IMPORTANT LEGACY NOTICE: Legacy Programs have not been reviewed by the current National Registry of Evidence-based Programs and Practices (NREPP). The programs in this database were reviewed only under the previous National Registry of Effective Prevention Programs system. This section is intended to be used for historical reference only. If you would like more information about a program listed here, please contact the program developer directly. The program developer of each Legacy Program listed here agreed to post program information on this site.

Minimal Intervention Approach to Problem Gambling

Brief Program Description

The prevalence of problems related to gambling has increased over the years, with social and economic costs, although unknown, assumed to be enormous. Gambling disorders are broadly defined as persistent and recurrent maladaptive gambling that disrupts personal, family, or vocational pursuits. One challenge for treatment providers is attracting problem gamblers, particularly women, to formal treatment programs. To such individuals, self-help workbooks may be an attractive, accessible, and cost-effective alternative to attending treatment programs or self-help groups.

In a recent study, the effectiveness of self-help workbooks for problem drinkers was enhanced by motivational telephone contact with a therapist in advance receipt of the self-help workbook.

Motivational Enhancement Therapy, developed by Miller and Rollnik (1991), is based on the idea that the main ingredients of brief interventions are motivational. They hypothesized that six basic principles are critical:

1. Feedback to the individuals about their personal risk
2. Provision of clear advice to change
3. Provision of a range of options in behavior change
4. Therapist empathy
5. Emphasis on the individual's responsibility for changing
6. Instillation of hope and self-efficacy

Motivational enhancement therapy is a directive, client-centered counseling style that helps individuals explore and resolve ambivalence about change.

Program Strategies

The first component, the self-help workbook, is based on a cognitive-behavioral model of problem gambling, relapse prevention techniques, and results of studies on the recovery process of problem gamblers. The workbook describes five cognitive-behavioral strategies: (1) cognitive restructuring, dealing with urges using (2) cognitive or (3) behavioral coping, (4) stimulus control (staying away from cues to gambling and limiting access to money), and (5) eliciting social support (telling others of the plan). The workbook also includes sections on selfassessment, goal setting, maintenance, and a listing of additional resources.

During the motivational enhancement interview, basic assessment information is obtained. In addition, the interviewer attempts to build a commitment to change by using the principles of motivational enhancement therapy.

Population Focus

Participants were individuals, ages 18 and over, who were concerned about their gambling and wanted to stop on their own.

Suitable Settings

This intervention is suitable for implementation in a home setting. Participants are contacted and interviewed at home by telephone.

Required Resources

The self-help workbook, Becoming a Winner: Defeating Problem Gambling is required.

Implementation Timeline

The motivational interview takes between 20 and 45 minutes to conduct. There are followup assessments conducted at 1-, 3-, and 12-months.

Outcomes

Evaluation of this program revealed the following:

• The group receiving the motivational interview showed greater improvement than the waiting-list control. The motivational interview group gambled fewer days, lost less money, and spent less per day gambling. The group receiving the workbook only did not differ significantly from the waiting-list control.
• In terms of clinical significance, 74% of the motivational enhancement group improved their gambling or quit gambling in the 1-month follow-up period compared with 61% and 44% of the workbook only and waiting list control groups, respectively.
• Eighty-four percent of participants reported a significant reduction in gambling over a 12-month follow-up period.

Contact Information

For indepth information on this program, please use the contact listed below.

Program Developer

In 2002, this program was designated as a Promising Program under SAMHSA's previous National Registry of Effective Prevention Programs system.