Establishing Best Treatment Practices for Pathological Gamblers

Lily Adelzadeh MS2, Iman Parhami MD MPH, Margarit Davtian MA,
Rory Reid PhD, Michael Campos PhD, Richard J. Rosenthal MD,
Timothy W. Fong MD

Department of Psychiatry and Biobehavioral Sciences
Semel Institute for Neuroscience and Human Behavior
University of California, Los Angeles

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BACKGROUND: 70-90% of the population gambles without incurring problems; 4% have a gambling disorder and 8% will experience one in their lifetime. Behavioral interventions, compared to pharmacological approaches, are more effective in treating gambling disorders.

OBJECTIVE: To determine the efficacy of a newly created six-session Manualized Behavioral Therapy (MBT) for pathological gamblers.

METHODS: Subjects recruited from the community were randomized into two treatment groups: MBT and treatment as usual (TAU). Both groups underwent six one-hour sessions with a psychologist for six weeks; the MBT group received a six-chapter workbook intended to guide the psychologist and subject. Each chapter provided information and exercises dealing with different aspects of the gamblers’ life as it related to gambling. The goal of this workbook was to help gamblers develop basic techniques to control gambling behavior and cope with its personal, vocational, and social consequences. Treatment efficacy was analyzed with outcome measures assessing the participants’ gambling behavior, craving, abstinence, and treatment completion.

RESULTS: 74 subjects were screened at baseline and randomized into two groups. 24 subjects attended the first session for each treatment and 11 of these subjects completed six sessions for each intervention. The means for gambling behavior (amount ($), duration (hours), and episodes (days)) and cravings decreased for each group but statistical analysis did not reveal significant within-subject or between-group differences in either treatment. The proportion of subjects that maintained abstinence was higher for participants in the MBT group. No adverse effects were reported for either treatment.

CONCLUSION: Preliminary findings suggest that both MBT and TAU are beneficial for pathological gamblers. While statistical differences were not observed between the two groups, findings indicate that MBT is not harmful, does not negatively affect pathological gamblers, and may even produce more positive treatment outcomes related to gambling abstinence.