Gambling and Brief Interventions

This study will compare four different combinations and durations of motivational enhancement therapy, cognitive behavioral therapy, and brief advice treatments for gambling versus a non-intervention condition to determine which is most effective in reducing problem gambling.

Gambling, if done compulsively, can cause psychological, physical, social, and vocational problems. Problem gambling, or compulsive gambling, is a progressive addiction characterized by a preoccupation with gambling, a need to bet more money more frequently, restlessness or irritability when attempting to stop, and gambling more to make up for losses. This study will compare four different combinations and durations of motivational enhancement therapy (MET), cognitive behavioral therapy (CBT), and brief advice treatments for gambling versus a non-intervention condition to determine which is most effective in reducing problem gambling. This open-label study will last a total of 9 months. Participants will be randomly assigned to one of four groups. Group 1 will have no intervention and will be instructed to call if they experience any gambling problems. Group 2 will receive 5 minutes of education on the hazards of heavy gambling. In addition, they will receive a 1-page brochure on problem gambling and its consequences. Group 3 will receive a 1-hour session of MET focused on increasing commitment to change by raising awareness of personal consequences of gambling. Group 4 will receive the same MET session as Group 3, as well as three 1-hour sessions of CBT focused on identifying specific social and mood cues associated with gambling. Treatment will end at Week 4. Participants will have two follow-up sessions held over the phone at Week 6 and again 9 months after enrollment. Gambling behavior, employment status, alcohol and drug use, psychiatric problems, and family problems will be assessed.

Inclusion Criteria: Meets criteria for problem gambling Two or more gambling episodes per month for 2 months prior to enrollment Has spent at least $50 per month on gambling for 2 months prior to enrollment Exclusion Criteria: Any uncontrolled psychiatric conditions Severe cognitive impairment Currently receiving treatment for gambling