Support for families to motivate treatment-refusing heavy gamblers to reduce their gambling and seek help: A pilot study

Participants received a brief structured intervention of up to six individual 60-minute sessions informed by Barber et al.’s (1995) intervention for heavy drinkers and adapted for use with gamblers. FRCM-Gam is based on learning theory principles and teaches CSOs to respond to the problem behaviour in a way that both empowers the CSOs and provides incentives for the gambler to change by decreasing the advantages of engaging in the problem behaviour and increasing the advantages of behaving differently. The intervention involves five graded steps of responses designed to gradually increase motivation for the gambler to change. Step one involves preparing the CSO by providing information about gambling addiction and CBT, the FRCM-Gam approach and collecting information about the gambler’s gambling behaviour. Step two involves identifying the benefits the gambler gains from gambling and identifying incompatible and desired behaviours (contingency management) and the principles of operant conditioning and shaping taught. At step three CSOs are taught to use the principles of operant conditioning and shaping to respond to the gambler when they display signs of gambling, non-gambling, or desirable behaviours. At step four CSOs make an agreement with the gambler about when they will engage in incompatible or desirable behaviours. Step five looks for ways to involve others in the behavioural plan if previous steps have not been successful. The experimental intervention will be delivered by up to six individual 60-minute sessions over six to eight weeks via in-person or telehealth videocall. The intervention will be delivered by a mental health clinician with a master's degree in CBT (psychologist, social worker, or psychiatric nurse),