Recovery from a gambling disorder is a complex, individualized process that has stymied researchers attempting to operationalize a standard tool to measure this outcome.
This article examines the latest research regarding treatment outcomes for gambling addiction. What lessons can clinicians learn from this research? How do the outcomes compare with those for addiction treatment?
Gambling Addiction Treatment – A Literature Review
A study in Addiction collated and reviewed the available literature on addiction treatment outcomes. “Measuring Treatment Outcomes in Gambling Disorders: A Systematic Review” looked at thirty-four scientific studies. In them, they found sixty-three possible treatment outcomes tied to gambling addiction treatment. This included various tools to measure:
- Gambling symptoms and severity
- Gambling behavior, such as the amount of time and money spent
- Rates of consistent abstinence and relapse behaviors
- Psychological disorders such as depression
- Functioning and well being, primarily using the Work and Social Adjustment or Quality of Life Scale
While the goal of the study was to determine a consistent operational measurement of the recovery outcome, the authors discovered:
- The treatment outcomes in these studies were inadequately defined and measured in ways that were inconsistent across the research. “Recovery” itself was ill-defined as abstinence, controlled gambling, or other less-defined behaviors. This makes the measurement of addiction treatment outcomes tied to recovery an imperfect scientific endeavor.
- Creating uniformity makes sense from a clinical perspective in order to operationalize effective treatments. The authors suggested, “Although moderate heterogeneity among studies is to be expected in meta-analysis, high degrees of inconsistency can seriously limit its application and validity.”
The authors extrapolated their findings to the substance use category of treatment and suggested that the field demonstrates notable inconsistencies related to benchmarking clinical outcomes. It is also notable that, while the mental health field has very established intervention methodologies, substance use addiction treatment lacks the same consistency.
However, two notable studies cited in the paper have suggested addiction treatment frameworks such as the Substance use Recovery Evaluator (SURE) and frameworks for gambling disorders that attempt to measure outcomes (the ‘Banff Consensus’). Many of the hodgepodge reporting frameworks rely on self-reporting, which is unreliable.
Self-reporting in gambling addiction is an imperfect science.
Too, the paper noted that, while alcohol addiction treatment modalities measure how much alcohol is needed to inflict harm to the patient, no such measurement in gambling exists. That is, of course, because this is a subjective measurement based on patient finances. In gambling disorders, there are no biological markers to track, such as blood alcohol levels.
Conclusions for Addiction Treatment Providers
The authors concluded that defining recovery from gambling disorders often culls measurements from the substance use profession. They pointed out that “a critical feature differentiating recovery in gambling disorder from all other forms of addiction is financial recovery.” Because the very nature of a financial recovery is individualized, making a consistent measurable outcome difficult to define. While creating a “single comprehensive multi-dimensional scale to measure recovery,” would be of huge benefit for clinical researchers, researchers are far from being able to systematize such a tool.
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