A systematic review and meta-analysis of the relative and complementary effects of motivational interviewing and cognitive-behavioral treatment for problem gambling and gambling disorder.
Mark R Hastings, David P Forman, Hyoun S Kim et al.
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In 30 seconds
This systematic review and meta-analysis compared combined motivational interviewing (MI) and cognitive-behavioral treatment (CBT) with either treatment alone for problem gambling and gambling disorder. It included eight randomized controlled trials with 1,078 participants. Compared with CBT alone, MI + CBT was associated with lower gambling behavior and disorder severity immediately after treatment (g = -0.17, 95% CI = -0.31, -0.04), but this difference was not significant at follow-up. Combined treatment did not significantly differ from MI alone at either assessment. Overall, results suggest that effects may depend on how the approaches are integrated.
Key findings
- Against CBT alone, MI + CBT showed a small significant advantage at posttreatment (g = -0.17, 95% CI = -0.31, -0.04).
- The advantage over CBT alone was not significant at follow-up (g = -0.17, 95% CI = -0.48, 0.13).
- MI + CBT did not significantly differ from MI alone at posttreatment (g = -0.05, 95% CI = -0.51, 0.41) or follow-up (g = -0.10, 95% CI = -0.47, 0.26).
Why it matters
The findings caution against assuming that combining motivational and skills-based treatment components consistently improves outcomes over either approach alone. The short-term advantage over CBT alone was not evident at follow-up, while adding CBT to MI showed no significant difference. This supports attention to treatment integration and outcome timing when interpreting evidence for psychological interventions for gambling problems.
What to keep in mind
The evidence base comprised eight studies, with only three examining the additive effect of CBT and five the additive effect of MI; the reported advantage over CBT alone was not significant at follow-up.