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Cited by 78Gambling Behavior and TreatmentsSubstance Abuse Treatment and OutcomesObsessive-Compulsive Spectrum Disorders

Is control a viable goal in the treatment of pathological gambling?

Ladouceur, Robert, Lachance, Stella, Fournier, Patricia-Maude·2009·Behaviour Research and Therapy
DOI 10.1016/j.brat.2008.11.004
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Abstract

According to a report of National Gambling Impact Study Commission (National Gambling Impact Study Commission (1999). Final report. Washington, DC: Government Printing Office.), 97% of problem gamblers in the United States do not seek treatment. Within the small proportion of problem gamblers who enter into treatment, a high percentage drops out. Despite the fact that some researchers argue against abstinence as the only acceptable treatment goal and that regaining control over gambling behaviour appears to be possible for some pathological gamblers (PG), abstinence has been the only gambling intervention treatment goal. The primary goal of this study was to verify whether controlled gambling is a viable goal for pathological gamblers. The second goal was to identify the characteristics that predicted a successful outcome for treatment with a controlled gambling goal. Eighty-nine PGs were enrolled in cognitive-behavioural treatment aimed at controlled gambling. Six and twelve month follow-ups were conducted in order to evaluate the maintenance of therapeutic gains and to identify significant predictors of successful controlled gambling. Results showed that using the intent-to-treat procedure, 63% had a score of 4 or less on the DSM-IV at the end of treatment. That proportion was 56% and 51% at the 6- and 12-month follow-ups. If we retain only those who completed the treatment, these proportions increased to 92%, 80% and 71% at post-treatment, 6- and 12-month follow-ups, respectively. On the majority of the measures, significant improvements were found at post-treatment and the therapeutic gains were maintained at the 6- and 12-month follow-ups. However, few variables were identified to predict who would benefit from control rather than abstinence. The clinical and philosophical implications of these results are discussed in this paper.

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  • Mixed results were identified for treatment goal in two different studies, whereby abstinence and controlled gambling were associated with positive treatment outcomes.

    “Lastly, mixed results were identified for treatment goal in two different studies, whereby abstinence (Toneatto & Dragonetti, 2008) and controlled gambling (Ladouceur, Lachance, & Fournier, 2009) were associated with positive treatment outcomes.”

    From Predictors of outcomes of psychological treatments for disordered gambling: A systematic review (2016) · cites this paper as Ladouceur et al., 2009

  • Ladouceur et al. (2009) suggested that controlled gambling was associated with more successful post-treatment outcomes.

    “one study (Ladouceur et al., 2009) suggesting that controlled gambling was associated with more successful posttreatment outcomes”

    From Predictors of outcomes of psychological treatments for disordered gambling: A systematic review (2016) · cites this paper as Ladouceur et al., 2009

  • In the systematic review, treatment goal (abstinence) was examined as a predictor of medium-term outcomes in three studies, and the table reports 33% of significant results.

    “| Treatment goal | Abbott et al. (2013) | x | x | x | 3 | 33% |”

    From Predictors of outcomes of psychological treatments for disordered gambling: A systematic review (2016) · cites this paper as Ladouceur et al. (2009)

  • The flexibility offered by online interventions may favor treatment adherence and even lead to a change of therapeutic objective toward abstinence, as observed in a large portion of the sample of gamblers receiving face-to-face treatment.

    “The flexibility offered by online interventions may favor treatment adherence and even lead to a change of therapeutic objective toward abstinence, as observed in a large portion of the sample of gamblers receiving face-to-face treatment in the study conducted by Ladouceur et al. (2009).”

    From Online and Mobile Interventions for Problem Gambling, Alcohol, and Drugs: A Systematic Review (2017) · cites this paper as Ladouceur et al. (2009)

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Authors
Ladouceur, R., Lachance, S., & Fournier, P.-M.
Affiliations
Université Laval (CA)
Corresponding author
Ladouceur, Robert
ORCID
Ladouceur, Robert
Venue
Behaviour Research and Therapy
Publisher
Elsevier BV
Published
2009-03
Volume
47
Issue
3
Pages
189-197
ISSN
0005-7967 (ISSN-L)
DOI
10.1016/j.brat.2008.11.004
OpenAlex
W2057988082
Cited by
78
References
52
Citations by year
2026: 2 · 2025: 1 · 2024: 2 · 2023: 3 · 2021: 2 · 2020: 4 · 2019: 6 · 2018: 4 · 2017: 11 · 2016: 4 · 2015: 6 · 2014: 11 · 2013: 9 · 2012: 7
FWCI
2.22
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Behaviour Research and Therapy (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
Keywords
gambling addiction, abstinence, treatment goals, cognitive-behavioral intervention, treatment outcome predictors, treatment discontinuation, problem gamblers
MeSH terms
Adult, Aged, Feasibility Studies, Female, Follow-Up Studies, Gambling, Humans, Disruptive, Impulse Control, and Conduct Disorders, Internal-External Control, Male, Middle Aged, Psychiatric Status Rating Scales, Cognitive Behavioral Therapy, Treatment Outcome

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