Controlled exposure to a gambling environment may decrease the desire to gamble

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In an exposure therapy session, people do not play, but are placed in a real or
In an exposure therapy session, people do not play, but are placed in a real or virtual environment that triggers their desire to play. They learn to tolerate the uncomfortable state created by this exposure and gradually develop the ability to cope with their desire to play.

The first meta-analysis of the effectiveness of this approach shows very encouraging results for at-risk or pathological gamblers

Exposure to an environment associated with gambling may be an effective approach to reducing the desire to gamble. This is the conclusion of researchers from Laval University and the Université du Québec en Outaouais who combed through studies on the effectiveness of exposure therapy for this type of problem. Their analysis was published in the scientific journal Current Addiction Reports.

Exposure therapy consists of placing a person repeatedly, progressively and in a controlled manner in an environment associated with his or her phobia, anxiety or obsessive-compulsive disorder," explains the study’s first author, Pierre-Yves Bergeron. The exposure can be real, imaginary or virtual.

In exposure therapy for gambling problems, people don’t gamble, but they are placed in an environment that triggers their desire to gamble," he says. In this way, they learn to tolerate the uncomfortable state created by this exposure and they gradually develop the ability to cope with their desire to gamble."

In order to assess the effectiveness of this approach, Pierre-Yves Bergeron and the other authors of the study reviewed 13 studies that had tested this intervention with 948 at-risk or pathological gamblers. These interventions varied in duration, ranging from one to 30 exposure sessions.

Their analyses revealed that:

  • The index of desire to gamble decreased by 30% between the beginning and end of the intervention
  • Studies that reassessed participants 6 or 12 months after the intervention reported that the decline in the desire to gamble index was not only maintained, but increased to 75%.
  • The gambling severity index was more than halved after the intervention and in the months following.
  • time spent gambling decreased from 18.5 hours per month to 3.2 hours after the intervention

"Exposure therapy could be an interesting complementary avenue for individuals who do not respond to cognitive behavioral therapy."

Currently, the main treatment for gambling problems is cognitive-behavioural therapy," says Pierre-Yves Bergeron. "It’s a knowledge-based approach. Patients must confront their beliefs and behaviours with knowledge from scientific psychology in order to restructure their thinking. This therapy is highly effective, but it would not work for all patients. Exposure therapy could be an interesting complementary avenue for people who do not respond to cognitive behavioural therapy. However, much research remains to be done before the full potential of exposure therapy for gambling problems can be used."

The study, published in Current Addiction Reports, is authored by Pierre-Yves Bergeron, Isabelle Giroux and Maxime Chrétien of the School of Psychology and the Quebec Centre of Excellence for Gambling Prevention and Treatment at Laval University, and Stéphane Bouchard of the Université du Québec en Outaouais.