Current Trends and Future Directions in the Study of Psychosocial Treatments for Pathological Gambling

Pathological gambling is a psychiatric disorder that has considerable public-health implications. Promising treatments for pathological gambling have been identified. However, most treatment research is limited by methodological problems that preclude drawing conclusions about treatment efficacy. We explore the empirical evidence for some currently practiced treatments for pathological gambling. We also discuss some of the challenges and future directions for research on how to treat the disorder. KEYWORDS—pathological gambling; treatment; psychotherapy Pathological gambling is an impulse-control disorder that results in disruptions of personal, family, and vocational activities (American Psychiatric Association, 2000). Pathological gamblers often have mental-health, legal, and financial problems as well. In North America, increasing opportunities to gamble in recent decades may have resulted in increases in the prevalence of pathological gambling. Estimates suggest that up to 5 million (1.6%) Americans have met diagnostic criteria for this disorder at some point in their lifetimes (Shaffer, Hall, & Vander Bilt, 1999). Although pathological gambling is fairly prevalent, less is known about its treatment than about the treatment of other problems with similar prevalence rates, such as cocaine addiction or schizophrenia. Several challenges face researchers studying the treatment of pathological gambling. Because the disorder has only recently emerged as a public-health concern, the field must catch up to the research advances in other areas. Research on gambling treatment has been limited by methodological problems, and controlled clinical trials of psychotherapeutic and pharmacological approaches for pathological gambling were almost nonexistent until the late 1990s. In this article we discuss the current state of research on psychosocial treatments for pathological gambling. We also highlight issues that have implications for future research.