If Treatment Exists, Will They Come? Refusal and Dropout in Psychological Treatment for Gambling Disorder

Session Title

Session 1-1-A: Treatment Stories

Presenters

Rory A. Pfund, University of MemphisFollow
Samuel C. Peter, University of MemphisFollow
James P. Whelan, University of MemphisFollow
Andrew W. Meyers, University of MemphisFollow

Presentation Type

Event

Location

Caesars Palace, Las Vegas, Nevada

Start Date

28-5-2019 9:15 AM

End Date

28-5-2019 10:40 AM

Disciplines

Clinical Psychology

Abstract

Abstract: Although growing empirical evidence supports the efficacy of psychological treatment for gambling disorder, individuals do not attend initial treatment sessions (refusal) or discontinue before they complete treatment (dropout). This creates a public health challenge given that these individuals will not benefit from otherwise efficacious treatments. In this presentation, we offer findings from two studies that bring attention to treatment refusal and treatment dropout.

In the treatment refusal study, prospective clients (n = 69) who scheduled an initial session at a state-funded, outpatient gambling clinic were randomly assigned to receive a motivational letter plus reminder call or a reminder call only in advance of their session. A chi-square revealed that a greater percentage of clients attended the initial session if they received the motivational letter and reminder call (77%) than if they received the reminder call only (51%).

In the treatment dropout study, we examined the time course of treatment dropout at a private practice, outpatient gambling clinic. Participants were 334 clients who met diagnostic criteria for gambling disorder. A survival analysis indicated that the greatest percentage of dropout occurred following the initial session but before the second session.

Implications: Our results indicate that treatment refusal and treatment dropout challenge the efficacious delivery of psychological treatment for gambling disorder. Interventions to increase initial attendance and treatment completion could prove valuable for improving treatment outcomes.

Keywords

treatment refusal, treatment dropout, psychological treatment, gambling disorder

Author Bios

Rory A. Pfund, MS is a fifth-year student in the clinical psychology program at The University of Memphis. He received his Bachelor of Science in psychology from University of Scranton in 2013. His research interests center on the processes and mechanisms that improve psychotherapy outcomes for individuals with gambling disorder. He is particularly interested in understanding the process of initiating and continuing psychotherapy to reach a successful outcome.

Samuel C. Peter, MS is a fourth-year student in the clinical psychology doctoral program at The University of Memphis. Mr. Peter’s research interests lie in the study of psychological assessment processes, including ways in which the accuracy and acceptability of assessment techniques can be improved.

James P. Whelan, PhD is a Professor of Psychology and the Co-director of The Institute for Gambling Education and Research at The University of Memphis. Established in 1999, the Institute includes funding outpatient clinic for individuals experiencing a gambling disorder and a research lab where we conduct translational research about risk and protective factors for gambling problems as well as research on the assessment and treatment of disordered gambling.

Andrew Meyers, PhD is Professor of Psychology at the University of Memphis. Over the past 28 years he has also served the university as department chairman and Vice President of Research. His primary research interest is on the assessment, prevention and treatment of problem gambling. He has over 150 publications on self-regulation, gambling, smoking, eating disorders, exercise and sport. Dr. Meyers is co-director of the Institute for Gambling Education and Research.

Funding Sources

N/A

Competing Interests

N/A