David P Smith1, Malcolm W Battersby2, Peter W Harvey3, Rene G Pols4, Robert Ladouceur5. 1. Flinders University, Department of Psychiatry, Flinders Human Behaviour and Health Research Unit, GPO Box 2100, Adelaide SA 2001, Australia. Electronic address: david.smith@flinders.edu.au. 2. Flinders University, Department of Psychiatry, Flinders Human Behaviour and Health Research Unit, GPO Box 2100, Adelaide SA 2001, Australia. Electronic address: malcolm.battersby@flinders.edu.au. 3. Flinders University, Department of Psychiatry, Flinders Human Behaviour and Health Research Unit, GPO Box 2100, Adelaide SA 2001, Australia. Electronic address: peter.harvey@flinders.edu.au. 4. Flinders University, Department of Psychiatry, Flinders Human Behaviour and Health Research Unit, GPO Box 2100, Adelaide SA 2001, Australia. Electronic address: rene.pols@flinders.edu.au. 5. Université Laval, School of Psychology, 2325, rue des Bibliothèques, Bureau 1328, Québec, Québec G1V 0A6, Canada. Electronic address: robert.ladouceur@psy.ulaval.ca.
Abstract
BACKGROUND:Problem gambling-specific cognitive therapy (CT) and behavioural (exposure-based) therapy (ET) are two core cognitive-behavioural techniques to treating the disorder, but no studies have directly compared them using a randomised trial. AIMS: To evaluate differential efficacy of CT and ET for adult problem gamblers at a South Australian gambling therapy service. METHODS: Two-group randomised, parallel design. Primary outcome was rated by participants using the Victorian Gambling Screen (VGS) at baseline, treatment-end, 1, 3, and 6 month follow-up. FINDINGS:Of eighty-seven participants who were randomised and started intervention (CT = 44; ET = 43), 51 (59%) completed intervention (CT = 30; ET = 21). Both groups experienced comparable reductions (improvement) in VGS scores at 12 weeks (mean difference -0.18, 95% CI: -4.48-4.11) and 6 month follow-up (mean difference 1.47, 95% CI: -4.46-7.39). CONCLUSIONS: Cognitive and exposure therapies are both viable and effective treatments for problem gambling. Large-scale trials are needed to compare them individually and combined to enhance retention rates and reduce drop-out.
RCT Entities:
BACKGROUND: Problem gambling-specific cognitive therapy (CT) and behavioural (exposure-based) therapy (ET) are two core cognitive-behavioural techniques to treating the disorder, but no studies have directly compared them using a randomised trial. AIMS: To evaluate differential efficacy of CT and ET for adult problem gamblers at a South Australian gambling therapy service. METHODS: Two-group randomised, parallel design. Primary outcome was rated by participants using the Victorian Gambling Screen (VGS) at baseline, treatment-end, 1, 3, and 6 month follow-up. FINDINGS: Of eighty-seven participants who were randomised and started intervention (CT = 44; ET = 43), 51 (59%) completed intervention (CT = 30; ET = 21). Both groups experienced comparable reductions (improvement) in VGS scores at 12 weeks (mean difference -0.18, 95% CI: -4.48-4.11) and 6 month follow-up (mean difference 1.47, 95% CI: -4.46-7.39). CONCLUSIONS: Cognitive and exposure therapies are both viable and effective treatments for problem gambling. Large-scale trials are needed to compare them individually and combined to enhance retention rates and reduce drop-out.
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