy (CBT), and addiction support groups comprise some of
the commonly used treatments for pathological gamblers. This study will compare the
effectiveness of three different treatment strategies, including psychoeducation therapy
plus case management, CBT, and CBT plus contingency management (CM), in reducing gambling
behaviors and other problems related to pathological gambling.
Participation in this study will last 2 years. All potential participants will undergo an
initial screening that will include questions about gambling behaviors and related problems
and psychiatric, medical, social, legal, and substance abuse history. Eligible participants
will be referred to Gambler's Anonymous (GA) and will be randomly assigned to one of three
treatment groups. All participants will attend a 50-minute session of their assigned
treatment each week for 8 weeks. They will also be encouraged to attend GA meetings during
- Group 1 participants will receive psychoeducation therapy plus case management. Therapy
sessions will include education about gambling and related problems. The case
management component of treatment will offer help with obtaining additional services
from the community as needed.
- Group 2 participants will attend CBT sessions, which will include learning about the
triggers that lead to gambling, developing alternatives to gambling, and avoiding
relapse after stopping gambling.
- Group 3 participants will receive CM in addition to CBT, as described above. The CM
component of treatment will encourage participants to partake in activities unrelated
to gambling by awarding vouchers, such as a gift certificate to a store or restaurant,
to participants for completing the alternative activities.
Gambling, substance use, and psychosocial problems will be assessed at pretreatment and
Months 2, 6, 9, 12, 18, and 24 follow-up evaluations. Participants will also be asked to
identify at least one person who is aware of their gambling problem and whom they regularly
contact. Researchers will interview the contact person by phone at pretreatment and Months
2, 6, 12, and 24. The interview will include questions about the participant's gambling
behaviors, personal relationships, legal status, use of health care and mental health
services, and any possible change of contact information.
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- Meets DSM-IV criteria for pathological gambling
- At least two gambling episodes in the 60 days prior to study entry
- Inability to read English at the 5th grade level (as assessed by the Slosson Oral
- Uncontrolled psychiatric conditions (e.g., active suicidal intention, psychosis,
bipolar disorder, or current alcohol or drug dependence other than nicotine)