CONGAM: Adding Contingency Management to Psychosocial Interventions for Disordered Gambling
This research will undertake a scoping and feasibility assessment of adding Contingency Management to existing psychological treatments for disordered gambling in the UK clinical gambling treatment settings.
The Research
Contingency management (CONGAM) is a behavioural therapy based on principles of operant conditioning, whereby positive reinforcement may be used to reward a desired behaviour. In the context of gambling, this takes the form of offering individuals an incentive, such as a shopping voucher, when they abstain from potentially harmful gambling behaviours. This type of treatment has been shown to be effective at promoting behaviour change in a wide range of areas such as substance use disorders and smoking cessation, however little is known about the efficacy of CONGAM for disordered gambling. Despite the success of CONGAM interventions in other settings, the application of CONGAM to gambling is somewhat controversial, due to the use of financial incentives which could be used by recipients to fund further gambling activity. As a result, addiction therapists, clinicians, and the general public may hold negative views about the approach and may have concerns about its long-term efficacy in dealing with the underlying causes of gambling addiction.
The first stage of the project will explore perceptions of the treatment, to find out what UK therapists and service users think about CONGAM. Then, a pilot of a survey measure of CONGAM for use in UK treatment settings will be conducted, and the effects of reinforcing both attendance at group therapy sessions and abstinence from gambling will be evaluated. In so doing, it will be possible to identify the best ways of measuring CONGAM outcomes as well as changes in mood, anxiety, depression and self-efficacy. Finally, the project will estimate the healthcare costs of adding CONGAM to existing treatment and identify potential barriers to the wider adoption of CONGAM based interventions to reduce gambling harm.
Methods
A mixed-methods approach including surveys, focus groups and quantitative feasibility analyses and inferential analysis.