Skip to main content
SpringerLink
Log in

Client Engagement Characteristics Associated with Problem Gambling Treatment Outcomes

  • Published:
International Journal of Mental Health and Addiction Aims and scope Submit manuscript

Abstract

Previous research examining the factors associated with problem gambling treatment outcomes has examined client factors and to date, treatment characteristics, therapist factors, and client-therapist interactions have essentially remained unexplored. This study aimed to investigate how client engagement variables (client-rated therapeutic alliance, therapist-rated therapeutic alliance, number of sessions attended, and client commitment) relate to treatment outcomes (gambling and general functioning) in a sample of 475 treatment-seeking problem gambling clients using a series of hierarchical regression analyses. Client-rated therapeutic alliance predicted both gambling and general functioning outcomes, but therapist-rated therapeutic alliance only predicted general functioning outcomes. There was no significant relationship between number of sessions and outcomes, but client commitment predicted gambling outcomes. Client satisfaction only mediated the relationships between therapeutic alliance and treatment outcomes. Taken together, the findings indicate that client engagement characteristics, in particular the therapeutic relationship, are active agents of change in psychological interventions for problem gambling.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Connors, G. J., Carroll, K. M., DiClemente, C. C., Longabaugh, R., & Donovan, D. M. (1997). The therapeutic alliance and its relationship to alcoholism treatment participation and outcome. Journal of Consulting and Clinical Psychology, 65(4), 588–598.

    Article  PubMed  CAS  Google Scholar 

  • Connors, G. J., DiClemente, C. C., Dermen, K. H., Kadden, R., Carroll, K. M., & Frone, M. R. (2000). Predicting the therapeutic alliance in alcoholism treatment. Journal of Studies on Alcohol, 61, 139–149.

    PubMed  CAS  Google Scholar 

  • Crisp, B. R., Jackson, A. C., Thomas, S. A., Thomason, N., Smith, S., Borrell, J., et al. (2001a). Is more better? The relationship between outcomes achieved by problem gamblers and the number of counselling sessions attended. Australian Social Work, 54(3), 83–92.

    Article  Google Scholar 

  • Crisp, B. R., Thomas, S. A., Jackson, A. C., & Thomason, N. (2001b). The influence of demographic, behavioural and treatment characteristics on problem gambling counselling outcomes. Australian Journal of Primary Health, 7(2), 32–36.

    Article  Google Scholar 

  • Dearing, R. L., Barrick, C., Derman, K. H., & Walitzer, K. S. (2005). Indicators of client engagement: influences on alcohol treatment satisfaction and outcomes. Psychology of Addictive Behaviors, 19(1), 71–78.

    Article  PubMed  Google Scholar 

  • Dowling, N. (2009). Client characteristics associated with treatment attrition and outcome in female pathological gambling. Addiction Research and Theory, 17(2)

  • Echeburua, E., Fernandez-Montalvo, J., & Baez, C. (2001). Predictors of therapeutic failure in slot-machine pathological gamblers following behavioural treatment. Behavioural and Cognitive Psychotherapy, 29, 379–393.

    Article  Google Scholar 

  • Evans, C., Mellor-Clark, J., Margison, F., Barkham, M., Audin, K., Connell, J., et al. (2000). CORE: Clinical Outcomes in Routine Evaluation. Journal of Mental Health, 9(3), 247–255.

    Article  Google Scholar 

  • Hansen, N. B., Lambert, M. J., & Forman, E. M. (2002). The psychotherapy dose-response effect and its implications for treatment delivery services. Clinical Psychology: Science and Practice, 9(3), 329–343.

    Article  Google Scholar 

  • Hawthorne, G., & Elliot, P. (2005). Imputing cross-sectional missing data: comparison of common techniques. Australian and New Zealand Journal of Psychiatry, 39, 583–590.

    Article  PubMed  Google Scholar 

  • Heppner, P. P., Cooper, C., Mulholland, A., & Wei, M. (2001). A brief, multidimensional, problem-solving psychotherapy outcome measure. Journal of Counseling Psychology, 48(3), 330–343.

    Article  Google Scholar 

  • Horvath, A. O., & Greenberg, L. S. (1989). The development and validation of a working alliance inventory. Journal of Counseling Psychology, 36(2), 223–233.

    Article  Google Scholar 

  • Horvath, A. O., & Symonds, B. D. (1991). Relation between working alliance and outcome in psychotherapy: a meta-analysis. Journal of Counselling Psychology, 38(2), 139–149.

    Article  Google Scholar 

  • Ilgen, M., Tiet, Q., Finney, J., & Moos, R. H. (2006). Self-efficacy, therapeutic alliance, and alcohol-use disorder treatment outcomes. Journal of Studies on Alcohol, 67, 465–472.

    PubMed  Google Scholar 

  • Jackson, A. C., Thomas, S. A., Thomason, N., Borrell, J., Crisp, B. R., Ho, W., et al. (2002). Longitudinal evaluation of the effectiveness of problem gambling counselling services, community education strategies and information products—Volume 2: Counselling interventions. Melbourne: Victorian Department of Human Services.

    Google Scholar 

  • Lambert, M. J., & Barley, D. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy, 38(4), 357–361.

    Article  Google Scholar 

  • Lambert, M. J., Burlingame, G. M., Umphress, V., Hansen, N. B., Vermeersch, D. A., Clouse, G. C., et al. (1996). The reliability and validity of the outcome questionnaire. Clinical Psychology and Psychotherapy, 3(4), 249–258.

    Article  Google Scholar 

  • Larsen, D. L., Attkinson, C. C., Hargraves, W. A., & Nguyen, T. D. (1979). Assessment of client/patient satisfaction: development of a general scale. Evaluation and Program Planning, 2, 197–207.

    Article  PubMed  CAS  Google Scholar 

  • Lopez Viets, V. C., & Miller, R. W. (1997). Treatment approaches for pathological gamblers. Clinical Psychology Review, 17, 689–702.

    Article  PubMed  CAS  Google Scholar 

  • Luborsky, L., Barber, J. P., Siqueland, L., Johnson, S., Najavits, L. M., Frank, A., et al. (1996). The revised Helping Alliance Questionnaire (HAI-II). Journal of Psychotherapy Practice and Research, 5(3), 260–270.

    Google Scholar 

  • Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review. Journal of Consulting and Clinical Psychology, 68(3), 438–450.

    Article  PubMed  CAS  Google Scholar 

  • McCormick, R. A., & Taber, J. I. (1988). Attributional style in pathological gamblers in treatment. Journal of Abnormal Psychology, 97, 368–370.

    Article  PubMed  CAS  Google Scholar 

  • McCormick, R. A., & Taber, J. I. (1991). Follow-up of male pathological gamblers after treatment: the relationship of intellectual variables to relapse. Journal of Gambling Studies, 7, 99–108.

    Article  Google Scholar 

  • Meier, P. S., Barrowclough, C., & Donmall, M. C. (2005). The role of the therapeutic alliance in the treatment of substance misuse: a critical review of the literature. Addiction, 100, 304–316.

    Article  PubMed  Google Scholar 

  • Miller, S., Duncan, B., Johnson, L., & Hubbell, M. (2000). Toward an outcome informed therapeutic practice. Psychotherapy in Australia, 6(2), 30–36.

    Google Scholar 

  • Milton, S., Crino, R., Hunt, C., & Prosser, E. (2002). The effect of compliance-improving interventions on the cognitive-behavioural treatment of pathological gambling. Journal of Gambling Studies, 18, 207–229.

    Article  PubMed  Google Scholar 

  • Najavits, L. M., & Weiss, R. D. (1994). Variations in therapist effectiveness in the treatment of patients with substance use disorders: an empirical review. Addiction, 89, 679–688.

    Article  PubMed  CAS  Google Scholar 

  • Neighbors, C., Lostutter, T. W., Larimer, M. E., & Takushi, R. Y. (2002). Measuring gambling outcomes among college students. Journal of Gambling Studies, 18(4), 339–360.

    Article  PubMed  Google Scholar 

  • Orlinksy, D. E., Grawe, K., & Parks, B. K. (1994). Process and outcome in psychotherapy: Noch einmal. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behaviour change (4th ed., pp. 270–376). New York: Wiley.

    Google Scholar 

  • Raylu, N., & Oei, T. P. S. (2007). Factors that predict treatment outcomes in a community treatment agency for problem gamblers. International Journal of Mental Health and Addiction, 5, 165–176.

    Article  Google Scholar 

  • Smith, S., Thomas, S. A., & Jackson, A. C. (2004). An exploration of the therapeutic relationship and counselling outcomes in a problem gambling counselling service. Journal of Social Work Practice, 18(1), 99–112.

    Article  Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (Eds.). (2005). Using multivariate statistics (5th ed.). New York: Harper Collins.

    Google Scholar 

Download references

Acknowledgements

ND was responsible for literature review, data analysis and interpretation, and manuscript preparation. SC was responsible for project design, data collection, and manuscript preparation. The authors would like to thank the staff and clients of the Gamblers Help Southern Problem Gambling Counselling Program for their participation in this project.

Disclosure

The authors have no conflict of interest.

Author information

Authors and Affiliations

  1. Problem Gambling Research and Treatment Centre, University of Melbourne, Old Geology Building, Vic, 3010, Australia

    Nicki A. Dowling

  2. Gamblers Help Southern, Bentleigh Bayside Community Health Service, Vic, Australia

    Sanja Cosic

Authors
  1. Nicki A. Dowling
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sanja Cosic
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nicki A. Dowling.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dowling, N.A., Cosic, S. Client Engagement Characteristics Associated with Problem Gambling Treatment Outcomes. Int J Ment Health Addiction 9, 656–671 (2011). https://doi.org/10.1007/s11469-010-9298-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11469-010-9298-x

Keywords

Search

Navigation