Winter 1996/1997

In our previous article we discussed what therapeutic methods are used in the treatment of pathological gambling. We will now turn our attention to the question of whether treatment is effective. As you know from previous articles, the State of Minnesota supports six outpatient treatment programs for pathological gambling. These six programs have been evaluated for the past 3 and one-half years. The primary purpose of this evaluation was to monitor the outcomes of clients who participated in treatment and determine if clients reduce or abstain from gambling involvement following treatment.

During the study period from April 1992 to January 1996, 1,446 clients were asked to participate in the study and 1,342 consented. Of these, 944 were admitted to treatment and 398 were not. Those not admitted to treatment either did not return to the program after an initial screening or they came specifically for an assessment only. Of the 944 admitted to treatment, 658 completed treatment and 286 participated in some level of treatment but did not complete the program. Paper and pencil tests measuring gambling behaviors and problems associated with gambling were administered to clients at intake, at discharge, and at 6 and 12 months following discharge. Six and twelve­ month follow-up data were obtained from 75% and 62% of the eligible sample, respectively.

There was a statistically significant decline in both gambling frequency and gambling problem severity from pretreatment to posttreatment. Figure 1 shows average gambling frequency for treatment completers, treatment noncompleters, and a no-treatment sample from pretreatment, to 6 and 12 month follow-up. Those who complete treatment show the best outcome; however, even the treatment noncompleters showed improvement, and the no-treatment group showed no change over time. 72% of those admitted improved, that is, they were daily or weekly gamblers before treatment and were gambling only once a month or less during the 6 months after treatment. Improvements also occurred in terms of better psychosocial functioning, less gambling debt, fewer friends who are gamblers, and fewer financial problems reported at follow-up.

In summary, most clients were gambling less or not at all after treatment and showed improvements in other areas of their lives, as well. However, some clients did not improve. These results are similar to those obtained from studies of the effectiveness of treatment for alcohol and drug abuse. This is not surprising, since gambling is a similar type of addiction and is treated with similar methods. Therefore, the answer to the question of whether treatment is effective is, "Yes, treatment is effective for most clients who participate". Those clients who complete treatment and continue to participate in posttreatment recovery services following primary treatment show the greatest improvements.

You may request a free copy of the full report from:
Patti Luther, Minnesota Department of Human Services, 444 Lafayette Rd. N., St. Paul, MN 55155-3828.
Phone: 1-612-297-4104 or
Fax: 1-612-296-7731.

For more information about this study and other gambling studies, point your Web browser to the following web site:
www.cbc.med.umn.edu/~randy/gambling

—Randy Stinchfield, PhD and
Ken Winters, PhD
University of Minnesota Medical School