Treatment approaches for pathological gamblers.

Outcome literature on the treatment of pathological gambling is reviewed, encompassing psychodynamic, behavioral, cognitive, cognitive-behavioral, multimodal, pharmacotherapeutic, and 12-step approaches. No properly controlled research has been conducted with psychodynamic or 12-step methods, and pharmacotherapies require replications with larger samples to determine their efficacy. Multimodal approaches have been tested most often in inpatient settings, and given the range of methods combined it is difficult to infer specific efficacy for treatment components. The largest volume of outcome research has focused on behavioral, cognitive, and combined cognitive-behavioral treatment methods, and findings from controlled and uncontrolled trials provide support for efficacy of these approaches. As a whole, the literature indicates that pathological gambling can be treated with highly successful outcomes. Needs for further research are considered.