Abstract: Cognitive-behavioral (CB) techniques have received substantial empirical support for reducing gambling disorder symptoms and behavior. What has not been established is whether gambling-focused treatment reduces psychological problems and improves quality of life. Individuals experiencing gambling-related harms report that sustained recovery involves changing both gambling behaviors and psychological problems and building a meaningful life. The current systematic review and meta-analysis aimed to examine the effect of CB techniques targeting gambling harms on nontargeted outcomes such as psychological problems and quality of life.
Following PRISMA guidelines, a systematic article search was conducted to locate published studies of randomized controlled trials of CB techniques targeting gambling harms and reporting nontargeted outcomes. Random effects meta-analysis was used to quantify the effect of CB techniques on nontargeted outcomes. Ten studies representing 797 participants were included. Eight studies reported the effect of CB techniques on anxiety, 8 on depression, 3 on substance use, and 7 on quality of life. CB techniques significantly reduced anxiety (g = -0.44), depression (g = -0.35), gambling frequency (g = -0.30), and gambling intensity (g = -0.36) at posttreatment, but not substance use. CB techniques also significantly improved quality of life (g = 0.39) at posttreatment.
Implications: The targeted reduction of gambling harms may serve as a mechanism of change for reducing psychological problems and improving quality of life. Future studies should employ longitudinal designs to understand the associations between gambling reductions and changes in nontargeted recovery outcomes over time
