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

January 21, 2020 updated by: Colchester East Hants Health Authority

Evaluating the Benefits of the Community Reinforcement and Family Training(CRAFT) Approach to Concerned Significant Others(CSO) of Individuals Engaged in Problem Gambling (IPGs)

Nova Scotia is experiencing a proliferation of gambling opportunities and their related gambling problems. The 2003 Nova Scotia Prevalence Study (2004) found that approximately 50,000 adult Nova Scotians are at some risk for problem gambling and that approximately 93,000 adult Nova Scotians are intimately connected to at least one person who has a gambling problem. The serious consequences of problem gambling are being felt by the Individuals engaging in Problem Gambling (IPGs), their Concerned Significant Others (CSOs) and their Communities.

Very few IPGs access support services for their gambling problems. Some reports (National Gambling Impact Study Commission 1999) have found that only 3% of IPGs seek treatment. The Nova Scotia Gambling Prevalence Study (2004) states: "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". While the CSOs of IPGs are seven times more likely to access professional addiction treatment the options for these individuals are limited and treatment programs often lack evidence in support of their effectiveness.

The Community Reinforcement and Family Training (CRAFT) (Meyers & Wolfe 2004) approach provides significant benefits to the CSOs of persons abusing alcohol and other drugs. They benefits include: improvement in the quality of life of the CSOs; increasing the rate of substance abusers entering treatment; and decreased substance use. CRAFT empowers CSOs by providing tools to positively influence theirs and their significant other's behavior.

The current study investigates the applicability and effectiveness of the CRAFT approach to the CSOs of IPGS.

It is predicted that benefits to the CSOs receiving CRAFT will significantly surpass those receiving treatment as usual. The predicted benefits are: improvement in quality of life for the CSO; engagement of IPGs in treatment; and decreased gambling by the IPGs. With these achieved outcomes, this research will provide opportunity for earlier intervention, improved individual and family functioning and a reduction of the negative impact of problem gambling on the community.

Study Overview

Status

Withdrawn

Conditions

Intervention / Treatment

Detailed Description

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.

Study Type

Interventional

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Canada
    • Nova Scotia
      • Amherst, Nova Scotia, Canada, B0M 1X0
        • Addiction Services
      • Pictou, Nova Scotia, Canada, B0K 1H0
        • Addiction Services
      • Truro, Nova Scotia, Canada
        • Addictions Services

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Concerned Significant Other (CSO) must have a significant relationship with the Individuals Engaged in Problem Gambling (IPG)(e.g. parent, child, sibling, friend, partner).
  2. CSO must have face-to-face contact with the IPG at least 3 days per week and for at least 1 hour per day with no anticipated relationship change (e.g. separation) over the next 90 days.
  3. Impaired functioning of the CSO consequential to their significant other being engaged in problem gambling.
  4. Evidence (from the CSOs) that the IPG meets Canadian Problem Gambling Index (CPGI) criteria for problem gambling.
  5. The CSO's primary motivation for treatment is to influence their IPG's gambling behaviour.

Exclusion Criteria:

  1. CSO meets CPGI criteria for having problem gambling.
  2. CSO has a condition, including substance dependency and/or significant psychopathology, which could impede the CSO's ability to understand and participate in treatment.
  3. The IPG has received treatment for problem gambling in the previous 3 months, is currently willing to receive treatment, or has been court ordered to receive treatment.
  4. Domestic violence is a significant risk based on the CSOs report and psychometric measure.
  5. The CSO is currently receiving psychotherapy for issues related to their IPG's gambling.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Treatment as Usual
Clients will receive 12 sessions of "Treatment as usual ", delivered 1 session per week for 12 consecutive weeks.
Behavioral: Treatment as Usual
Clients will receive Treatment as Usual delivered over 12 session. There will be 1 session per week.
Other Names:
  • Cognitive Behavioural Therapy
  • Motivational Enhancement
Experimental: CRAFT Treatment
Clients will receive 12 sessions of "CRAFT", delivered 1 session per week for 12 consecutive weeks.
Behavioral: CRAFT treatment
Clients will receive 12 sessions of CRAFT delivered over a 12 week period. There will be 1 session per week.
Other Names:
  • Community Reinforcement Approach and Family Training

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Concerned Significant Other Status (Quality of Life)
Time Frame: Baseline: At 0 weeks

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)
Baseline: At 0 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Concerned Significant Other Status (Quality of Life)
Time Frame: Post treatment: 1 week

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)
Post treatment: 1 week
Concerned Significant Other Status (Quality of Life)
Time Frame: Follow up: 9 months

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)
Follow up: 9 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Colchester East Hants Health Authority

Collaborators

University of Calgary
Dalhousie University
Pictou County Health Authority

Investigators

  • Principal Investigator: Greg Purvis, MSc, Pictou County Health Authority
  • Principal Investigator: David Hodgins, PhD, University of Calgary

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Anticipated)

June 3, 2011

Primary Completion (Actual)

April 15, 2012

Study Completion (Actual)

April 15, 2012

Study Registration Dates

First Submitted

February 4, 2011

First Submitted That Met QC Criteria

April 21, 2011

First Posted (Estimate)

April 22, 2011

Study Record Updates

Last Update Posted (Actual)

January 23, 2020

Last Update Submitted That Met QC Criteria

January 21, 2020

Last Verified

April 1, 2011

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 001 (Buy Pharma Ecza Deposu San. Tic. Ltd.)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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