People with gambling disorder and risky alcohol habits benefit more from motivational interviewing than from cognitive behavioral group therapy

Abstract

Background. Effective psychological treatment, including cognitive behavioral therapy and motivational interviewing (MI), is available for people with problematic gambling behaviors. To advance the development of treatment for gambling disorder, it is critical to further investigate how comorbidity impacts different types of treatments. The purpose of this study was to investigate whether screening for risky alcohol habits can provide guidance on whether people with gambling disorder should be recommended cognitive behavioral group therapy (CBGT) or MI.Methods. The present study is a secondary analysis of a previous randomized controlled trial that compared the effects of CBGT, MI and a waitlist control group in the treatment of disordered gambling. Assessment and treatment was conducted at an outpatient dependency clinic in Stockholm, Sweden, where 53 trial participants with gambling disorder began treatment. A modified version of the National Opinion Research Centre DSM-IV Screen for gambling problems was used to assess gambling disorder. The Alcohol Use Disorders Identification Test (AUDIT) was used to screen for risky alcohol habits.Results. The interaction between treatment and alcohol habits was significant and suggests that patients with gambling disorder and risky alcohol habits were better helped by MI, while those without risky alcohol habits were better helped by CBGT.Conclusions. The results support a screening procedure including the AUDIT prior to starting treatment for gambling disorder because the result of the screening can provide guidance in the choice of treatment. Patients with gambling disorder and risky alcohol habits are likely to be best helped if they are referred to MI, while those without risky alcohol habits are likely to be best helped if they are referred to CBGT.

Longitudinal Assessment of a Manualized Group Treatment Program for Gambling Disorder: The Ohio Problem Gambling Treatment Model for Adults with Co-Occurring Disorders

“…While other behavioral health programs have successfully utilized group-based approaches to address GD treatment (Carlbring et al, 2009;Jiménez-Murcia et al, 2007, few, if any, are guided by manuals tailored specifically for individuals with GD and other co-occurring disorders. Instead, most are guided by CBT (Josephson et al, 2016) or other similar therapeutic approaches (e.g., mindfulness-based cognitive therapy; de Lisle et al, 2011). Individual practitioners, then, select methods by which to apply these theories, often guided by theoretical models that apply CBT concepts to GD (see Sharpe & Tarrier, 1993).…”

“…These modules were developed specifically to address issues related to gamblers with cooccurring disorders. For example, in the "Rational Thinking" module, the counselor facilitated group-based MI sessions, an approach used more frequently to address behavioral and substance use disorders (see Krejci & Neugebauer, 2015;Velasquez et al, 2006) than GD (see Josephson et al, 2016). In this module, participants listed various life events that might trigger co-occurring disorders like depression, anxiety, substance abuse, and other potentially harmful behaviors, and the facilitator then discussed pathways by which these behaviors can, in turn, trigger unwanted gambling behaviors.…”

Motivational telephone intervention to risk gamblers by a state-owned gambling operator in Sweden

“…The intervention is carried out by Svenska Spel staff trained in MI. All staff involved have undergone at least a 3 days MI training by a licensed psychologist experienced in gambling-related research ( 28 ), and they regularly receive updated training, as well as individual and group supervision in MI.…”

Treatment of gambling disorder: review of evidence-based aspects for best practice

“…All psychological interventions have globally been shown to be effective in reducing gambling symptoms compared with no treatment or waitlist control conditions [13,14]. With respect to the specific therapeutic methods, studies have shown that the best efficacy is achieved with a cognitivebehavioral approach [5,7,8,11,15,16], as well as with interventions using motivational interviewing techniques [15][16][17][18][19].…”