McIntosh C C, Crino R D, O'Neill K
St Vincent's Hospital Gambling Treatment Program, Darlinghurst, NSW, Australia.
Charles Sturt University, Bathurst, NSW, Australia.
J Gambl Stud. 2016 Dec;32(4):1305-1325. doi: 10.1007/s10899-016-9602-1.
The problem gambling (PG) intervention literature is characterised by a variety of psychological treatments and approaches, with varying levels of evidence (PGRTC in Guideline for screening, assessment and treatment in problem and pathological gambling. Monash University, Melbourne, 2011). A recent PG systematic review (Maynard et al. in Res Soc Work Pract, 2015. doi: 10.1177/1049731515606977 ) and the success of mindfulness-based interventions to effectively treat disorders commonly comorbid with PG suggested mindfulness-based interventions may be effective for treating PG. The current study tested the effectiveness of three interventions to treat PGs: 1. case formulation driven Cognitive Behaviour Therapy (CBT); 2. manualised CBT; and 3. mindfulness-based treatment. All three interventions tested returned large effect size improvements in PG behaviour after seven sessions (Cohen's d range 1.46-2.01), at post-treatment and at 3 and 6-month follow-up. All of the interventions were rated as acceptable by participants at post-treatment. This study suggests that the mindfulness-based and TAU interventions used in the current study appear to be effective at reducing PG behavior and associated distress and they also appear to generalise to improvements in other measures such as quality of life-mental functioning and certain mindfulness facets more effectively than the manualised form of CBT utilised used here. Secondly, a brief mindfulness intervention delivered after psycho-education and a brief CBT intervention may be a useful supplement to traditional CBT treatments by addressing transdiagnostic processes such as rumination and thought suppression. Thirdly, CBT interventions continue to report effectiveness in reducing PG behaviour and associated distress consistent with the prevailing literature and clinical direction.
问题赌博（PG）干预文献的特点是有多种心理治疗方法和途径，其证据水平各不相同（见《问题与病态赌博的筛查、评估和治疗指南》中的PGRTC。莫纳什大学，墨尔本，2011年）。最近一项关于PG的系统评价（梅纳德等人，《社会工作实践研究》，2015年。doi:10.1177/1049731515606977）以及基于正念的干预措施成功有效治疗通常与PG共病的疾病表明，基于正念的干预措施可能对治疗PG有效。本研究测试了三种治疗PG的干预措施的有效性：1. 基于个案制定的认知行为疗法（CBT）；2. 手册化CBT；3. 基于正念的治疗。在七次治疗后、治疗后以及3个月和6个月随访时，所有测试的三种干预措施都使PG行为有了较大的效应量改善（科恩d值范围为1.46 - 2.01）。所有干预措施在治疗后都被参与者评为可接受。本研究表明，本研究中使用的基于正念的干预措施和常规治疗似乎在减少PG行为及相关痛苦方面有效，而且它们似乎比这里使用的手册化CBT形式更有效地推广到其他指标的改善，如生活质量 - 心理功能和某些正念方面。其次，在心理教育后进行的简短正念干预和简短CBT干预可能是传统CBT治疗的有用补充，因为它可以解决诸如反刍和思维抑制等跨诊断过程。第三，CBT干预措施在减少PG行为及相关痛苦方面继续显示出有效性，这与现有文献和临床方向一致。
