Faculté des sciences sociales, École de psychologie, Université Laval, 2325, rue des Bibliothèques, Félix-Antoine-Savard Building, Québec, QC, G1V 0A6, Canada.
CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Installation du CRDM-IU, Point de service Louvain, Centre de réadaptation en dépendance de Montréal-Institut universitaire, 950, de Louvain Est, Montréal, QC, H2M 2E8, Canada.
J Gambl Stud. 2018 Jun;34(2):561-580. doi: 10.1007/s10899-017-9717-z.
Available evidence suggests that self-help treatments may reduce problem gambling severity but inconsistencies of results across clinical trials leave the extent of their benefits unclear. Moreover, no self-help treatment has yet been validated within a French Canadian setting. The current study therefore assesses the efficacy of a French language self-help treatment including three motivational telephone interviews spread over an 11-week period and a cognitive-behavioral self-help workbook. At-risk and pathological gamblers were randomly assigned to the treatment group (n = 31) or the waiting list (n = 31). Relative to the waiting list, the treatment group showed a statistically significant reduction in the number of DSM-5 gambling disorder criteria met, gambling habits, and gambling consequences at Week 11. Perceived self-efficacy and life satisfaction also significantly improved after 11 weeks for the treatment group, but not for the waiting list group. At Week 11, 13% of participants had dropped out of the study. All significant changes reported for the treatment group were maintained throughout 1, 6 and 12-month follow-ups. Results support the efficacy of the self-help treatment to reduce problem gambling severity, gambling behaviour and to improve overall functioning among a sample of French Canadian problem gamblers over short, medium and long term. Findings from this study lend support to the appropriateness of self-help treatments for problem gamblers and help clarify inconsistencies found in the literature. The low dropout rate is discussed with respect to the advantages of the self-help format. Clinical and methodological implications of the results are put forth.
现有证据表明，自助治疗可能会降低赌博问题的严重程度，但临床试验结果的不一致性使得其益处尚不清楚。此外，在加拿大法语环境中，还没有一种自助治疗方法得到验证。因此，本研究评估了一种包括三次为期 11 周的动机性电话访谈和认知行为自助手册的法语自助治疗的疗效。有风险和病态赌博者被随机分配到治疗组（n=31）或等待名单组（n=31）。与等待名单组相比，治疗组在第 11 周时，符合 DSM-5 赌博障碍标准的人数、赌博习惯和赌博后果均有统计学显著减少。治疗组在 11 周后，自我效能感和生活满意度也显著提高，但等待名单组没有。第 11 周时，有 13%的参与者退出了研究。治疗组报告的所有显著变化在 1、6 和 12 个月的随访中都得到了维持。研究结果支持自助治疗在降低加拿大法语问题赌博者的赌博严重程度、赌博行为和改善整体功能方面的有效性，无论是短期、中期还是长期。本研究的结果为问题赌博者使用自助治疗提供了合理性，并有助于澄清文献中的不一致性。低辍学率与自助格式的优势有关。最后提出了对临床和方法学的启示。
