Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-02T21:39:08.328Z Has data issue: false hasContentIssue false

CBT for adolescent pathological gambling – lessons from adult research

Published online by Cambridge University Press:  13 June 2014

Ciaran Clarke*
Affiliation:
Department of Child & Adolescent Psychiatry, Mater Misericordiae Hospital, Metropolitan Building, James Joyce Street, Dublin 1, Ireland
Norbertas Skokauskas
Affiliation:
Department of Psychiatry, St James's Hospital, Dublin 8, Ireland
*
*Correspondence E-mail: [email protected]

Abstract

Objectives: Features of gambling, particularly among young people have changed over the past decade and, while there are no data from Ireland, there are suggestions from those working in the field that pathological gambling is increasing among adolescents. Relatively little is known about the effective treatment of pathological gambling in adolescents. This paper aims to review research in cognitive behavioural treatments with a view to their application in adolescents. Research among adolescence is given prominence when this is available.

Methods: The methodology comprised a literature search of Medline, Psycinfo, and EMBASE databases, using the search terms: ‘cognitive behavioural therapy’; ‘gambling; ‘psychology’; ‘epidemiology’; ‘adolescent’; ‘motivation’; ‘effectiveness’; ‘outcome’; ‘relapse’; and ‘internet’. In addition, a hand search of Clinical Psychological Reviews, Journal of Gambling Studies, Addiction, Psychology of Addictive Behaviors, and International Gambling Studies (1997-2007) was performed.

Results: A total of 23 studies comprising various cognitive and behavioural approaches were identified, all but three of them confined to adult subjects. Study methodology and quality varied greatly, with many case studies or small case series, and only three randomised control trials. None used an intention-to-treat analysis, and there was little long-term follow-up. Almost ail indicated, with more or less evidence, that cognitive behavioural strategies might be beneficial.

Conclusions: Many varieties and modifications of cognitive behavioural therapy have been applied to pathological gambling, though there are few studies of any psychological treatments for adolescent gamblers. Methodological problems surround much of the research. Notwithstanding these reservations cognitive behavioural approaches seem to offer promise in managing this serious problem.

Type
Review
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Becona, E. Pathological gambling in Spanish children and adolescents: an emerging problem. Psychol Rep 1997; 81(1):275–87.CrossRefGoogle ScholarPubMed
2.Wood, RT, Griffiths, MD. The acquisition, development and maintenance of lottery and scratchcard gambling in adolescence. J Adolesc 1998; 21(3): 265–73.CrossRefGoogle ScholarPubMed
3.Derevensky, JL, Gupta, R. Prevalence estimates of adolescent gambling: a comparison of the SOGS-RA, DSM-IV-J, and the GA 20 questions. J Gambl Stud 2000; 16(2-3): 227–51.CrossRefGoogle ScholarPubMed
4.Shaffer, HJ, Hall, MN. Updating and refining prevalence estimates of disordered gambling behaviour in the United States and Canada. Can J Public Health 2001; 92(3): 168–72.CrossRefGoogle ScholarPubMed
5.Welte, JW, Barnes, GM, Tidwell, MC, Hoffman, JH. The prevalence of problem gambling among U.S. adolescents and young adults: results from a national survey. J Gambl Stud 2008; 24(2): 119–33.CrossRefGoogle Scholar
6.Griffiths, M, Wood, RTA. Risk factors in adolescence: The case of gambling, videogame playing, and the internet. J Gambl Stud 2000; 16(2-3): 199225.CrossRefGoogle ScholarPubMed
7.Griffiths, M, S, Chevalier. Addiction in Adolescence: Why don't adolescent addicts turn up for treatment? Psyke & Logos 2005; 26(1): 2731.CrossRefGoogle Scholar
8.Griffiths, M. Adolescent gambling. London; New York: Routledge; 1995.Google Scholar
9.Hayer, T, Griffiths, M, Meyer, G, editors. Gambling. New York, NY, US: Springer Science + Business Media; 2005.Google Scholar
10.Goorney, AB. Treatment of a Compulsive Horse Race Gambler By Aversion Therapy. Br J Psychiatry 1968; 508: 329–33.CrossRefGoogle Scholar
11.Cotler, SB. The use of different behavioural techniques in treating a case of compulsive gambling. Behavior Ther 1971; 4: 579–84.CrossRefGoogle Scholar
12.Seager, CP. Treatment of compulsive gamblers by electrical aversion. Br J Psychiatry 1971;540:545–53.Google Scholar
13.Beck, AT. Thinking and depression. I. Idiosyncratic content and cognitive distortions. Arch Gen Psychiatry 1963; 14: 324–33.CrossRefGoogle Scholar
14.Beck, AT. Cognitive therapy of depression. New York: Guilford Press; 1979.Google Scholar
15.Gadboury, A, Ladouceur, R. Erroneous perceptions and gambling. J Soc Behav & Personality 1989; 4(4): 411–20.Google Scholar
16.Sylvain, C, Ladouceur, R. Corrective cognition and gambling habits of players of video poker. Can J Behavioural Sci 1992; 24(4): 479–89.CrossRefGoogle Scholar
17.Toneatto, T, Blitz-Miller, T, Calderwood, K, Dragonetti, R, Tsanos, A. Cognitive distortions in heavy gambling. J Gambl Stud 1997; 13(3): 253–66.CrossRefGoogle ScholarPubMed
18.Bandura, A. Self-efficacy: The exercise of control. New York: W H Freeman/Times Books/Henry Holt & Co, 1997.Google Scholar
19.Bartzokis, G, Beckson, M, Lu, PH, Nuechterlein, KH, Edwards, N, Mintz, J. Age-related changes in frontal and temporal lobe volumes in men: a magnetic resonance imaging study. Arch Gen Psychiatry 2001; 58(5): 461–65.CrossRefGoogle Scholar
20.Gogtay, N, Giedd, JN, Lusk, Let al.Dynamic mapping of human cortical development during childhood through early adulthood. Proc Natl Acad Sci USA 2004; 101(21): 8174–79.CrossRefGoogle ScholarPubMed
21.Gaboury, A, Ladouceur, R. Correction of irrational thinking during American roulette. Can J Behavioural Sci 1990; 22(4): 417–23.CrossRefGoogle Scholar
22.May, RK, Whelan, JP, Meyers, AW, Steenbergh, TA. Gambling-related Irrational Beliefs in the Maintenance and Modification of Gambling Behaviour. Int Gambl Stud 2005; 5(2): 155–67.CrossRefGoogle Scholar
23.Ladouceur, R, Sylvain, C, Boutin, Cet al.Cognitive treatment of pathological gambling. J Nerv Men Dis 2001; 189(11): 774–80.CrossRefGoogle ScholarPubMed
24.Toneatto, T, Sobell, LC. Pathological gambling treated with cognitive behavior therapy: A case report. Addictive Behav 1990; 15(5): 497501.CrossRefGoogle ScholarPubMed
25.Breen, RB, Kruedelbach, NG, Walker, HI. Cognitive changes in pathological gamblers following a 28-day inpatient program. Psych Addictive Behav 2001; 15(3): 246–48.CrossRefGoogle ScholarPubMed
26.Cautela, JR. The Pavlovian Basis of Reciprocal Inhibition Therapy. Pavlovian J Biol Sci 1966; 1(4): 293300.Google Scholar
27.McConaghy, N, Armstrong, MS, Blaszczynski, A, Allcock, C. Controlled comparison of aversive therapy and imaginal desensitization in compulsive gambling. Br J Psychiatry 1983;142:366–72.CrossRefGoogle ScholarPubMed
28.Symes, BA, Nicki, RM. A preliminary consideration of cue-exposure, responseprevention treatment for pathological gambling behaviour: Two case studies. J Gambl Stud 1997; 13(2): 145–57.CrossRefGoogle ScholarPubMed
29.Arribas Saiz, MP, Martinez Sanchez, JJ. Individual treatment of pathologic gamblers: Case descriptions. Analisis y Modificacion de Conducta 1991; 17(52): 255–69.Google Scholar
30.Ladouceur, R, Boisvert, JM, Dumont, J. Cognitive-behavioral treatment for adolescent pathological gamblers. Behavior Mod 1994; 18(2): 230–42.CrossRefGoogle ScholarPubMed
31.Sylvain, C, Ladouceur, R, Boisvert, JM. Cognitive and behavioural treatment of pathological gambling: A controlled study. J Consulting Clin Psychology 1997; 65(5): 727–32.CrossRefGoogle ScholarPubMed
32.Petry, NM, Ammerman, Y, Bohl, Jet al.Cognitive-behavioral therapy for pathological gamblers. J Consulting Clin Psychology 2006; 74(3): 555–67.CrossRefGoogle ScholarPubMed
33.Ladouceur, R, Sylvain, C, Boutin, C, Lachance, S, Doucet, C, Leblond, J, Group therapy for pathological gamblers: A cognitive approach. Behav Res Ther 2003; 41 (5): 587–96.CrossRefGoogle ScholarPubMed
34.Jimenez-Murcia, S, Alvarez-Moya, EM, Granero, Ret al.Cognitive-behavioral group treatment for pathological gambling: Analysis of effectiveness and predictors of therapy outcome. Psychother Res 2007; 17(5): 544–52.CrossRefGoogle Scholar
35Echeburua Odriozola, E, Baez Gallo, C, Fernandez-Montalvo, J. Comparative effectiveness of different therapeutic modalities in psychological treatment of pathological gambling: An experimental study. Analisis y Modificacion de Conducta 1994; 20(73): 617–43.Google Scholar
36.Gupta, R, Derevensky, JL. Adolescents with gambling problems: From research to treatment. J Gambl Studies 2000; 16(2-3): 315–42.CrossRefGoogle Scholar
37.Prochaska, JO, DiClemente, CC, Norcross, JC. In search of how people change. Applications to addictive behaviors. Am Psychol 1992; 47(9): 1102–14.CrossRefGoogle ScholarPubMed
38.Prochaska, JO, DiClemente, CC. Stages of change in the modification of problem behaviors. Prog Behav Modif 1992; 28: 183218.Google ScholarPubMed
39.Hodgins, DC, Currie, S, El-Guebaly, N, Peden, N. Brief motivational treatment for problem gambling: A 24-month follow-up. Psychol Addict Behav 2004; 18(3): 293–96.CrossRefGoogle Scholar
40.Wulfert, E, Blanchard, EB, Martell, R. Conceptualizing and treating pathological gambling: A motivationally enhanced cognitive behavioural approach. Cog Behavioural Pract 2003; 10(1): 6172.CrossRefGoogle Scholar
41.Wulfert, E, Blanchard, EB, Freidenberg, BM, Martell, RS. Retaining pathological gamblers in cognitive behavior therapy through motivational enhancement: A pilot study. Behav Modification 2006; 30(3):315–40.CrossRefGoogle ScholarPubMed
42.Takushi, RY, Neighbors, C, Larimer, ME, Lostutter, TW, Cronce, JM, Marlatt, GA. Indicated prevention of problem gambling among college students. J Gambl Stud 2004; 20(1): 8393.CrossRefGoogle ScholarPubMed
43.Lesieur, HR, Blume, SB. The South Oaks Gambling Screen (SOGS): A new instrument for the identification of pathological gamblers. Am J Psychiatry 1987; 144(9): 1184–88.Google ScholarPubMed
44.Pallesen, S, Mitsem, M, Kvale, G, Johnsen, BH, Molde, H. Outcome of psychological treatments of pathological gambling: A review and meta-analysis. Addiction 2005; 100(10): 1412–22.CrossRefGoogle ScholarPubMed
45.Coman, GJ, Evans, BJ, Burrows, GD. An innovative cognitive strategy to assist problem gamblers. Br J Guid Counsel 2005; 33(1): 129–40.Google Scholar
46.Blaszczynski, A, McConaghy, N, Frankova, A. Control versus abstinence in the treatment of pathological gambling: a two to nine year follow-up. Br J Addict 1991; 86(3): 299306.CrossRefGoogle ScholarPubMed
47.Shaffer, HJ, LaPlante, DA, LaBrie, RA, Kidman, RC, Donato, AN, Stanton, MV. Toward a Syndrome Model of Addiction: Multiple Expressions, Common Etiology. Harvard Rev Psychiatry 2004; 12(6): 367–74.CrossRefGoogle Scholar
48.Cronce, Corbin, Steinberg, Potenza. Self-perception of Gambling Problems among Adolescents Identified as At-risk or Problem Gamblers. J Gambl Stud 2007; 23(4): 363–75.CrossRefGoogle ScholarPubMed
49.Kabat-Zinn, J. Mindfulness-based interventions in context: Past, present, and future. Clin Psychology: Science and Practice 2003; 10(2): 144–56.Google Scholar
50.Segal, ZV, Teasdale, JD, Williams, JMG, editors. Mindfulness-based cognitive therapy: Theoretical rationale and empirical status. NY: Guildford Press; 2004.Google Scholar
51.Shaffer, HJ, Hall, MN, Vander Bilt, J. Estimating the prevalence of disordered gambling behavior in the United States and Canada: a research synthesis. Am J Public Health 1999; 89(9): 1369–76.CrossRefGoogle Scholar