Current Research Activities of the Gambling Treatment Clinic (GTC)

Problem Gambling Treatments

Cognitive Therapy Effectiveness Study

A major GTC project nearing completion is the measurement of the effectiveness of cognitive therapy in the treatment of problem gambling. Cognitive therapy is based on the idea that individuals gamble excessively because they erroneously believe that they will be able to either win or recoup their losses. Cognitive therapy, through education, argument and demonstration, aims to instill in the individual a more realistic set of beliefs and by doing so, decrease their motivation to gamble. With the aid of trained and experiences clinical staff, we were able to collect data that compared clients and their functioning on a number of domains both before they started cognitive therapy for their problem gambling and 6 months, 1 year and 2 years after they finished treatment at the GTC. The results have been encouraging and will be both published and presented at a national gambling conference towards the end of the year.

Controlled Trial of Gambling Therapies

A large-scale undertaking by the GTC at the University of Sydney has been the commencement in July 2006 of a 2 year controlled trial of different gambling therapies. The trial is unique in that it is designed to allow the direct comparison of the efficacy of four different leading therapies in the treatment of problem gambling, Each therapy has a theoretical orientation and approach that differentiates from the others, and all have received wide support and use in the Australian context. Individuals who seek help for problem gambling from the GTC at any one of its campus and outreach locations receive one of four problem gambling therapies. We measure treatment outcomes by looking at both the immediate and longer-term changes within the individual in the amount of time and money they invest in gambling, as well as their experience of gambling related problems. We envisage that the results of this trial will be able to inform and improve clinical practice by outlining the most efficacious treatment method for problem gambling.

Treatment Effectiveness Study

Treatment approaches to problem gambling follow from beliefs about the causes of excessive gambling. The Eighth Survey of Problem Gamblers receiving treatment in NSW (Walker, Shannon, Blaszczynski & Sharpe, 2005) demonstrated that any approach used by a counsellor reflects one of several principles. The first principle assumes that the gambling is a means of the individual escaping from problems other than gambling (gambling as an escape); the second assumes that the individual experiences intense urges to gamble which are difficult to control (gambling as an addiction), and the third principle assumes that the individual mistakenly believes that he or she will win money (gambling as caused by erroneous cognition). The aim of the study was to assess the effectiveness of face-to-face counselling and/or treatment according to the treatment approach used by the counselor. The study commenced in 2006 and used a sample of individual problem gamblers who sought help from RGF funded services in three Sydney regions (Coastal, Western and South West). The study involves classifying the treatment approach of participating agencies, and collecting both baseline and follow up measures on individuals who receive treatment at each agency. The study is projected to conclude at the end of 2007 and will form the basis for a report to the Rehabilitation Gambling Fund.

Problem gambling measures

Structured Clinical Interview for Pathological Gambling (SCIP)

The Structured Clinical Interview for Pathological Gambling (SCIP) is another instrument developed at the GTC, and is designed to provide a gold standard psychiatric interview in the diagnosis of pathological gambling. While based around DSM-IV criteria, it is features a set question order, structure and decision criteria that would allow maximum reliability among clinicians in the diagnosis of pathological gambling in an individual. The SCIP is currently being used at the GTC in the initial assessment of clients presenting with a gambling problem and will also undergo reliability testing in a more general sample of regular gamblers. Current research being conducted at the GTC is also examining how the results of SCIP assessments may differ from those that utilise other DSM-IV based instruments.

Gambling Effects Scale

 In 2004 a group of leading researchers and practitioners working in the field of problem gambling came together in Banff, Canada to discuss best practice regarding the treatment and assessment of problem gambling. One of the recommendations of the Banff consensus was the need to refocus on measuring the problems caused by gambling especially in light of the fact that currently, there is no published scale which provides a direct and valid measure of the severity of problems caused by excessive gambling. Developed by GTC staff at the University of Sydney, the Gambling Effects Scale (GES) is the first such measure of its kind in the world. The GES is a multi-dimensional scale that is designed to be a pure measure of the problems caused by excessive gambling and betting behaviour. It looks at both the existence and severity of gambling related harm in the personal, interpersonal, financial, legal and work/study domain and by doing so it measures not only the problems in the gamblers life but also the amount to which these problems can be attributed to excessive gambling. The GES is currently undergoing reliability and validity testing at the GTC with the aim that it is published and made available for use in both clinical and prevalence studies.

Past Research

The gambling treatment clinic has contributed to the following research:

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