Pathological Gambling Clinical Trial
Official title:
Evaluating the Benefits of the Community Reinforcement and Family Training(CRAFT) Approach to Concerned Significant Others(CSO) of Individuals Engaged in Problem Gambling (IPGs)
Nova Scotia is experiencing a proliferation of gambling opportunities and their related
gambling problems. The 2003 Nova Scotia Prevalence Study (2004) found that approximately
50,000 adult Nova Scotians are at some risk for problem gambling and that approximately
93,000 adult Nova Scotians are intimately connected to at least one person who has a gambling
problem. The serious consequences of problem gambling are being felt by the Individuals
engaging in Problem Gambling (IPGs), their Concerned Significant Others (CSOs) and their
Communities.
Very few IPGs access support services for their gambling problems. Some reports (National
Gambling Impact Study Commission 1999) have found that only 3% of IPGs seek treatment. The
Nova Scotia Gambling Prevalence Study (2004) states: "Overall, 3.5% (26,000 adults) have been
motivated to help someone else with a current gambling problem versus 0.5% (3,700 adults)
seeking assistance or information for a personal problem". While the CSOs of IPGs are seven
times more likely to access professional addiction treatment the options for these
individuals are limited and treatment programs often lack evidence in support of their
effectiveness.
The Community Reinforcement and Family Training (CRAFT) (Meyers & Wolfe 2004) approach
provides significant benefits to the CSOs of persons abusing alcohol and other drugs. They
benefits include: improvement in the quality of life of the CSOs; increasing the rate of
substance abusers entering treatment; and decreased substance use. CRAFT empowers CSOs by
providing tools to positively influence theirs and their significant other's behavior.
The current study investigates the applicability and effectiveness of the CRAFT approach to
the CSOs of IPGS.
It is predicted that benefits to the CSOs receiving CRAFT will significantly surpass those
receiving treatment as usual. The predicted benefits are: improvement in quality of life for
the CSO; engagement of IPGs in treatment; and decreased gambling by the IPGs. With these
achieved outcomes, this research will provide opportunity for earlier intervention, improved
individual and family functioning and a reduction of the negative impact of problem gambling
on the community.
It has been estimated that 50,000 adult Nova Scotians are at some risk for problem gambling
and approximately 93,000 adult Nova Scotians are intimately connected to at least one person
who has a gambling problem (Nova Scotia Prevalence Study 2004). The serious consequences of
problem gambling are being felt by Individuals engaged in Problem Gambling (IPGs), their
Concerned Significant Others (CSOs) and their Communities.
It is known that despite the negative consequence of problem gambling very few IPGs access
services for treating their gambling problems. The Nova Scotia Gambling Prevalence Study
(2004) has shown that CSOs are seven times more likely to access services than IPGs "Overall,
3.5% (26,000 adults) have been motivated to help someone else with a current gambling problem
versus 0.5% (3,700 adults) seeking assistance or information for a personal problem". Despite
such findings the treatment options for the CSOs of IPGs are limited (Crisp, B.R. et al.
2001; Shaw, M.C. et al. 2007).
The Community Reinforcement and Family Training (CRAFT) (Meyers & Wolfe 2004) model for CSOs
of substance abusers has demonstrated significant success with the following outcomes:
improvement in the quality of life of CSOs; engagement of the substance abuser in treatment;
and decreased substance use. CRAFT empowers CSOs by providing tools to positively influence
their own and their significant others behavior through a cognitive behavioral approach.
This current project investigates the applicability and effectiveness of the CRAFT model as a
tool for supporting the CSOs of problem gamblers. A comparative analysis will be completed
with random assignment of 60 CSOs to either of Group A (CRAFT) or Group B (treatment as
usual). Twelve individual treatment sessions will be offered to each of the CSOs. It is
predicted the outcomes of from Group A (CRAFT) will significantly surpass those from Group B
(treatment as usual). The predicted outcomes are: improvement in quality of life for the
CSOs; engagement of the IPGs in treatment; and decreased gambling by the IPGs. All therapists
in the CRAFT experimental group have been certified in the CRAFT model. A comparative
analysis will be conducted with the CRAFT approach (Group A) and the traditional treatment
approach (Group B). Model adherence will be supervised and tested.
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