Cognitive versus exposure therapy for problem gambling: Randomised controlled trial.
BACKGROUND
Problem gambling-specific cognitive therapy (CT) and behavioural (exposure-based) therapy (ET) are two core cognitive-behavioural techniques to treating the disorder, but no studies have directly compared them using a randomised trial.


OBJECTIVE
To evaluate differential efficacy of CT and ET for adult problem gamblers at a South Australian gambling therapy service.


METHODS
Two-group randomised, parallel design. Primary outcome was rated by participants using the Victorian Gambling Screen (VGS) at baseline, treatment-end, 1, 3, and 6 month follow-up.


RESULTS
Of eighty-seven participants who were randomised and started intervention (CT = 44; ET = 43), 51 (59%) completed intervention (CT = 30; ET = 21). Both groups experienced comparable reductions (improvement) in VGS scores at 12 weeks (mean difference -0.18, 95% CI: -4.48-4.11) and 6 month follow-up (mean difference 1.47, 95% CI: -4.46-7.39).


CONCLUSIONS
Cognitive and exposure therapies are both viable and effective treatments for problem gambling. Large-scale trials are needed to compare them individually and combined to enhance retention rates and reduce drop-out.
Flinders University, Department of Psychiatry, Flinders Human Behaviour and Health Research Unit, GPO Box 2100, Adelaide SA 2001, Australia. Electronic address: david.smith@flinders.edu.au.
David P
DP
Smith
Flinders University, Department of Psychiatry, Flinders Human Behaviour and Health Research Unit, GPO Box 2100, Adelaide SA 2001, Australia. Electronic address: malcolm.battersby@flinders.edu.au.
Malcolm W
MW
Battersby
Flinders University, Department of Psychiatry, Flinders Human Behaviour and Health Research Unit, GPO Box 2100, Adelaide SA 2001, Australia. Electronic address: peter.harvey@flinders.edu.au.
Peter W
PW
Harvey
Flinders University, Department of Psychiatry, Flinders Human Behaviour and Health Research Unit, GPO Box 2100, Adelaide SA 2001, Australia. Electronic address: rene.pols@flinders.edu.au.
Rene G
RG
Pols
Université Laval, School of Psychology, 2325, rue des Bibliothèques, Bureau 1328, Québec, Québec G1V 0A6, Canada. Electronic address: robert.ladouceur@psy.ulaval.ca.
Robert
R
Ladouceur
D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005715:Gambling / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
Cognitive therapy; Exposure therapy; Problem gambling; Randomised controlled trial