Brief Interventions for Problem Gamblers

Transcription

1 Brief Interventions for Problem Gamblers Gerhard Meyer Boris Dickow 6th European Conference on Gambling Studies and Policy Issues Work in Progress, 29 June 2 July 2005, Malmö This research w financially supported by a grant from Arbeitsausschuss Münzautomaten

2 Background Self-help workbooks Motivational enhancement therapy (Miller & Rollnick, 1991) Studies with problem gamblers Dickerson et al. (1990) Robson et al. (2002) Hodgins et al. (2001, 2004)

3 Objectives Confirmation of effects of minimal interventions such self-help workbooks and motivational enhancement telephone interviews on gambling behavior, the readiness of change, and the extent of gambling related problems in a sample of gamblers on amusement with prize (AWP) machines, who clsified their own gambling behaviour problematic and were motivated for change.

4 Hypothesis Participants who received the self-help workbook and additional motivational interviewing will show a greater reduction in gambling and greater improvement than those receiving the self-help workbook only.

5 Flyer Method 1/5 Flyer and poster in arcades/gambling halls Just for fun? (freecall( freecall)

6 Method 2/5 Randomized matched samples First call Random matching Self-help workbook + motivational interviewing Self-help workbook Control group waiting list

7 Course of Meurement Method 3/5 2-months follow-up 2 Monate 6-months follow-up 6 Monate 12-months follow-up 12 Monate T0 T1 T2 T3 beline ta

8 Stage-bed Workbook for Method 4/5 Problem Gamblers Intro & Filter Chapter 1: Stay I am! Chapter 2: Changing? Yes and No! Chapter 3: Preparation Chapter 4: Full speed ahead Chapter 5: Stay the course

9 Motivational Interviewing Method 5/5 Feedback Responsibility Advice Options Empathy Self-efficacy

10 Instruments 1/2 Severity of pathological gambling Short Questionnaire of Gambling Behaviour (Petry & Baulig, 2003) Gambling behaviour Frequency (ys/week) Duration (hours/y) Stakes (losses/y in )

11 2/2 Instruments Gambling related problems: Familiy Financial situation Emotional state Relationship to other people Quality of life Readiness to change Importance Confidence of change

12 Subjects 1/2 58 male gamblers on AWP machines Age: 21 to 48 Reaction to flyer and poster (with information of the research project) presented in arcades/gambling halls

13 Subjects 2/2 Clsified their gambling behaviour problematic 88% agreed to at let 10 items of the Kurzfragebogen zum Glücksspielverhalten (Short Questionnaire of Gambling Behaviour)

14 Results 1/ Readiness of change in both groups (number of gamblers, N) Group 1 (workbook + motivational interview) Gruppe 1 (mit KB) Gruppe 2 (ohne KB) Group 2 (workbook only) 0 Pre pre 2 months 2 Monate 6 months 6 Monate 12 Monate 12 months

15 Results 2/8 Use of the workbook after two months ys/week 0 Tage/Woche 1-2 ys/week 1-2 Tage/Woche 3-7 Tage/Woche 3-7 ys/week Group 1 Gruppe 1 (mit KB) (workbook + motivational interview) Gruppe 2 (ohne KB) Group 2 (workbook only)

16 4 Degree of gambling related problems Results 3/8 Ausmaß spielbezogener Beltungen pre Pre 2 Monate 2 months 6 Monate 6 months 12 Monate 12 months Group 1 (workbook + Gruppe motivational 1 (mit KB) interview) Gruppe Group 2(ohne KB) (workbook only)

17 140 Stakes (in ) 120 Results 4/8 Spieleinsätze (EUR) pre Pre 6 months 2 months 2 Monate 6 Monate 12 Monate 12 months Group 1 (workbook + motivational interview) Group 2 (workbook only) Gruppe 1 (mit KB) Gruppe 2 (ohne KB)

18 5 Frequency (ys/week) Results 5/8 Häufigkeit (Tage je Woche) pre Pre 2 Monate 2 months 6 Monate 6 months 12 Monate 12 months Group 1 (workbook + motivational interview) Group 2 (workbook only) Gruppe 1 (mit KB) Gruppe 2 (ohne KB)

19 4,0 Hours spent gambling/y Results 6/8 Spieluer (Stunden) 3,5 3,0 2,5 2,0 1,5 1,0,5 0,0 pre Pre 2 Monate 2 months 6 Monate 6 months 12 Monate Group 1 (workbook + Gruppe motivational 1 (mit KB) interview) Gruppe (ohne KB) Group 2 (workbook only) 12 months

20 Results 7/8 N Anzahl improved verbessert Significant clinical improvement ( > 50%, 6 months) not nicht improved verbessert Group 1 (workbook + Gruppe motivational 1 (mit KB) interview) Gruppe Group 2 2 (ohne KB) (workbook only)

21 Results 8/8 N Anzahl improved verbessert Significant clinical improvement ( > 50%, 12 months) not nicht improved verbessert Group 1 (workbook + Gruppe motivational 1 (mit KB) interview) Gruppe Group 2 2 (ohne KB) (workbook only)

22 Discussion 1/2 Results consistent with previous research Eier to control frequency than session expenditure Card-bed play to set limits

23 Discussion 2/2 Benefit from motivational interviewing Identification of problem gamblers in the venue Training of employees (e.g. in motivational interviewing) Limitation: no control group

24 Self-help workbooks useful in any situation!