Online Coping Skills Counseling for Problem Gambling and Trauma

University of Windsor

Status: Completed

Conditions: Posttraumatic Stress Disorder; Gambling Disorder; Trauma, Psychological; Problem Gambling

Treatments: Behavioral: Seeking Safety; Behavioral: CBT for Pathological Gambling

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT03145792

LG-15-13

Details and patient eligibility

About

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.

Full 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.

Enrollment: 65 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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65 participants in 2 patient groups

Seeking Safety

Experimental group

Description:

Behavioral therapy for trauma and addiction.

Treatment:

Behavioral: Seeking Safety

CBT for Pathological Gambling

Active Comparator group

Description:

Behavioral therapy for gambling problems.

Treatment:

Behavioral: CBT for Pathological Gambling