The perceived importance of a Therapeutical Contract in a CBT based treatment of problem gamblers

This study aims to test the efficacy of a Cognitive Behavioral Therapy (CBT) combined with an initial therapeutical contract (TC) in a Portuguese outpatient treatment center for Problem Gamblers (PG) with specific and practical variables like; gambling abstinence, self-exclusion, limited access to money, predetermined psychotherapy sessions for problem gambler and significant others as well of some consequences if relapse, Gamblers Anonymous attendance, therapeutical exercises, and a Relapse Prevention Program (RPP) among others. As far as we are aware, this is the first study in Portugal that evaluates the efficacy of a psychotherapeutic program in the treatment of PG.

The same self-questionnaire assessment data was collected at two different times: moment 1 (N = 165) of pre-treatment was completed after the first session and moment 2 (N = 40), between the 15th and the 20th psychotherapy session. The protocol focused on socio demographics, gambling behavior’s, relapse questionnaire, gambling disorder assessment and other diagnostics measures.

Preliminary results showed significant differences between moment 1 and moment 2 concerning the improvement of a psychological measure of quality of life; improvement in general symptomatology (depression, anxiety, sensorial interference, obsession/compulsion and psychoticism) and decrease of motor impulsivity. It is expected that abstinent group will show development in overall emotional adjustment and well-being in their lives and respective adherence to different variables of the TC. Finally, different motivations seem to appear concerning the abstinent behavior and its treatment.

This study shows how the combination of CBT, TC and RPP helps PG to achieve better results concerning their gambling addiction. This study may help clinicians to improve their understanding and intervention with PG and it provides information for responsible gambling interventions.