Concepción Báez

Comparative effectiveness of three therapeutic modalities in the psychological treatment of pathological gambling : Long-term outcome

The aim of this paper was to test the comparative effectiveness of three therapeutic modalities : a) individual stimulus control and exposure with response prevention ; b) group cognitive restructuring ; and c) a+b in the treatment of pathological gambling with slot machines. An additional waiting-list group was used to evaluate the spontaneous evolution of the non-treated gamblers. The sample consisted of 64 patients selected according to DSM-III-R criteria. A multigroup experimental design with repeated measures (pretreatment, posttreatment and 1, 3, 6 and 12-month follow-up) was used. Most treated patients gave up gambling as well as improved, albeit more slowly, in family/social and psychological functioning. The success rate was higher in the individual treatment compared both to group and combined treatment. There was also an improvement in gambling in the control group between the pretreatment and the 6-month follow-up and there was no difference between the combined treatment and control group. Individual stimulus control and exposure with response prevention appears to be a cost-effective therapy for pathological gambling. Implications of this study for clinical practice and future research in this field are discussed.

Relapse prevention in the treatment of slot-machine pathological gambling: long-term outcome

The aim of this paper was, on the one hand, to determine the efficacy of stimulus control and exposure with response prevention in stopping pathological gambling and, on the other hand, to test the comparative effectiveness of two therapeutic modalities (individual and group) for relapse prevention, relative to a control group, in order to maintain abstinence. The sample consisted of 69 patients selected according to DSM-IV criteria. At the first part of the study, a one-group design with repeated measures of assessment (pre- and posttreatment) was used. At the second part, a multi-group experimental design with repeated measures (pretreatment, posttreatment, and 1-, 3-, 6-, and 12-month follow-up) was used. All treated patients gave up gambling at the end of the first part of the study. In the second part, results related to relapse showed a success rate higher in both individual and group relapse prevention than in the control group. These results raise the necessity of using relapse prevention programs in the treatment of pathological gambling. Implications of this study for clinical practice and future research in this field are discussed.

PREDICTORS OF THERAPEUTIC FAILURE IN SLOT-MACHINE PATHOLOGICAL GAMBLERS FOLLOWING BEHAVIOURAL TREATMENT

This research was supported by grant UPV 006.231-HA182.95 from the University of the Basque Country. The second author has had a predoctoral research grant from the Basque Country Government.