Commentary on Nilsson <i>et al</i>. (2020): The development of effective interventions for concerned significant others affected by gambling harms

Dowling, Nicki A.

doi:10.1111/add.15026

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…An increased interest is evident in the literature in how affected others can be assisted in their distress in the context of addiction (Edgren et al, 2022; Merkouris et al, 2022), but efficacy is reportedly low for affected others' improvement with individual‐based interventions (Dowling, 2020). Primary clients' and partners' symptoms collected in this RCT showed that at baseline, primary clients relative to partners exhibited more severe symptoms of addiction, mental health comorbidities, and emotion dysregulation.…”

Section: Discussionmentioning

confidence: 99%

Congruence couple therapy for alcohol use and gambling disorders with comorbidities (part I): Outcomes from a randomized controlled trial

et al. 2022

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A nonblinded randomized trial was conducted at two Canadian provincial outpatient addiction clinics that tested the effectiveness of a systemic congruence couple therapy (CCT) versus individual‐based treatment‐as‐usual (TAU) on nine clinical outcomes: (1) primary outcomes—alcohol use and gambling, psychiatric symptoms, and couple adjustment; (2) secondary outcomes—emotion regulation, substance use, depression, post‐traumatic stress symptoms, and life stress. Data of primary clients and partners (N = 46) were analyzed longitudinally across baseline, posttreatment (5 months), and follow‐up (8 months). Alcohol use disorder (95%) and gambling disorder (5%) were in the severe range at baseline, and co‐addiction was 27%. Psychiatric comorbidity was 100%, and 18% of couples were jointly addicted. Between‐group comparison favored CCT in primary outcomes with medium‐to‐large effect sizes (Cohen's h = 0.74–1.44). Secondary outcomes were also significantly stronger for CCT (Cohen's h = 0.27–1.53). Within‐group, for all primary outcomes, a significant proportion of symptomatic CCT clients and partners improved, converging with ANOVA results of large effect sizes (0.14–0.29). All secondary outcomes improved significantly in CCT with large effect sizes (0.14–0.50). TAU showed significant within‐group improvement in alcohol use, other substance use, and life stress with large effect sizes (0.16–0.40). Primary clients and partners made largely equivalent improvement within CCT and within TAU. Results were triangulated with clients' satisfaction ratings and counselors' reports. Overall, significant within‐group effects were detected for CCT both clinically and statistically and between‐group difference favored CCT. Future trials are required to validate these promising findings.

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Section: Discussionmentioning

confidence: 99%

Congruence couple therapy for alcohol use and gambling disorders with comorbidities (part I): Outcomes from a randomized controlled trial

et al. 2022

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“…The harm experienced by CSOs varies markedly depending on the relationship to the gambler, and as such tailored interventions that meet specific needs are necessary, which may lead to better adherence and outcomes ( Magnusson, 2019 ). Poor efficacy ratings for CSO interventions may indicate that current interventions are not meeting the needs of CSOs, and this calls for further research to identify help-seeking preferences, effective intervention content, and usage of appropriate instruments to evaluate the outcomes ( Dowling, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Treatment for the concerned significant others of gamblers: A systematic review

Edgren

Pörtfors

Raisamo

et al. 2022

JBA

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Background and aims Research recognizes the extent of harm experienced by concerned significant others (CSOs) of gamblers. This systematic review’s aims are to examine the interventions for CSOs, evaluate potential benefits, and thematically describe treatment processes. The Stress-Strain-Coping-Support model (SSCS) served as the theoretical framework. Methods Database searches were conducted in: MEDLINE, CINAHL Complete, Web of Science Core Collection, Social Services Abstracts, Applied Social Science Index and Abstracts, Cochrane Central Register of Controlled Trials, and APA PsycInfo (between 01/Jan 2011–10/Jun 2021). Other search methods were also utilized. Inclusion criteria: interventions for CSOs with CSO specific outcomes. The Evidence Project Risk of Bias Tool was used for assessment. Results 19/768 records were included. Nine interventions were utilized: 3 CSO directed, 4 for couples, and 2 low threshold online interventions. A quantitative synthesis (N = 7 studies) of effect size estimates for depression and anxiety measures didn’t indicate any intervention to have better outcomes than others. Core themes in the treatment process identified in the qualitative synthesis (N = 7) included: information and understanding, social support, coping skills, communication, and strain. Limitations in the evidence related to sampling, control-conditions and outcome measurements. Discussion and conclusion Several interventions were identified, yet no specific interventions appeared more beneficial than others. Using the SSCS model, commonalities and differences in intervention content were identified, along with themes that influence treatment processes. The need for tailored interventions is discussed. Future treatment efficacy research should carefully select study designs and outcome measurements. PROSPERO (CRD42021229408).

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“…Moreover, a Swedish study by Hofmarcher et al ( 2020 ) noted that the country's societal costs of problem gambling included €38.58 million for the treatment of violence and €196.95 million in the treatment of emotional distress experienced by affected others (Hofmarcher et al, 2020 ). Despite these financial investments, the efficacy of these interventions has been doubted, which merits further research to inform the development of effective interventions specifically tailored for the needs affected others of problem gambling (Dowling, 2020 ).…”

Section: The Importance Of This Systematic Reviewmentioning

confidence: 99%

“…Although the prevalence of affected others has been given little attention in the literature, available figures range between 2% (Wenzel et al, 2008 ) and 19.3% (Salonen et al, 2014 ) depending on the definition and methodology used by researchers (Salonen et al, 2014 ; Svensson et al, 2013 ). This highlights the need for developing effective interventions aimed at supporting this needy population (Dowling, 2020 ; Heineman, 1994 ; Orford, 1994 ; Steinberg, 1993 ; Tepperman, 1985 ).…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Psychosocial Interventions in Minimising the Harm Caused to Affected Others of Problem Gambling: A Systematic Review and Meta-Analysis

2023

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Problem gambling not only impacts gamblers but also protrudes onto several affected others who experience adverse impacts, including financial, health, relationships, and psychological problems. The aims of this systematic review were twofold; to identify the psychosocial interventions to minimise the harm caused to affected others of problem gambling and to assess their efficacy. This study was conducted as outlined in the research protocol PROSPERO (CRD42021239138). Database searches were conducted in CENTRAL, MEDLINE, Social Science Database, CINHAL Complete, Academic Search Ultimate and PsycINFO. Randomised controlled trials of psychosocial interventions that aimed to minimise the harm caused to affected others of problem gambling written in English were eligible for inclusion. Risk of bias for included studies was assessed using the Cochrane ROB 2.0 tool. The identified interventions focused on two approaches to supporting affected others: interventions involving both the problem gambler and affected others, and interventions involving affected others only. As the interventions and outcome measures used were sufficiently similar, a meta-analysis was conducted. The quantitative synthesis revealed that generally, treatment groups were unable to show greater benefits over control groups. The goal for future interventions aimed at affected others of problem gambling should focus primarily on the wellbeing of affected others. The standardisation of outcome measures and data collection time points for better comparison of future research is needed.

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Commentary on Nilsson et al. (2020): The development of effective interventions for concerned significant others affected by gambling harms

Cited by 5 publications

References 15 publications

Congruence couple therapy for alcohol use and gambling disorders with comorbidities (part I): Outcomes from a randomized controlled trial

Congruence couple therapy for alcohol use and gambling disorders with comorbidities (part I): Outcomes from a randomized controlled trial

Treatment for the concerned significant others of gamblers: A systematic review

The Efficacy of Psychosocial Interventions in Minimising the Harm Caused to Affected Others of Problem Gambling: A Systematic Review and Meta-Analysis

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