Brief Self-directed Gambling Treatment (BSGT)
Brief Self-directed Gambling Treatment (BSGT) was developed in recognition of the fact that only a small proportion of individuals who are suffering problems with gambling seek formal face-to-face treatment. At most, 10% of pathological gamblers attend treatment in jurisdictions where fully developed and accessible face-to-face treatments are avaliable. At the same time, there is evidence that some of these individuals recover naturally and prefer this route to recovery. BSGT is designed to enhance the likelihood and success of this "self-directed" recovery. The treatment invovles very brief telephone contact in the form of a motivational interview (20-40 minutes) after which clients are sent a copy of the 40 page self-help workbook by mail. Clients are recruited through media announcements or through contact with a gambling helpline service.
BSGT is now included in SAMHSA's National Registry of Evidence-based Programs and Practices (NREPP)
Specific Behavioral Outcomes:
Three randomized trials provide evidence of the efficacy of BSGT. Two of these trials tested the telephone-mailed self-help workbook treatment specifically and the other trial assessed a face-to-face version. In each of these trials, specific behavioral outcomes included gambling frequency and expenditures as primary outcomes and gambling problem severity as a secondary outcome.
Trial 1 (Hodgins, Currie, & el-Guebaly, 2001) randomly assigned 102 individuals with gambling problems to one of three conditions: BSGT, workbook only, and waiting list control. The initial report followed individuals for 12 months, with interviews at three, six, and 12 months (85% follow-up rate). Participants in the BSGT were more likely to have significantly reduced days of gambling and expendtures at 3, 6, and 12 months. Similar results were also found in a further 24 month follow-up (78% follow-up rate; Hodgins, Currie, el-Guebaly, & Peden, 2004).
Trial 2 (Hodgins, Currie, Currie, & Fick, 2009) provided a replication and extension of the above design with a larger sample size (N = 314). Individuals with gambling problems were randomly assigned to one of four conditions: BSGT, workbook only, wait list control and BSGT control with extended telephone contact in the form of 5 monthly booster calls. Results of a 12 month follow-up (85% follow-up rate) showed an advantage of the two BSGT conditions over the workbook only and wait list control groups. There was no added advantage of the booster calls over BSGT with a single telephone contact.
The BSGT telephone intervention uses a motivational interviewing model that encourages clients to identify and resolve their ambivalent feelings about changing their gambling involvment and to voice a commitment to change. A detailed analyses of audio tapes from these telephone contacts provided support for the therapeutic effectiveness of this model. Strength of commitment, identified by blinded raters of the sessions, correlated with gambling outcomes in the follow-up year (Hodgins, Ching, & McEwan, 2009).
Trial 3 (Diskin, & Hodgins, 2009) assessed a face-to-face session of the BSGT. Participants (N = 81) were randomly assigned to receive a face-to-face motivational interview about their gambling concerns or a structured clinical interview. Particpants in both groups received the self-help workbook. Results showed an advantage for the motivational interview on frequency of gambling and expenditures.
Materials and training support for BSGT are avilable, including:
BSGT is now live on the NREPP website.
Becoming a Winner self-help workbook - This workbook is 40 pages and includes a variety of personlized exercises to help with motivation and to help with developing behavioral strategies for reducing or quitting gambling. The workbook is easily modified to make it jurisdiction and agency specific (e.g., logos, local content about resources).
BSGT Therapist intervention manual - This document provides an annotated structure for conducting the motivational interviewing model.
BSGT Therapist training powerpoint presentation and video - This presentation is designed to be used in training therapists.
BSGT Participant follow-up interview schedule - Follow-up interviews have used a variety of standardized assessment tools, including the Timeline Followback interview and Gambling Abstinence Self-efficacy Scale.
The following artices are provided:
Hodgins, D.C., Currie, S., & el-Guebaly, N. (2001). Motivational enchancement and self-help treatments for problem gambing. Journal of Consulting and Clinical Psychology, 69, 50-57.
Hodgins, D.C., Currie, S.R., el-Guebaly, N., & Peden, N. (2004). Brief motivational treatment for problem gambling: 24 month follow-up. Psychology of Addictive Behaviors, 18, 293-296.
Hodgins, D.C., Currie, S.R., Currie, G., & Fick, G.H. (2009). A randomized trail of brief motivational treatments for pathological gamblers: More is not necessarily better. Journal of Consulting and Clinical Psychology, 77(5), 950-960.
Diskin, K.M., & Hodgins, D.C. (2009). A randomized controlled trial of a single session motivational intervention for concerned gamblers. Behaviour Research and Therapy, 47(5), 382-388.
Hodgins, D.C., Ching, L.E., & MacEwan, J. (2009). Strength of commitment language in motivational interviewing and gambling outcomes. Psychology of Addictive Behaviors, 23(1), 122-130.