Gambling Disorder, Trauma, Psychological, Problem Gambling, Posttraumatic Stress Disorder
Conditions
Brief summary
This randomized controlled trial examines the efficacy of two behavioral therapies. Seeking Safety, which addresses co-occurring problem gambling (PG) and posttraumatic stress disorder (PTSD), is being compared to Cognitive-Behavioral Therapy for PG, which addresses only PG. Both models are delivered via telehealth.
Detailed description
Our key study question is whether an integrated focus on PG and PTSD (Seeking Safety; SS) offers a useful new option for clinical care compared to a purely problem gambling approach (Cognitive-Behavioral Therapy for PG; CBT-PG). This question-the impact of integrated versus non-integrated treatment for co-occurring disorders-is one of the key issues in the field currently and has never been studied in relation to PG and PTSD. Our aims are: 1. To conduct an RCT of SS versus CBT-PG in a sample of 84 people with current PG and PTSD (full or subthreshold). 2. To evaluate outcomes from baseline to end of treatment and 12 month followup on two primary variables (money lost gambling and number of gambling sessions) and several secondary variables. Our hypotheses are: (a) SS will do no worse than CBT-PG on the primary PG outcomes as both treatments are designed to address addiction; i.e., both will show improvement from baseline to end of treatment and maintenance of gains through the followup. (b) SS will show superior results on trauma symptoms as SS is designed to address those, whereas CBT-PG is not.
Interventions
BEHAVIORALSeeking Safety
Seeking Safety (SS) is a present-focused, evidence-based cognitive-behavioral therapy for trauma and/or addiction. It offers safe coping skills and education relevant to both problem areas.
BEHAVIORALCBT for Pathological Gambling
Cognitive Behavior Therapy for Pathological Gambling (CBT-PG) is an evidence-based therapy for gambling problems. It focuses on cognitive correction, problem solving, social skills and relapse prevention.
Sponsors
Manitoba Gambling Research Program
Treatment Innovations
University of Manitoba
University of Windsor
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age 18 and over * Recruited from the province of Manitoba, Canada * Meets criteria for PTSD (full or subthreshold) on the Clinician-Administered PTSD Scale (CAPS) * Meets gambling disorder criteria per the DSM-5 Diagnostic Interview of Gambling Severity
Exclusion criteria
* Current uncontrolled psychotic or bipolar I disorder * Suicidal or homicidal ideation with intent and/or plan * Currently engaging in or planning to engage in any manualized, formal, evidence-based PTSD therapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Money spent gambling | 6-weeks (mid-treatment), 12-weeks (end-of-treatment), and 12-months | Change from baseline in amount of money spent gambling in the past month |
| Number of gambling sessions | 6-weeks (mid-treatment), 12-weeks (end-of-treatment), and 12-months | Change from baseline in number of days in the past month during which gambling occurred |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PTSD Checklist (PCL) scores | 6-weeks (mid-treatment), 12-weeks (end-of-treatment), and 12-months | Posttraumatic stress disorder (PTSD) symptoms |
| Trauma Symptom Checklist 40 | 6-weeks (mid-treatment), 12-weeks (end-of-treatment), and 12-months | Change in baseline in broad trauma-related symptoms |
| Brief Symptom Inventory-18 scores | 6-weeks (mid-treatment), 12-weeks (end-of-treatment), and 12-months | Change from baseline in general psychiatric symptoms |
| Brief Addiction Monitor scores | 6-weeks (mid-treatment), 12-weeks (end-of-treatment), and 12-months | Change from baseline in substance use and associated problems |
Countries
United States
Outcome results
None listed