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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
65
Seeking Safety (SS) is a present-focused, evidence-based cognitive-behavioral therapy for trauma and/or addiction. It offers safe coping skills and education relevant to both problem areas.
Cognitive Behavior Therapy for Pathological Gambling (CBT-PG) is an evidence-based therapy for gambling problems. It focuses on cognitive correction, problem solving, social skills and relapse prevention.
Treatment Innovations
Newton Center, Massachusetts, United States
Money spent gambling
Change from baseline in amount of money spent gambling in the past month
Time frame: 6-weeks (mid-treatment), 12-weeks (end-of-treatment), and 12-months
Number of gambling sessions
Change from baseline in number of days in the past month during which gambling occurred
Time frame: 6-weeks (mid-treatment), 12-weeks (end-of-treatment), and 12-months
PTSD Checklist (PCL) scores
Posttraumatic stress disorder (PTSD) symptoms
Time frame: 6-weeks (mid-treatment), 12-weeks (end-of-treatment), and 12-months
Trauma Symptom Checklist 40
Change in baseline in broad trauma-related symptoms
Time frame: 6-weeks (mid-treatment), 12-weeks (end-of-treatment), and 12-months
Brief Symptom Inventory-18 scores
Change from baseline in general psychiatric symptoms
Time frame: 6-weeks (mid-treatment), 12-weeks (end-of-treatment), and 12-months
Brief Addiction Monitor scores
Change from baseline in substance use and associated problems
Time frame: 6-weeks (mid-treatment), 12-weeks (end-of-treatment), and 12-months
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