Psychology ETDs

Publication Date

Spring 5-1-2024

Abstract

As legalized gambling becomes more accessible and the prevalence of gambling problems are expected to rise, there is growing interest in effective psychological interventions that reduce gambling problems. A previous meta-analysis (Yakovenko, 2015) concluded that Motivational Interviewing (MI) was associated with significant reductions in gambling frequency and intensity. Yet, that analysis only included five studies and had methodological limitations. Notably, the majority of studies included in the meta-analysis combined MI with another intervention, blurring the effect of MI’s specific contributions on outcomes. To improve upon this work, the current study performed an updated systematic review and random-effects meta-analysis that 1) characterized the literature investigating the use of MI-based interventions (MBIs) for gambling problems, 2) quantified the effect of MBIs on gambling outcomes, and 3) identified conditions that strengthen or weaken MBI’s effects. Ten studies, representing 985 participants from four countries were identified in the systematic search. MBIs varied in their descriptions, and no study met the proposed criteria for establishing MI intervention integrity in clinical trials (Miller & Rollnick, 2014). When pooled, MBIs showed a small superior effect on gambling frequency (g = -.12) and intensity (g = -.15) and no effect on gambling severity (endorsed symptoms of gambling disorder), relative to non-motivational controls. MBIs combined with a cognitive-behavioral workbook doubled the effects in the pooled analysis, and MBIs in isolation showed considerably weaker effects. Higher effect sizes were associated with the inclusion of assessment feedback and the use of inactive comparison groups. The findings advance our knowledge of the empirical work that has investigated MI for gambling problems. Recommendations for future research are offered and include the use of objective fidelity monitoring to ensure MI delivery and the use of study designs that permit evaluation of MI’s direct effects on gambling behavior and severity.

Degree Name

Psychology

Level of Degree

Doctoral

Department Name

Psychology

First Committee Member (Chair)

Theresa Moyers

Second Committee Member

Barbara McCrady

Third Committee Member

Margo Hurlocker

Fourth Committee Member

Rory Phund

Fifth Committee Member

Kevin Knight

Language

English

Keywords

motivational interviewing, gambling, meta-analysis

Document Type

Dissertation

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