Cognitive-Behavioral Treatment of Gambling

Study Overview
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Brief Summary
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This study will determine the effectiveness of cognitive behavior therapy (CBT) and contingency management (CM) in reducing gambling behaviors and other related problems in pathological gambling. Study hypothesis: Participants who receive CBT and CM will attend more treatment sessions and show better outcomes than those who receive CBT alone.

Detailed Description
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Pathological gambling has become an increasingly problematic condition in the United States, often causing serious financial, psychological, and public health consequences. In an effort to treat this growing problem, researchers have evaluated numerous therapies; one such therapy is CBT. CBT has been shown to improve pathological gambling outcomes. However, evidence suggests that adding CM to CBT could result in even more improved outcomes. This study will compare the effectiveness of CBT and CM with that of CBT alone in reducing pathological gambling. This study will last 12 months. Participants will be randomly assigned to receive either CBT and CM or CBT alone for 8 weeks. CBT will focus on reducing gambling urges and helping patients develop alternative behaviors to gambling. CM will focus on encouraging patients to avoid gambling. Participants in the CBT and CM group will receive voucher incentives for completing homework assignments and engaging in non-gambling social activities. The vouchers will allow participants to take part in non-gambling activities of their choice. Changes in gambling activities and problems will be assessed with self-report scales and interviews at study start and at Weeks 10, 24, and 52. Participants will be asked to identify at least one person who knows about their gambling and will have regular contact with them over the 12 months of the study. This person will be interviewed at study start and at Months 2, 6, and 12. Contact persons will be asked about participants' gambling behaviors, personal relationships, legal problems, use of health care and mental health services, and how the participant can be contacted if he or she moves. For information on related studies, please follow these links: http://clinicaltrials.gov/show/NCT00158314 http://clinicaltrials.gov/show/NCT00618462

Official Title
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Enhanced Cognitive Behavior Therapy for the Treatment of Pathological Gambling

Conditions
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Gambling, Mental Health

Intervention / Treatment
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* Behavioral: Cognitive behavior therapy
* Behavioral: Contingency management


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of pathological gambling At least 1 gambling episode within 30 days prior to study entry Able to read English at a 5th grade level Willing and able to comply with all study requirements Exclusion Criteria: Uncontrolled psychiatric conditions

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Behavioral: Cognitive behavior therapy|Receive 8 50-minute sessions of one-on-one cognitive behavioral therapy|
|Behavioral: Contingency management|Receive vouchers that can be spent on rewards for completing activities that support abstinence from gambling|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Addiction Severity Index (ASI) gambling severity scores |  |  | 
| amount spent gambling per gambling episode |  |  | 
| longest period of non-gambling |  |  | 
| days until first gambling episode |  |  | 
| percent of days gambling |  |  | 
| proportion meeting diagnostic criteria |  |  | 
| number of treatment sessions attended |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Psychosocial functioning |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CBT, CM, Pathological Gambling