Community Reinforcement Approach and Family Training (CRAFT) for Problem Gambling

• Concerned Significant Other Status (Quality of Life) [ Time Frame: Baseline: At 0 weeks ] [ Designated as safety issue: Yes ]

  Measured through the following Tests:

  Beck Depression Inventory (Beck, Steer & Garbin 1988) State/Trait Anxiety Inventory (Speilberger 1999) State-trait Anger Expression Inventory-II (Speilberger et al. 1988) DSM -IV Screening Questionnaire; Social functioning and Resources Scale (Moos et al 1987) Physical symptoms (Moos et al 1987)

  
  

• Concerned Significant Other Status (Quality of Life) [ Time Frame: Post treatment: 1 week ] [ Designated as safety issue: Yes ]

  Measured through the following Tests:

  Beck Depression Inventory (Beck, Steer & Garbin 1988) State/Trait Anxiety Inventory (Speilberger 1999) State-trait Anger Expression Inventory-II (Speilberger et al. 1988) DSM -IV Screening Questionnaire; Social functioning and Resources Scale (Moos et al 1987) Physical symptoms (Moos et al 1987) Significant Other Status (Quality of Life)

  
  
• Concerned Significant Other Status (Quality of Life) [ Time Frame: Follow up: 9 months ] [ Designated as safety issue: Yes ]

  Measured through the following Tests:

  Beck Depression Inventory (Beck, Steer & Garbin 1988) State/Trait Anxiety Inventory (Speilberger 1999) State-trait Anger Expression Inventory-II (Speilberger et al. 1988) DSM -IV Screening Questionnaire; Social functioning and Resources Scale (Moos et al 1987) Physical symptoms (Moos et al 1987)

  
  

It has been estimated that 50,000 adult Nova Scotians are at some risk for problem gambling and approximately 93,000 adult Nova Scotians are intimately connected to at least one person who has a gambling problem (Nova Scotia Prevalence Study 2004). The serious consequences of problem gambling are being felt by Individuals engaged in Problem Gambling (IPGs), their Concerned Significant Others (CSOs) and their Communities.

It is known that despite the negative consequence of problem gambling very few IPGs access services for treating their gambling problems. The Nova Scotia Gambling Prevalence Study (2004) has shown that CSOs are seven times more likely to access services than IPGs "Overall, 3.5% (26,000 adults) have been motivated to help someone else with a current gambling problem versus 0.5% (3,700 adults) seeking assistance or information for a personal problem". Despite such findings the treatment options for the CSOs of IPGs are limited (Crisp, B.R. et al. 2001; Shaw, M.C. et al. 2007).

The Community Reinforcement and Family Training (CRAFT) (Meyers & Wolfe 2004) model for CSOs of substance abusers has demonstrated significant success with the following outcomes: improvement in the quality of life of CSOs; engagement of the substance abuser in treatment; and decreased substance use. CRAFT empowers CSOs by providing tools to positively influence their own and their significant others behavior through a cognitive behavioral approach.

This current project investigates the applicability and effectiveness of the CRAFT model as a tool for supporting the CSOs of problem gamblers. A comparative analysis will be completed with random assignment of 60 CSOs to either of Group A (CRAFT) or Group B (treatment as usual). Twelve individual treatment sessions will be offered to each of the CSOs. It is predicted the outcomes of from Group A (CRAFT) will significantly surpass those from Group B (treatment as usual). The predicted outcomes are: improvement in quality of life for the CSOs; engagement of the IPGs in treatment; and decreased gambling by the IPGs. All therapists in the CRAFT experimental group have been certified in the CRAFT model. A comparative analysis will be conducted with the CRAFT approach (Group A) and the traditional treatment approach (Group B). Model adherence will be supervised and tested.