Cognitive-behavioral treatment for gambling harm: Umbrella review and meta-analysis

Rory A Pfund; Meredith K Ginley; Hyoun S Kim; Cassandra L Boness; Tori L Horn; James P Whelan

doi:10.1016/j.cpr.2023.102336

Cognitive-behavioral treatment for gambling harm: Umbrella review and meta-analysis

Clin Psychol Rev. 2023 Nov:105:102336. doi: 10.1016/j.cpr.2023.102336. Epub 2023 Sep 9.

Authors

Rory A Pfund¹, Meredith K Ginley², Hyoun S Kim³, Cassandra L Boness⁴, Tori L Horn⁵, James P Whelan⁵

Affiliations

¹ Tennessee Institute for Gambling Education & Research, USA; Department of Psychology, University of Memphis, USA. Electronic address: rapfund@memphis.edu.
² Tennessee Institute for Gambling Education & Research, USA; Department of Psychology, East Tennessee State University, USA.
³ Department of Psychology, Toronto Metropolitan University, Canada.
⁴ Center on Alcohol, Substance use, And Addictions, University of New Mexico, USA.
⁵ Tennessee Institute for Gambling Education & Research, USA; Department of Psychology, University of Memphis, USA.

PMID: 37717456
DOI: 10.1016/j.cpr.2023.102336

Abstract

The aim of the current umbrella review and meta-analysis was to evaluate the methodological rigor of existing meta-analyses on cognitive-behavioral treatment (CBT) for gambling harm. The Cochrane Database of Systematic Reviews, PsycINFO, and PubMed were searched for meta-analyses of CBT for gambling harm among individuals aged 18 years and older. The search yielded five meta-analyses that met inclusion criteria, representing 56 unique studies and 5389 participants. The methodological rigor for one meta-analyses was rated high, two were moderate, and two were critically low. Including only moderate- to high-quality meta-analyses, a robust variance estimation meta-analysis indicated that CBT significantly reduced gambling disorder severity (g = -0.91), gambling frequency (g = -0.52), and gambling intensity (g = -0.32) relative to minimal and no treatment control at posttreatment, suggesting 65%-82% of participants receiving CBT will show greater reductions in these outcomes than minimal or no treatment controls. Overall, there is strong evidence for CBT in reducing gambling harm and gambling behavior, and this evidence provides individuals, clinicians, managed care companies, and policymakers with clear recommendations about treatment selection.

Keywords: CBT; Evidence-based practice; Gambling disorder; Problem gambling.

Publication types

Review