The piloting of a brief relational psychodynamic protocol (psychodynamic addiction model) for problem gambling and other compulsive addictions: A retrospective analysis

Abstract

The paper describes a treatment pilot for gambling and compulsive addiction within an NHS problem gambling clinic. The pilot study used a brief relational psychodynamic treatment protocol specifically designed to meet the needs of a group of patients who had not responded to CBT and who had other addictions or co‐morbidities. Seventy‐two (n = 72) patients were offered 12 sessions of therapy by four psychodynamic counsellors. Results were assessed using scores from a pre‐ and post‐treatment patient health questionnaire, the generalised anxiety disorder—7 (GAD‐7) and the Problem Gambling Severity Index (PGSI). Weekly feedback and supervision from counsellors and patients were used to assess the treatment model. The results highlighted that the psychodynamic addiction model was associated with reduced depression (Mean = 14.9; SD: 6.7), anxiety (Mean = 11.5; SD: 5.9), and gambling severity (p < .001), suggesting that a relational psychodynamic treatment is needed for complex patients with compulsive addiction, where CBT had not been successful. These results also highlight the importance of the therapeutic relationship as a critical factor in the treatment of patients with compulsive addiction problems.

Effective Treatment and Support for Problem Gambling

“…However, while CBT and the other strategies mentioned do have the potential to effectively treat patients with co-occurring disorders; [32][33][34] patients with more complex diagnoses and needs may require additional forms of treatment. The literature sourced suggests that some patients may benefit from problem gambling treatment that specifically addresses sources of anxiety and depression, 52,90,91,97 and patients with particularly complex needs may benefit from residential treatment options. 67 Also, considering that gambling harms typically extend beyond the individual gambler, 62 it may be useful to offer treatment options for concerned significant others.…”

“…90 › A retrospective analysis of pilot study data (UK) evaluated a brief psychodynamic therapy treatment protocol for problem gambling patients with co-occurring mental health and addiction problems, and early-life difficulties. 91 › Psychodynamic therapy aims to treat the underlying emotional issues and conflicts that might have triggered a person's gambling addiction.…”

Gambling disorder and NHS treatment: an overview

“…Recent research conducted in the clinic has found that this brief, relational type of psychotherapy proved effective treatment for clients when CBT was not an appropriate therapy. 22 Other psychological and psychosocial treatments for which there is some encouraging evidence include motivational enhancement therapies and mutual aid groups such as Gamblers Anonymous. 21 The impact of problem gambling is also widely seen in the family, 23 with research showing that family involvement in problem gambling treatment is linked to better treatment outcomes and improved individual and family functioning.…”