Effect of cognitive-behavioral techniques for problem gambling and gambling disorder: A systematic review and meta-analysis

Aims

To measure the effect of cognitive-behavioral techniques (CBTs) on gambling disorder severity and gambling behavior at post-treatment and follow-up.

Method

Seven databases and two clinical trial registries were searched to identify peer-reviewed studies and unpublished studies of randomized controlled trials. The Cochrane Risk of Bias tool assessed risk of bias in the included studies. A random effect meta-analysis with robust variance estimation was conducted to measure the effect of CBTs relative to minimally treated or no treatment control groups.

Results

Twenty-nine studies representing 3991 participants were identified. CBTs significantly reduced gambling disorder severity (g = −1.14, 95% CI = −1.68, −0.60, 95% prediction interval [PI] = −2.97, 0.69), gambling frequency (g = −0.54, 95% CI = −0.80, −0.27, 95% PI = −1.48, 0.40) and gambling intensity (g = −0.32, 95% CI = −0.51, −0.13, 95% PI = −0.76, 0.12) at post-treatment relative to control. CBTs had no significant effect on follow-up outcomes. Analyses supported the presence of publication bias and high heterogeneity in effect size estimates.

Conclusions

Cognitive-behavioral techniques are a promising treatment for reducing gambling disorder and gambling behavior; however, the effect of cognitive-behavioral techniques on gambling disorder severity and gambling frequency and intensity at post-treatment is overestimated, and cognitive-behavioral techniques may not be reliably efficacious for all individuals seeking treatment for problem gambling and gambling disorder.