Abstract
This study measured the outcome of four state-supported outpatient gambling treatment programs in Minnesota. The programs were developed specifically for the treatment of pathological gamblers and offered multiple modalities of treatment including individual, group, education, twelve-step work, family groups, and financial counseling. The therapeutic orientation was eclectic with an emphasis on the twelve steps of Gamblers Anonymous (GA) and a treatment goal of abstinence. The sample included 348 men and 220 women treated between January 1992 and January 1995. A pretest-posttest design was utilized with multidimensional assessments obtained at intake, discharge, six-months, and twelve-months post-discharge. Variables assessed included a range of clinical and outcome variables. At six month follow-up, 28% reported that they had abstained from gambling during the six months following discharge and an additional 20% had gambled less than once per month. Almost half of the sample (48%) showed clinically significant improvement in gambling frequency at six monthfollow-up. Outcome variables of gambling frequency, SOGS scores, amount of money gambled, number of friends who gamble, psychosocial problems, and number of financial problems, all showed statistically significant improvements from pretreatment to follow-up. The treatment programs yielded outcome results similar to those reported for alcohol and drug abuse treatment programs.
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REFERENCES
American Psychiatric Association. (1989). Diagnostic and statistical manual of mental disorders (3rd ed., revised). Washington, DC: Author.
Babor, T. F., Stephens, R. S., & Marlatt, G. A. (1987). Verbal report methods in clinical research on alcoholism: Response bias and its minimization. Journal of Studies on Alcohol, 48, 410–424.
Bergin, A., & Lambert, M. (1978). The evaluation of therapeutic outcomes. In A. Bergin & S. Garfield (Eds.), Handbook of psychotherapy and behavior change: An empirical analysis (pp. 139–190). New York: Wiley.
Beutler, L. E. (1990). Methodology: What are the design issues involved in the defined research priorities. In L. S. Onken & J. D. Blaine (Eds.), Psychotherapy and counseling in the treatment of drug abuse (pp. 105–118). Rockville, MD: National Institute on Drug Abuse.
Blackman, S., Simone, R. V., Thoms, D. R., & Blackman, S. (1989). The Gamblers Treatment Clinic of St. Vincent's North Richmond Community Mental Health Center: Characteristics of the clients and outcome of treatment. International Journal of the Addictions, 24, 29–37.
Collins, L., & Horn, J. (Eds.) (1991). Best methods for the analysis of change: Recent advances, unanswered questions, future directions. Washington, DC: American Psychological Association.
Cronbach, L. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297–334.
DeCaria, C. M., Hollander, E., Grossman, R., Wong, C. M., Mosovich, S. A., & Cherkasky, S. (1996). Diagnosis, neurobiology, and treatment of pathological gambling. Journal of Clinical Psychiatry, 57 (supplement 8), 80–84.
Emerson, M. O., & Laundergan, J. C. (1996). Gambling and problem gambling among adult Minnesotans: Changes 1990 to 1994. Journal of Gambling Studies, 12, 291–304.
Emrick, C. D., & Hansen, J. (1983). Assertions regarding effectiveness of treatment for alcoholism: Fact or fantasy? American Psychologist, 38, 1078–1088.
Gambino, B., & Cummings, T. (1989). Treatment for compulsive gambling: Where are we now? In H. J. Shaffer, S. A. Stein, B. Gambino and T. N. Cummings (Eds.), Compulsive gambling: Theory, research, and practice (pp. 315–335). Lexington, MA: Lexington Books.
Harrison, P. A., & Hoffmann, N. (1989). CATOR report: Adolescent treatment completers one year later. St. Paul, MN: Chemical Abuse/Addiction Treatment Outcome Registry.
Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.
Knapp, T. J., & Lech, B. C. (1987). Pathological gambling: A review with recommendations. Advances in Behavior Research and Therapy, 9, 21–49.
Lambert, M., DeJulio, S., & Christensen, E. (1983). The assessment of psychotherapy outcome. New York: Wiley.
Larsen, D., Attkisson, C., Hargreaves, W., & Nguyen, J. (1979). Assessment of client/patient satisfaction: Development of a general scale. Evaluation and Program Planning, 2, 197–207.
Lesieur, H. R., & Blume, S. B. (1987). The South Oaks Gambling Screen (SOGS): A new instrument for the identification of pathological gamblers. American Journal of Psychiatry, 144, 1184–1188.
Lesieur, H. R., & Blume, S. B. (1991). Evaluation of patients treated for pathological gambling in a combined alcohol, substance abuse and pathological gambling treatment unit using the Addiction Severity Index. British Journal of Addiction, 86, 1017–1028.
Lesieur, H. R., & Rosenthal, R. (1991). Pathological gambling: A review of the literature (Prepared for the American Psychiatric Association Task Force on DSM-IV Committee on Disorders of Impulse Control Not Elsewhere Classified). Journal of Gambling Studies, 7, 5–39.
Moore, T. L. (1998). Gambling Treatment Evaluation Update. Wilsonville, OR: Herbert & Louis.
Murray, J. B. (1993). Review of research on pathological gambling. Psychological Reports, 72, 791–810.
Nathan, P. E., & Lansky, D. (1978). Common methodological problems in research on the addictions. Journal of Consulting and Clinical Psychology, 46, 713–726.
National Research Council (1999). Pathological gambling: A critical review. Washington, DC: National Academy Press.
Nunnally, J. (1978). Psychometric theory (2nd ed.). New York: McGraw Hill, Inc.
Petry, N. M., & Armentano, C. (1999). Prevalence, assessment, and treatment of pathological gambling: A review. Psychiatric Services, 50, 1021–1027.
Russo, A. M., Taber, J. I., McCormick, R. A., & Ramirez, L. F. (1984). An outcome study of an inpatient treatment program for pathological gamblers. Hospital and Community Psychiatry, 35, 823–827.
Sobell, L C. (1978). A critique of alcoholism treatment evaluation. In G. A. Marlatt & P. E. Nathan (Eds.), Behavioral assessment and treatment of alcoholism (pp. 166–182). New Brunswick, NJ: Rutgers University Center of Alcohol Studies.
Stinchfield, R. D., Niforopulos, L., & Feder, S. (1994). Follow-up contact bias in adolescent substance abuse treatment outcome research. Journal of Studies on Alcohol, 55, 285–289.
Stinchfield, R., & Owen, P. (1998). Hazelden's Model of Treatment and its Outcome. Addictive Behaviors, 23, 669–683.
Stinchfield, R. D., Owen, P., & Winters, K. (1994). Group therapy for substance abuse: A review of the empirical research. In A. Fuhriman & G. Burlingame (Eds.), Handbook of group psychotherapy (pp. 458–488). New York: Wiley.
Stinchfield, R., & Winters, K. (1996). Effectiveness of Six State-Supported Compulsive Gambling Treatment Programs in Minnesota. Saint Paul, MN: Compulsive Gambling Program, Minnesota Department of Human Services.
Stinchfield, R., & Winters, K. C. (1997). Measuring change in adolescent substance misuse with the Personal Experience Inventory (PEI). Substance Use and Misuse, 32, 63–76.
Strupp, H. H. (1993). Psychotherapy research: Evolution and current trends. In T. K. Fagan & G. R. VandenBos (Eds.), Exploring applied psychology: Origins and critical analyses (pp. 157–193). Washington, DC: American Psychological Association.
Sylvain, C., Ladouceur, R., & Boisvert, J. (1997). Cognitive and behavioral treatment of pathological gambling: A controlled study. Journal of Consulting and Clinical Psychology, 65, 727–732.
Taber, J. I., McCormick, R. A., Russo, A. M., Adkins, B. J., & Ramirez, L. F. (1987). Follow-up of pathological gamblers after treatment. American Journal of Psychiatry, 144, 757–761.
Toneatto, T., & Sobell, L. C. (1990). Pathological gambling treated with cognitive behavior therapy: A case report. Addictive Behaviors, 15, 497–501.
Viets, V. C. L., & Miller, W. R. (1997). Treatment approaches for pathological gamblers. Clinical Psychology Review, 17, 689–702.
Volberg, R. A. (1988). Compulsive gambling treatment program evaluation: Final report. Albany, NY: NYS Office of Mental Health.
Walker, M. B. (1993). Treatment strategies for problem gambling: A review of effectiveness. In W. R. Eadington and J. A. Cornelius (Eds.), Gambling behavior and problem gambling (pp. 533–566). Reno, NV: William R. Eadington & Judy A. Cornelius.