The Challenge of Retaining Gamblers in Treatment: Comparing Cognitive Motivational Behavior Therapy and CBT

Gambling disorder is characterized by low treatment-seeking and high dropout rates. Effective treatments should therefore address not only symptom reduction but also retention. Cognitive Motivational Behavior Therapy (CMBT) addresses this need by seamlessly integrating motivational interviewing (MI) principles into a cognitive behavioral therapy (CBT) framework, creating a unified therapeutic approach designed to enhance both engagement and clinical outcomes. We tested the effectiveness of CMBT against traditional CBT in a randomized controlled trial with 63 treatment-seeking participants diagnosed with gambling disorder. Clients received 12 weekly sessions of either CMBT or CBT and were assessed pre/posttreatment and during a 12-month follow-up period.CMBT participants completed significantly more treatment sessions (M = 10.5) than CBT participants (M = 8). Both treatments reduced urges to gamble and erroneous beliefs about gambling from baseline through follow-up. Linear mixed models revealed that CMBT participants reported higher motivation to change and had gambled on fewer days at the 3-month follow-up compared to CBT participants. CMBT participants also spent less money on gambling posttreatment and at the 12-month follow-up.Both CMBT and CBT are effective treatments for gambling disorder. CMBT offers some incremental advantages over CBT in treatment retention, readiness to change, and gambling behavior.