Comparative Effectiveness of Three Therapeutic Modalities in the Psychological Treatment of Pathological Gambling: Long-Term Outcome

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Abstract
The aim of this paper was to test the comparative effectiveness of three therapeutic modalities: a) individual stimulus control and exposure with response prevention; b) group cognitive restructuring; and c) a+b in the treatment of pathological gambling with slot machines. An additional waiting-list group was used to evaluate the spontaneous evolution of the non-treated gamblers. The sample consisted of 64 patients selected according to DSM-III-R criteria. A multigroup experimental design with repeated measures (pretreatment, posttreatment and 1, 3, 6 and 12-month follow-up) was used. Most treated patients gave up gambling as well as improved, albeit more slowly, in family/social and psychological functioning. The success rate was higher in the individual treatment compared both to group and combined treatment. There was also an improvement in gambling in the control group between the pretreatment and the 6–month follow-up and there was no difference between the combined treatment and control group. Individual stimulus control and exposure with response prevention appears to be a cost-effective therapy for pathological gambling. Implications of this study for clinical practice and future research in this field are discussed.