Problem Gambling Research and Treatment Centre DRAFT GUIDELINE FOR SCREENING, ASSESSMENT AND TREATMENT IN PROBLEM AND PATHOLOGICAL GAMBLING DRAFT FOR PURPOSE OF PUBLIC CONSULTATION ONLY NOT TO BE CITED BEFORE PUBLICATION The Problem Gambling Research and Treatment Centre is a joint initiative of the Victorian Government, the University of Melbourne and Monash University © 2011 Monash University ISBN 978-0-9870540-0-5 Draft guideline for purpose of publication consultation only. Not to be cited before publication. PROBLEM GAMBLING RESEARCH AND TREATMENT CENTRE Page 2 Draft guideline for purpose of publication consultation only. Not to be cited before publication. PROBLEM GAMBLING RESEARCH AND TREATMENT CENTRE TABLE OF CONTENTS TABLE OF CONTENTS ...................................................................................................................................... 3 LIST OF TABLES ................................................................................................................................................ 5 LIST OF ABBREVIATIONS .............................................................................................................................. 6 ACKNOWLEDGMENTS ..................................................................................................................................... 7 SUMMARY OF RECOMMENDATIONS .......................................................................................................... 9 SCREENING AND ASSESSMENT ...................................................................................................................................... 10 TREATMENT .................................................................................................................................................................... 12 RESEARCH RECOMMENDATIONS FOR SCREENING AND FOR ASSESSMENT ............................................................ 14 RESEARCH RECOMMENDATIONS FOR TREATMENT ................................................................................................... 15 WHAT IS THIS DOCUMENT AND WHAT IS ITS PURPOSE?............................................................... 18 WHEN WILL THIS GUIDELINE BE UPDATED? ...................................................................................... 19 BACKGROUND ................................................................................................................................................ 20 CONCEPTUALISING AND DEFINING PROBLEM AND PATHOLOGICAL GAMBLING ................................................... 20 PREVALENCE OF PROBLEM AND PATHOLOGICAL GAMBLING ................................................................................... 21 GAMBLING MODALITIES ................................................................................................................................................. 21 GAMBLING ISSUES FOR DIFFERENT SUB-POPULATIONS ................................................................ 23 PEOPLE WITH GAMBLING PROBLEMS AND CO-OCCURRING PSYCHIATRIC SYMPTOMS ........................................ 24 GENDER AND GAMBLING ............................................................................................................................................... 26 AGE AND GAMBLING ....................................................................................................................................................... 27 Young people .................................................................................................................................................................... 27 Seniors ................................................................................................................................................................................. 27 INDIGENOUS COMMUNITIES AND GAMBLING .............................................................................................................. 28 CULTURALLY AND LINGUISTICALLY DIVERSE (CALD) COMMUNITIES AND GAMBLING ..................................... 29 OBJECTIVES ..................................................................................................................................................... 31 SCOPE ................................................................................................................................................................ 31 TARGET AUDIENCE ....................................................................................................................................... 31 FOCUS OF THE GUIDELINE ......................................................................................................................... 31 METHODS ......................................................................................................................................................... 32 MULTIDISCIPLINARY CONTRIBUTION TO GUIDELINE DEVELOPMENT .................................................................... 32 IDENTIFICATION OF CLINICAL QUESTIONS.................................................................................................................. 32 IDENTIFICATION AND REVIEW OF EXISTING RELEVANT GAMBLING GUIDELINES ................................................. 33 SEARCH METHODS .......................................................................................................................................................... 33 EVIDENCE REVIEW ......................................................................................................................................................... 33 Screening of the evidence ........................................................................................................................................... 33 Assessment of methodological quality ................................................................................................................. 33 HOW RECOMMENDATIONS WERE FORMULATED ....................................................................................................... 34 PROPOSED PUBLIC CONSULTATION PROCESS (CURRENTLY UNDERWAY) ............................................................. 34 LIMITATIONS OF THIS GUIDELINE .......................................................................................................... 35 GENERALISABILITY AND APPLICABILITY OF THE STUDIES REVIEWED TO SUPPORT THE GUIDELINE ............... 35 MEDICAL INFORMATION ................................................................................................................................................ 35 LACK OF EVIDENCE ......................................................................................................................................................... 35 COST EFFECTIVENESS..................................................................................................................................................... 36 PART 1 SCREENING AND ASSESSMENT .................................................................................................. 37 Page 3 Draft guideline for purpose of publication consultation only. Not to be cited before publication. PROBLEM GAMBLING RESEARCH AND TREATMENT CENTRE CONCEPTUALISING SCREENING AND ASSESSMENT .................................................................................................... 37 POTENTIAL BENEFITS OF SCREENING AND ASSESSMENT ......................................................................................... 38 CLINICAL QUESTIONS FOR SCREENING AND FOR ASSESSMENT................................................................................ 40 OUTCOMES FOR SCREENING AND FOR ASSESSMENT ................................................................................................. 40 EVIDENCE-BASED RECOMMENDATIONS FOR SCREENING AND FOR ASSESSMENT ................................................ 41 IMPORTANT BACKGROUND ISSUES TO CONSIDER FOR SCREENING AND FOR ASSESSMENT ................................ 42 Measurement tools used for screening, assessment and diagnosis in problem and pathological gambling ............................................................................................................................................................................ 42 Who should be screened and what type of screening should be used? .................................................. 43 Which tools should be used to screen and assess potential problem/ pathological gamblers? 45 Lifetime and past year gambling ............................................................................................................................ 46 What should be assessed in addition to gambling measures for people who potentially have problem/ pathological gambling? ......................................................................................................................... 48 What is the role of GPs in screening and assessment? .................................................................................. 48 Review of potential screening and assessment tools ..................................................................................... 50 Commentary about the available screening and assessment tools ........................................................ 57 How to assess which tools should be recommended ...................................................................................... 58 RECOMMENDATIONS FOR SCREENING AND FOR ASSESSMENT ...............................................................................