A Systematic Review and Meta-Analysis of the Relative and Complementary Benefits of Motivational Interviewing and Cognitive-Behavioral Treatment for Problem Gambling and Gambling Disorder

Session Title

Poster session

Presentation Type

Poster Presentation

Start Date

27-5-2026 12:00 AM

Abstract

The available empirical research suggests that an intervention combining motivational interviewing (MI) and cognitive-behavioral therapy (CBT) is the most effective treatment for problem gambling and gambling disorder. However, the unique contribution of motivational components from MI versus skills-based components from CBT remains unclear. The current systematic review and meta-analysis used a dismantling design to isolate the effects of MI and CBT by comparing combined interventions with only MI or only CBT. Seven trials (N = 953) met inclusion criteria. Random-effects meta-analyses with robust variance estimation were conducted using between-group Hedges’s g effect sizes to evaluate the effectiveness of MI + CBT compared to either MI alone or CBT alone at posttreatment. Outcomes were gambling behavior and gambling disorder symptom severity. Posttreatment outcomes were not significantly different between MI + CBT versus MI only, while MI + CBT had significantly more favorable outcomes at posttreatment compared to CBT only. These findings indicate that motivational components improve outcomes when added to skills-based components on average, but adding skills-based components did not improve outcomes when added to motivational components on average. The latter is strongly inconsistent with prior research and suggests that the clinical decision of when to add skills-based components to motivational components may be nuanced.

Author Bios

Mark Hastings is a research assistant at the University of Memphis, conducting research with the Tennessee Institute for Gambling Education and Research. His current research interests include personalized treatments for gambling disorder, treatment effectiveness, and the intersection of gambling and suicide.

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May 27th, 12:00 AM

A Systematic Review and Meta-Analysis of the Relative and Complementary Benefits of Motivational Interviewing and Cognitive-Behavioral Treatment for Problem Gambling and Gambling Disorder

The available empirical research suggests that an intervention combining motivational interviewing (MI) and cognitive-behavioral therapy (CBT) is the most effective treatment for problem gambling and gambling disorder. However, the unique contribution of motivational components from MI versus skills-based components from CBT remains unclear. The current systematic review and meta-analysis used a dismantling design to isolate the effects of MI and CBT by comparing combined interventions with only MI or only CBT. Seven trials (N = 953) met inclusion criteria. Random-effects meta-analyses with robust variance estimation were conducted using between-group Hedges’s g effect sizes to evaluate the effectiveness of MI + CBT compared to either MI alone or CBT alone at posttreatment. Outcomes were gambling behavior and gambling disorder symptom severity. Posttreatment outcomes were not significantly different between MI + CBT versus MI only, while MI + CBT had significantly more favorable outcomes at posttreatment compared to CBT only. These findings indicate that motivational components improve outcomes when added to skills-based components on average, but adding skills-based components did not improve outcomes when added to motivational components on average. The latter is strongly inconsistent with prior research and suggests that the clinical decision of when to add skills-based components to motivational components may be nuanced.