Skip to main content

Latest Developments in Treatment for Disordered Gambling: Review and Critical Evaluation of Outcome Studies


Purpose of review

Over the last decade, treatments for disordered gambling have developed rapidly. The goal of this paper is to review and to critically evaluate the literature published on the treatment of disordered gambling in the past 3 years. Important findings are emphasized and accompanied by the authors’ personal observations on controversial results or hypotheses of interest.

Recent findings

Cognitive-behavioral interventions have been evaluated in treatment of Hong Kong Chinese individuals as well as in combination with mindfulness-based approaches. Personalized-feedback interventions have received increased attention, with brief treatments demonstrating overall efficacy. Pharmacological treatments continue to receive only limited support. On the other hand, web-based treatments appear to show promise.


Cognitive-behavioral and brief treatments remain the most empirically supported approaches, but new inventive combinations of treatments such as web-based therapies are emerging. Future research could benefit from diversification of types of treatments evaluated as well as an examination of what is considered “evidence-based.”

This is a preview of subscription content, access via your institution.


Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.

    American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM 5. Washington, D.C: American Psychiatric Association; 2013.

  2. 2.

    Hodgins DC, Currie SR, el-Guebaly N. Motivational enhancement and self-help treatments for problem gambling. J Consult Clin Psychol. 2001;69(1):50–7.

    CAS  Article  PubMed  Google Scholar 

  3. 3.

    Yakovenko I, Quigley L, Hemmelgarn BR, Hodgins DC, Ronksley P. The efficacy of motivational interviewing for disordered gambling: systematic review and meta-analysis. Addict Behav. 2015;43:72–82.

    Article  PubMed  Google Scholar 

  4. 4.

    Pallesen S, Molde H, Arnestad HM, Laberg JC, Skutle A, Iversen E, et al. Outcome of pharmacological treatments of pathological gambling: a review and meta-analysis. J Clin Psychopharm. 2007;27(4):357–64.

    Article  Google Scholar 

  5. 5.

    Gooding P, Tarrier N. A systematic review and meta-analysis of cognitive-behavioural interventions to reduce problem gambling: hedging our bets? Behav Res Ther. 2009;47(7):592–607.

    Article  PubMed  Google Scholar 

  6. 6.

    Chambless DL, Baker MJ, Baucom DH, Beutler LE, Calhoun KS, Crits-Christoph P, et al. Update on empirically validated therapies II. Clin Psychol. 1998;51(1):3–16.

    Google Scholar 

  7. 7.

    Yakovenko I, Hodgins DC. Treatment of disordered gambling. In: Gobet F, Schiller M, editors. Problem gambling: cognition, prevention and treatment. New York, NY: Palgrave Macmillan; 2014. p. 221–51.

    Chapter  Google Scholar 

  8. 8.

    Petry NM. Psychosocial treatments for problem and pathological gambling. In: Bowden-Jones H, George S, editors. A clinician’s guide to working with problem gamblers. New York, NY: Routledge; 2015. p. 123–33.

    Google Scholar 

  9. 9.•

    Hodgins DC, Stea JN, Grant JE. Gambling disorders. Lancet. 2011;378:1874–84. The authors provide a detailed summary of key features of gambling disorders. In a concise review, prevalence, etiology, screening, diagnosis, and treatment are discussed with suggestions for future directions in research. The article is recommended as a succinct overview of disordered gambling for readers new to this area of research.

    Article  PubMed  Google Scholar 

  10. 10.•

    Cowlishaw S, Merkouris S, Dowling N, Anderson C, Jackson A, Thomas S. Psychological therapies for pathological and problem gambling. Cochrane Database Syst Rev. 2012;11:CD008937. A comprehensive review of all randomized-controlled trials conducted on psychological therapies for disordered gambling as of 2012. The article uses stringent quality criteria and represents one of the most rigorous recent reviews of the literature.

    PubMed  Google Scholar 

  11. 11.

    Toneatto T, Pillai S, Courtice EL. Mindfulness-enhanced cognitive behavior therapy for problem gambling: a controlled pilot study. Int J Ment Health Addict. 2014;12:197–205.

    Article  Google Scholar 

  12. 12.

    Shonin E, Gordon WV, Griffiths MD. Cognitive behavioral therapy (CBT) and meditation awareness training (MAT) for the treatment of co-occurring schizophrenia and pathological gambling: a case study. Int J Ment Health Addict. 2014;12:181–96.

    Article  Google Scholar 

  13. 13.

    Wong DFK, Chung CLP, Wu J, Tang J, Lau P. A preliminary study of an integrated and culturally attuned cognitive behavioral group treatment for Chinese problem gamblers in Hong Kong. J Gambl Stud. 2015;31:1015–27.

    Article  PubMed  Google Scholar 

  14. 14.

    Marceaux JC, Melville CL. Twelve-step facilitated versus mapping-enhanced cognitive-behavioral therapy for pathological gambling: a controlled study. J Gambl Stud. 2011;27(1):171–90. doi:10.1007/s10899-010-9196-y.

    Article  PubMed  Google Scholar 

  15. 15.

    Swan JL, Hodgins DC. Brief interventions for disordered gambling. Can J Addict. 2015;6(2):29–36.

    Google Scholar 

  16. 16.

    Hodgins DC, Currie SR, Currie G, Fick GH. Randomized trial of a brief motivational treatments for pathological gamblers: more is not necessarily better. J Consult Clin Psychol. 2009;77(5):950–60.

    Article  PubMed  Google Scholar 

  17. 17.

    Neighbors C, Rodriguez LM, Rinker DV, Gonzales RG, Agana M, Tackett JL, et al. Efficacy of personalized normative feedback as a brief intervention for college student gambling: a randomized controlled trial. J Consult Clin Psychol. 2015;83(3):500–11.

    Article  PubMed  PubMed Central  Google Scholar 

  18. 18.•

    Toneatto T. Single-session interventions for problem gambling may be as effective as longer treatments: results of a randomized control trial. Addict Behav. 2016;52:58–65. The study compares the efficacy of cognitive, behavioral, motivational, and single-session interventions up to 12 months follow-up. The design represents one of the few and the most recent direct comparison of psychotherapies for disordered gambling with the most evidence base.

    Article  PubMed  Google Scholar 

  19. 19.

    Celio MA, Lisman SA. Examining the efficacy of a personalized normative feedback intervention to reduce college student gambling. J Am Coll Health. 2014;62(3):154–65.

    Article  PubMed  PubMed Central  Google Scholar 

  20. 20.

    Petry NM, Gonzalez-Ibanez A. Internet gambling in problem gambling college students. J Gambl Stud. 2015;31:397–408.

    Article  PubMed  PubMed Central  Google Scholar 

  21. 21.

    Stea JN, Hodgins DC, Fung T. Abstinence versus moderation goals in brief motivational treatment for pathological gambling. J Gambl Stud. 2015;31:1029–45.

    Article  PubMed  Google Scholar 

  22. 22.•

    Yip SW, Potenza MN. Treatment of gambling disorders. Curr Treat Option Psychiat. 2014;1:189–203. In addition to a thorough review of pharmacological treatments for disordered gambling, the article provides a summary of the standard dosage, contraindications, main drug interactions, main side effects, cost, and special points with regard to the use of all of the major categories of drugs that have been evaluated for treatment of gambling disorders.

    Article  Google Scholar 

  23. 23.

    Bartley CA, Bloch MH. Meta-analysis: pharmacological treatment of pathological gambling. Expert Rev Neurother. 2013;13(8):887–94.

    CAS  Article  PubMed  Google Scholar 

  24. 24.

    Grant J, Kim S, Hollander E, Potenza M. Predicting response to opiate antagonists and placebo in the treatment of pathological gambling. Psychopharmacology. 2008;200(4):521–7.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  25. 25.

    Kovanen L, Basnet S, Castrén S, Pankakoski M, Saarikoski ST, Partonen T, et al. A randomized, double-blind, placebo-controlled trial of as-needed naltrexone in the treatment of pathological gambling. Eur Addict Res. 2016;22:70–9.

    Article  PubMed  Google Scholar 

  26. 26.

    Berlin HA, Braun A, Simeon D, Koran LM, Potenza MN, McElroy SL, et al. A double-blind, placebo-controlled trial of topiramate for pathological gambling. World J Biol Psychia. 2013;14:121–8.

    Article  Google Scholar 

  27. 27.

    Grant JE, Odlaug BL, Chamberlain SR, Potenza MN, Schreiber LR, Donahue CB, et al. A randomized, placebo-controlled trial of N-acetylcysteine plus imaginal desensitization for nicotine-dependent pathological gamblers. J Clin Psychiat. 2014;75(1):39–45.

    CAS  Article  Google Scholar 

  28. 28.

    Hollander E, Pallanti S, Allen A, Sood E, Rossi NB. Does sustained-release lithium reduce impulsive gambling and affective instability versus placebo in pathological gamblers with bipolar spectrum disorders? Am J Psychiatry. 2005;162:137–45.

    Article  PubMed  Google Scholar 

  29. 29.

    Grant JE, Potenza MN. Escitalopram treatment of pathological gambling with co-occurring anxiety: an open-label pilot study with double-blind discontinuation. Int Clin Psychopharmacol. 2006;21:203–9.

    Article  PubMed  Google Scholar 

  30. 30.

    Cunningham JA. Little use of treatment among problem gamblers. Psychiatr Serv. 2005;56:1024–5.

    Article  PubMed  Google Scholar 

  31. 31.

    Slutske WS, Blaszczynski A, Martin NG. Sex differences in the rates of recovery, treatment-seeking, and natural recovery in pathological gambling: results from an Australian community-based twin survey. Twin Res Hum Genet. 2009;12:425–32.

    Article  PubMed  Google Scholar 

  32. 32.

    Portnoy DB, Scott-Sheldon LA, Johnson BT, Carey MB. Computer-delivered interventions for health promotion and behavioral risk reduction: a meta-analysis of 75 randomized controlled trials, 1988–2007. Prev Med. 2008;47:3–16.

    Article  PubMed  PubMed Central  Google Scholar 

  33. 33.

    Carlbring P, Smit F. Randomized trial of Internet-delivered self-help with telephone support for pathological gamblers. J Consult Clin Psychol. 2008;76:1090–4.

    Article  PubMed  Google Scholar 

  34. 34.

    Cunningham JA, Hodgins DC, Toneatto T, Rai A, Cordingley J. Pilot study of a personalized feedback intervention for problem gamblers. Behav Ther. 2009;40:219–24.

    Article  PubMed  Google Scholar 

  35. 35.

    Cunningham JA, Hodgins DC, Toneatto T, Murphy M. A randomized controlled trial of a personalized feedback intervention for problem gamblers. PLoS One. 2012;7:e31586.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  36. 36.

    Carlbring P, Degerman N, Jonsson J, Andersson G. Internet-based treatment of pathological gambling with a three-year follow-up. Cogn Behav Ther. 2012;41(4):321–34.

    Article  PubMed  PubMed Central  Google Scholar 

  37. 37.

    Canale N, Vieno A, Griffiths MD, Marino C, Chieco F, Disperati F, et al. The efficacy of a web-based gambling intervention program for high school students: a preliminary randomized study. Comput Hum Behav. 2016;55:946–54.

    Article  Google Scholar 

  38. 38.

    Luquiens A, Lagadec M, Tanguy M, Reynaud M. Efficacy of online psychotherapies in poker gambling disorder: an online randomized clinical trial. Eur Psychiatry. 2015;30(Supplement 1):28–31.

    Google Scholar 

  39. 39.

    Hodgins DC, Fick GH, Murray R, Cunningham JA. Internet-based interventions for disordered gamblers: study protocol for a randomized controlled trial of online self-directed cognitive-behavioural motivational therapy. BMC Public Health. 2013;13:10.

    Article  PubMed  PubMed Central  Google Scholar 

  40. 40.

    Magnusson K, Nilsson A, Hellner Gumpert C, Andersson G, Carlbring P. Internet-delivered cognitive-behavioural therapy for concerned significant others of people with problem gambling: study protocol for a randomised wait-list controlled trial. BMJ Open. 2015;5, e008724. doi:10.1136/bmjopen-2015-008724.

    Article  PubMed  PubMed Central  Google Scholar 

  41. 41.

    Hodgins DC, Toneatto T, Makarchuk K, Skinner W, Vincent S. Minimal treatment approaches for concerned significant others of problem gamblers: a randomized controlled trial. J Gambl Stud. 2007;23(2):215–30. doi:10.1007/s10899-006-9052-2.

    Article  PubMed  Google Scholar 

  42. 42.

    Lee BK, Rovers M. ‘Bringing torn lives together again’: effects of the first congruence couple therapy training application to clients in pathological gambling. Int Gambl Stud. 2008;8(1):113–29. doi:10.1080/14459790701878137.

    Article  Google Scholar 

  43. 43.

    Gainsbury SM. Review of self-exclusion from gambling venues as an intervention for problem gambling. J Gambl Stud. 2014;30(2):229–51.

    Article  PubMed  Google Scholar 

  44. 44.

    Petry NM. Gamblers anonymous and cognitive-behavioral therapies for pathological gamblers. J Gambl Stud. 2005;21(1):27–33. doi:10.1007/s10899-004-1919-5.

    Article  PubMed  Google Scholar 

  45. 45.•

    Fink A, Parhami I, Rosenthal RJ, Campos MD, Siani A, Fong TW. How transparent is behavioral intervention research on pathological gambling and other gambling-related disorders? A systematic literature review. Addiction. 2012;107:1915–28. The article illustrates weaknesses in transparency of reporting of disordered gambling intervention research. Recommendations for improvement are provided along with sources of existing reporting guidelines for both randomized and non-randomized designs.

    Article  PubMed  PubMed Central  Google Scholar 

  46. 46.

    Des Jarlais DC, Lyles C, Crepaz N. Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: the TREND statement. Am J Public Health. 2004;94:361–6.

    Article  PubMed  PubMed Central  Google Scholar 

  47. 47.

    Altman DG. Better reporting of randomised controlled trials: the CONSORT statement. BMJ. 1996;313:570–1.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  48. 48.•

    Tolin DF, McKay D, Forman EM, Klonsky ED, Thombs BD. Empirically supported treatment: recommendations for a new model. Clin Psychol-Sci Pract. 2015;22(4):317–38. The article is a detailed overview of the criticisms laid toward the APA criteria for empirically-supported treatments. The authors provide recommendations for new ways of conceptualizing “empirically-supported” based on the research over the last two decades.

    Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Igor Yakovenko.

Ethics declarations

Conflict of Interest

Igor Yakovenko and David C. Hodgins declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Gambling

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Yakovenko, I., Hodgins, D.C. Latest Developments in Treatment for Disordered Gambling: Review and Critical Evaluation of Outcome Studies. Curr Addict Rep 3, 299–306 (2016).

Download citation


  • Disordered gambling
  • Treatment
  • Review
  • Gambling
  • Evidence-based
  • Pathological gambling