Exposure Therapy for Gambling Disorder: Systematic Review and Meta-analysis

Abstract

Purpose of Review: Cognitive behaviour therapy is the gold standard for the treatment of gambling disorder. Obstacles remain regarding its efficacy, namely relapses and difficulty in implementing cognitive restructuring for some clients. Given these observations, behavioural interventions for gambling disorder, such as exposure therapy, which aims to decrease gambling craving, may be effective as a complementary or alternative intervention to cognitive behaviour therapy. This systematic review and meta-analysis aims to explore how exposure therapy for gambling disorder has been studied and to evaluate its efficacy. To answer these questions, 3406 studies, retrieved using PsycNet, Medline and Google Scholar, were screened. Recent Findings: After two screenings, 13 papers were selected for the systematic review and five were statistically combined for the meta-analysis. Quantitative results support exposure therapy’s efficacy to decrease gambling craving at post-intervention (g = − 0.955) and at last follow-up (6 or 12 months; − 1.010). Results also show a large decrease in gambling severity as documented by screening instruments (− 1.087) as well as time spent gambling (− 2.136) at post-intervention. Furthermore, a large decrease in gambling measured via screening instruments (− 1.162) and erroneous beliefs (− 1.308) was found at last follow-up. Summary: This is the first meta-analysis on behavioural exposure therapy for gambling disorder. Results support that exposure therapy reduces gambling cravings and severity, as well as time spent gambling and erroneous beliefs. These results are discussed in comparison to other therapeutic approaches and are interpreted according to the high risk of bias in included studies.