The influence of CBT based treatment and therapeutical contract guidelines on a problem gambler abstinence treatment
Background: This ongoing longitudinal study aims to test the impact of a Cognitive Behavioral Therapy (CBT) combined with an initial set of guidelines named therapeutical contract (TC) in a Portuguese treatment centre for Problem Gamblers (PG) with variables like; gambling abstinence, self-exclusion, limited access to money, psychotherapy sessions for problem gambler and significant others, Gamblers Anonymous attendance, therapeutical exercises, pre-determined consequences if relapse, among others . As far as we are aware, this is a pioneer study in Portugal.
Methods: The same self-questionnaire assessment data was collected at two different times: moment 1 (N = 240) of pre-treatment was completed after the first session and moment 2 (N = 37), between the 12th and the 20th psychotherapy session. The protocol focused on socio demographics, gambling behaviour’s, relapse questionnaire, gambling disorder assessment and other diagnostics measures.
Results: Preliminary results showed statistically significant differences between moment 1 and moment 2 concerning the improvement of a psychological measure of quality of life (Psychological and Physical domain; Social Relationships and Environmental) recovery in overall symptomatology (depression, anxiety, sensorial intersensivity, obsession/compulsion and psychoticism) and decrease of Unplanned Impulsivity. As the sample increases it is expected that abstinent group will show differences in type/mode of gambling, respective adherence to different variables of the TC at moment 2 and a decrease in relapses.
Conclusion: This study shows how the combination of CBT and TC helps PG to achieve better treatment results and may help clinicians to improve their understanding and intervention with patients and it provides information for responsible gambling interventions as well as relapse prevention. Structured guidelines seem to help clients to go throught treatment process with more awarness and efficacy concerning abstinence positive outcomes.
