title: Experiences and Perceptions of Problem Gamblers on Cognitive and Exposure Therapies When Taking Part in a Randomised Controlled Trial: A Qualitative Study.
abstract: In South Australia (SA) problem gambling is mainly a result of the widespread availability of electronic gaming machines. A key treatment provider in SA offers free cognitive and behavioural therapy (CBT) to help-seeking problem gamblers. The CBT program focuses on the treatment of clients' urge to gamble using exposure therapy (ET) and cognitive therapy (CT) to restructure erroneous gambling beliefs. The aim of this study was to explore treatment specific and non-specific effects for CT alone and ET alone using qualitative interviews. Interviewees were a sub-sample of participants from a randomised trial that investigated the relative efficacy of CT versus ET. Findings revealed that all interviewees gained benefit from their respective therapies and their comments did not appear to favour one therapy over another. Both treatment specific and treatment non-specific effects were well supported as playing a therapeutic role to recovery. Participants' comments in both therapy groups suggested that symptom reduction was experienced on a gambling related urge-cognition continuum. In addition to symptom improvement from therapy-specific mechanisms, ET participants described a general acquisition of "rational thought" from their program of therapy and CT participants had "taken-over" their gambling urges. The findings also highlighted areas for further improvement including therapy drop-out.
authors.affiliation: Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, Flinders University, GPO Box 2100, Adelaide, SA, 2001, Australia. david.smith@flinders.edu.au.
authors.forename: David
authors.initials: D
authors.lastname: Smith
authors.affiliation: Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, Flinders University, GPO Box 2100, Adelaide, SA, 2001, Australia.
authors.forename: Rene
authors.initials: R
authors.lastname: Pols
authors.affiliation: Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, Flinders University, GPO Box 2100, Adelaide, SA, 2001, Australia.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Lavis
authors.affiliation: Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, Flinders University, GPO Box 2100, Adelaide, SA, 2001, Australia.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Battersby
authors.affiliation: Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, Flinders University, GPO Box 2100, Adelaide, SA, 2001, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Harvey
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005715:Gambling / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008297:Male; D062405:Motivational Interviewing / Q000379:methods*; D011613:Psychotherapy / Q000379:methods; D011615:Psychotherapy, Group / Q000379:methods; D036301:Qualitative Research; D012309:Risk-Taking; D020377:Self Efficacy; D013021:South Australia
keywords: Cognitive therapy; Exposure therapy; Qualitative study; Randomized controlled trial