Internet-delivered cognitive-behavioral therapy for significant others of treatment-refusing problem gamblers: A randomized wait-list controlled trial.

Abstract

Over the last couple of decades evidence-based psychotherapies have flourished, and there are now therapies that are well-established for a wide range of problems. At the same time the mental-health burden is still enormous, and challenges to the dissemination of treatments are substantial. Despite the considerable gains in knowledge that have been made, many issues remain unsolved, and there are many reasons to be skeptical of the current quality of the evidence.

“When I’m not angry I am anxious”: The lived experiences of individuals in a relationship with a non-help-seeking problem gambler—A hermeneutic phenomenological study

“…This was a common experience across the sample. Thus, unilateral interventions designed for partners or families, that rely on the ability to respond to gambling behavior reliably and consistently (such as CRAFT; Hodgins, Toneatto, et al, 2007; Magnusson et al, 2019; Makarchuk et al, 2002; Nayoski & Hodgins, 2016), would be particularly challenging. That said, a recent study involving couples, in which one member was a problem gambler, provides some early evidence that partners living with a problem gambler can, in fact, influence the gamblers’ behavior (Côté et al, 2019).…”

“…There have been four attempts at adapting the CRAFT model to assist CSOs of PGs to influence treatment-refusing gamblers ( Hodgins, Toneatto, et al, 2007; Magnusson et al, 2019; Makarchuk et al, 2002; Nayoski & Hodgins, 2016). Though there was some limited evidence that the well-being of CSOs improved, none of the interventions thus far have been successful in motivating the gambler into treatment.…”

“…Further, Makarchuk et al (2002) reported that difficulty in identifying precisely when gambling has occurred was the biggest challenge to modifying the CRAFT materials for use with PGs. If CSOs of problem gamblers are unable to reliably detect gambling behavior, then CRAFT interventions would prove challenging to apply effectively in this context, a point similarly raised by Magnusson et al (2019). The reviewed literature highlights the pervasive impact of PG on partners, and the potential, albeit early indications, that partners may be able to lessen denial among unadmitters and encourage help-seeking.…”

Affected Others Responsivity to Gambling Harm: An International Taxonomy of Consumer-Derived Behaviour Change Techniques

“…Gambler-focused treatment approaches involve affected others with the purpose of supporting the gambler in behaviour change [16,[25][26][27][28][29][30]. Gambler-focused approaches aim to provide education, advice and counselling for affected others and are a primary reason family contact help services [16,31].…”

“…Gambler-focused approaches aim to provide education, advice and counselling for affected others and are a primary reason family contact help services [16,31]. Many treatments, such as Community Reinforcement and Family Training (CRAFT), have a blended approach which focuses on improving individual functioning and the quality of the relationship, as well as training in communication, stress reduction, problem solving and financial management and learning skills to encourage gambling reduction and help seeking [27,29,30,32,33].…”