Cognitive-Motivational Behavior Therapy for Pathological Gamblers
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 75 |
| Updated: | 4/21/2016 |
| Start Date: | August 2009 |
| End Date: | December 2016 |
Gambling Addiction: Treatment Mediators and Moderators
In the proposed two-arm randomized controlled trial, 200 patients meeting DSM-IV criteria
for PG will be randomized to 12 sessions of Cognitive-Motivational Behavior Therapy (CMBT)
or to Cognitive Behavior Therapy (CBT).
for PG will be randomized to 12 sessions of Cognitive-Motivational Behavior Therapy (CMBT)
or to Cognitive Behavior Therapy (CBT).
CMBT has been developed by our team over the last five years, and has shown very promising
results in a small, NIMH-funded randomized pilot trial (R21 MH 064568). We will assess
patients biweekly during the active treatment phase and follow them for 12 months after the
end of treatment to obtain data on long-term treatment outcome. We hypothesize that CMBT
will show higher efficacy and retention than CBT in the treatment phase, and that gains will
be maintained at a higher rate during follow-up.
A second major purpose of the proposed study is to elucidate the presumed mechanisms of
change by examining potential mediators (readiness to change, irrational beliefs about
gambling, coping skills, therapeutic alliance) and moderators (psychiatric comorbidity with
Axis I and II disorders, family history of PG, impulsivity, and baseline motivation to
change) of treatment response. A better understanding of how the proposed interventions work
will help advance the science and treatment of PG and will be helpful in the future
refinement and adaptation of CMBT. Identifying patient subgroups for which the intervention
is particularly effective is essential for rational treatment selection. Thus, the immediate
goal of the project is to compare CBMT versus CBT for the treatment of PG. A long-term goal
of the proposed research is to establish effective treatment procedures that reduce the
considerable individual and social costs of PG.
results in a small, NIMH-funded randomized pilot trial (R21 MH 064568). We will assess
patients biweekly during the active treatment phase and follow them for 12 months after the
end of treatment to obtain data on long-term treatment outcome. We hypothesize that CMBT
will show higher efficacy and retention than CBT in the treatment phase, and that gains will
be maintained at a higher rate during follow-up.
A second major purpose of the proposed study is to elucidate the presumed mechanisms of
change by examining potential mediators (readiness to change, irrational beliefs about
gambling, coping skills, therapeutic alliance) and moderators (psychiatric comorbidity with
Axis I and II disorders, family history of PG, impulsivity, and baseline motivation to
change) of treatment response. A better understanding of how the proposed interventions work
will help advance the science and treatment of PG and will be helpful in the future
refinement and adaptation of CMBT. Identifying patient subgroups for which the intervention
is particularly effective is essential for rational treatment selection. Thus, the immediate
goal of the project is to compare CBMT versus CBT for the treatment of PG. A long-term goal
of the proposed research is to establish effective treatment procedures that reduce the
considerable individual and social costs of PG.
Inclusion Criteria:
- pathological gambling
- be able to read, understand and sign an informed consent form prior to any procedure
and must be willing to comply with all study procedures and timelines
Exclusion Criteria:
- to meet DSM-IV criteria for comorbid substance use disorders in the last six months
- current comorbid psychiatric conditions which require treatment and are not clearly
secondary to pathological gambling
- psychotropic medication
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