Trial Outcomes & Findings for Integrative Couple Treatment for Pathological Gambling (NCT NCT02240485)

NCT ID: NCT02240485

Last Updated: 2022-04-04

Results Overview

Outcome measure for Gamblers The G-SAS is a 12-item self-rated scale designed to assess gambling symptom severity and change during treatment. Each 12-item scale has a score ranging from 0 - 4 (adjective anchors for 0 and 4 vary for each item but "0 means no symptoms" and "4 means extreme symptoms"). All items ask for an average symptom based on the past 7 days (average urge, frequency, duration and control,thoughts associated with gambling,time spent on gambling,anticipatory tension and/or excitement, emotional distress). The total score ranges from 0 to 48. A score between 8 and 20 is an indicator of low urges to gamble, between 21 and 30, moderate urges, between 31 and 40 severe urges and a score of over 40 reveals the presence of extreme urges in the player.

• Recruitment status: COMPLETED
• Study phase: NA
• Target enrollment: 80 participants
• Primary outcome timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)
• Results posted on: 2022-04-04

Participant Flow

Recruitment was carried out in two phases: Phase I: 1st march 2011 to 3th april 2013 Phase II: 31th october 2014 to 1st june 2016. Recruitment took place in nine specialized treatment center in the province of Quebec (Canada).

Eighteen couples took part in the research eligibility, but they weren't enrolled in the study based on the exclusion criteria of the study :n=4 Low commitment towards relationship;n=4 Problematic alcohol/drug use [gambler]; n=3 Severe violence last 12 month; n=2 Low risk gambling [gambler]; n=2 Serious mental health problems [partner]; n=1 Partner with a gambling disorder ; n=1 Cohabitation less then six month ;n=1 Refused categorization

Participant milestones

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
3 Months Post-admission STARTED	44	36
3 Months Post-admission COMPLETED	41	30
3 Months Post-admission NOT COMPLETED	3	6
9 Months Post-admission STARTED	41	30
9 Months Post-admission COMPLETED	38	26
9 Months Post-admission NOT COMPLETED	3	4
18 Months Post-admission STARTED	38	26
18 Months Post-admission COMPLETED	35	21
18 Months Post-admission NOT COMPLETED	3	5

Reasons for withdrawal

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
3 Months Post-admission Lost to Follow-up	1	5
3 Months Post-admission Withdrawal by Subject	2	1
9 Months Post-admission Lost to Follow-up	3	1
9 Months Post-admission Withdrawal by Subject	0	3
18 Months Post-admission Lost to Follow-up	1	1
18 Months Post-admission Withdrawal by Subject	2	4

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Measure	Integrative Couple Treatment for Pathological Gambling n=44 Participants Already described in the "Intervention Description" section Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Well described in the Intervention section Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.	Total n=80 Participants Total of all reporting groups
Age, Categorical Gamblers · <=18 years	0 Participants n=44 Participants	0 Participants n=36 Participants	0 Participants n=80 Participants
Age, Categorical Gamblers · Between 18 and 65 years	42 Participants n=44 Participants	35 Participants n=36 Participants	77 Participants n=80 Participants
Age, Categorical Gamblers · >=65 years	2 Participants n=44 Participants	1 Participants n=36 Participants	3 Participants n=80 Participants
Age, Categorical Partners · <=18 years	0 Participants n=44 Participants	0 Participants n=36 Participants	0 Participants n=80 Participants
Age, Categorical Partners · Between 18 and 65 years	41 Participants n=44 Participants	34 Participants n=36 Participants	75 Participants n=80 Participants
Age, Categorical Partners · >=65 years	3 Participants n=44 Participants	2 Participants n=36 Participants	5 Participants n=80 Participants
Age, Continuous Gamblers	42 years STANDARD_DEVIATION 14 • n=44 Participants	41 years STANDARD_DEVIATION 12 • n=36 Participants	42 years STANDARD_DEVIATION 13 • n=80 Participants
Age, Continuous Partners	42 years STANDARD_DEVIATION 13 • n=44 Participants	40 years STANDARD_DEVIATION 14 • n=36 Participants	41 years STANDARD_DEVIATION 14 • n=80 Participants
Sex: Female, Male Gamblers · Female	13 Participants n=44 Participants	7 Participants n=36 Participants	20 Participants n=80 Participants
Sex: Female, Male Gamblers · Male	31 Participants n=44 Participants	29 Participants n=36 Participants	60 Participants n=80 Participants
Sex: Female, Male Partners · Female	31 Participants n=44 Participants	30 Participants n=36 Participants	61 Participants n=80 Participants
Sex: Female, Male Partners · Male	13 Participants n=44 Participants	6 Participants n=36 Participants	19 Participants n=80 Participants
Race and Ethnicity Not Collected	—	—	0 Participants Race and Ethnicity were not collected from any participant.
Region of Enrollment Canada	44 Participants n=44 Participants	36 Participants n=36 Participants	80 Participants n=80 Participants

PRIMARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome measure for Gamblers

The G-SAS is a 12-item self-rated scale designed to assess gambling symptom severity and change during treatment.

Each 12-item scale has a score ranging from 0 - 4 (adjective anchors for 0 and 4 vary for each item but "0 means no symptoms" and "4 means extreme symptoms").

All items ask for an average symptom based on the past 7 days (average urge, frequency, duration and control,thoughts associated with gambling,time spent on gambling,anticipatory tension and/or excitement, emotional distress).

The total score ranges from 0 to 48.

A score between 8 and 20 is an indicator of low urges to gamble, between 21 and 30, moderate urges, between 31 and 40 severe urges and a score of over 40 reveals the presence of extreme urges in the player.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Gambling Symptom Assessment Scale (G-SAS) Admission	18.52 score on a scale Standard Deviation 1.08	16.66 score on a scale Standard Deviation 1.20
Gambling Symptom Assessment Scale (G-SAS) 3 months post-admission	6.85 score on a scale Standard Deviation 1.14	12.39 score on a scale Standard Deviation 1.31
Gambling Symptom Assessment Scale (G-SAS) 9 months post-admission	4.30 score on a scale Standard Deviation 1.17	11.08 score on a scale Standard Deviation 1.44
Gambling Symptom Assessment Scale (G-SAS) 18 months post-admission	4.01 score on a scale Standard Deviation 1.21	10.80 score on a scale Standard Deviation 1.53

PRIMARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Gamblers

Among 12 types of gambling activities, the highest frequency of gambling behaviors for the past 6 months (never = 0; every or almost every day=5). Maximum score is 5. The higher is the score, the higher is the frequency.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Frequency of the Most Problematic Game Admission	3.66 score on a scale Standard Deviation .15	3.56 score on a scale Standard Deviation .16
Frequency of the Most Problematic Game 3 months post-admission	2.14 score on a scale Standard Deviation .19	2.20 score on a scale Standard Deviation .20
Frequency of the Most Problematic Game 9 months post-admission	1.68 score on a scale Standard Deviation .21	2.37 score on a scale Standard Deviation .22
Frequency of the Most Problematic Game 18 months post-admission	2.17 score on a scale Standard Deviation .20	2.73 score on a scale Standard Deviation .24

PRIMARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Gamblers

The DEBA-Jeu is a very brief screening grid comprising eight Likert-type items in five points (never = 0, always = 4). The eight items form a scale where the total score varies between 0 and 32. The suggested breaking points are as follows: 0 to 1 = No problem gambling; 2 to 5 =Problem gambling ; 6 to 24 = High probability of problem gambling.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Detection of Gambling Problems and Services Need ("Détection et Besoin d'Aide en Regard du Jeu Excessif- DÉBA-Jeu") Admission	19.41 score on a scale Standard Deviation .88	20.45 score on a scale Standard Deviation .97
Detection of Gambling Problems and Services Need ("Détection et Besoin d'Aide en Regard du Jeu Excessif- DÉBA-Jeu") 3 months post-admission	6.29 score on a scale Standard Deviation .90	7.90 score on a scale Standard Deviation 1.07
Detection of Gambling Problems and Services Need ("Détection et Besoin d'Aide en Regard du Jeu Excessif- DÉBA-Jeu") 9 months post-admission	4.47 score on a scale Standard Deviation .95	6.01 score on a scale Standard Deviation 1.14
Detection of Gambling Problems and Services Need ("Détection et Besoin d'Aide en Regard du Jeu Excessif- DÉBA-Jeu") 18 months post-admission	4.47 score on a scale Standard Deviation .98	6.26 score on a scale Standard Deviation 1.27

PRIMARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome measure for Gamblers

The Canadian Problem Gambling Index (CPGI) is a 9-item measure with a 4-point Likert-type scale (0 = Never, 3 = Almost always).It asks questions about an individual's gambling habits in the last three months from four categories:

Gambling involvement; Problem gambling behaviour; Adverse Consequences; Correlates of problem gambling.

Scores for the nine items are summed, and the results are interpreted as follows: 0 = non-problem ; 1-4 = low risk; 5-7 = moderate risk; 8 and + (maximum 27) = probable pathological player.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Canadian Problem Gambling Index (CPGI) 18 months post-admission	4.26 score on a scale Standard Deviation .83	4.91 score on a scale Standard Deviation 1.08
Canadian Problem Gambling Index (CPGI) Admission	14.85 score on a scale Standard Deviation .74	15.68 score on a scale Standard Deviation .82
Canadian Problem Gambling Index (CPGI) 3 months post-admission	5.86 score on a scale Standard Deviation .77	6.97 score on a scale Standard Deviation .89
Canadian Problem Gambling Index (CPGI) 9 months post-admission	3.98 score on a scale Standard Deviation .80	5.31 score on a scale Standard Deviation .97

PRIMARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome measure for Gamblers

Total Money spent in canadian dollars for all gambling activities during the last 3 months previous each research interview.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Canadian Dollars Spent on Gambling Admission	4587.87 canadian dollars Standard Deviation 483.66	4244.70 canadian dollars Standard Deviation 534.75
Canadian Dollars Spent on Gambling 9 months post-admission	351.49 canadian dollars Standard Deviation 517.16	390.14 canadian dollars Standard Deviation 620.98
Canadian Dollars Spent on Gambling 3 months post-admission	452.53 canadian dollars Standard Deviation 500.54	825.71 canadian dollars Standard Deviation 582.02
Canadian Dollars Spent on Gambling 18 months post-admission	1062.09 canadian dollars Standard Deviation 535.53	446.57 canadian dollars Standard Deviation 681.53

PRIMARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Gamblers

The ICOG is used to measure two aspects of control related to the JHA processes, namely the level of control over the desire to start playing (e.g., when I decide not to play, I watch stick to that decision) as well as the level of control once the game has started (e.g., when I knew I had little time to play, I would limit myself to the scheduled time). This questionnaire has a total of 10 items and uses a 5-point Likert-type scale ranging from "Never = 1" to "Always = 5", with 4 inverted items.

The total score varies between 10 and 50. A high control represents a score between 10 and 16, a moderate control between 17 and 23 and a score of 24 and more presents a low control in the player.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Impaired Control Over Gambling Scale (ICOG) 3 months post-admission	17.89 score on a scale Standard Deviation 1.34	22.31 score on a scale Standard Deviation 1.58
Impaired Control Over Gambling Scale (ICOG) 9 months post-admission	16.11 score on a scale Standard Deviation 1.41	20.59 score on a scale Standard Deviation 1.69
Impaired Control Over Gambling Scale (ICOG) 18 months post-admission	15.69 score on a scale Standard Deviation 1.45	18.26 score on a scale Standard Deviation 1.86
Impaired Control Over Gambling Scale (ICOG) Admission	35.95 score on a scale Standard Deviation 1.29	37.92 score on a scale Standard Deviation 1.44

PRIMARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Gamblers

This questionnaire measures people's beliefs about gambling. The ICROLJ has 29 items and uses a 4-point Likert-type scale ranging from "Strongly disagree" = 0 to "Strongly agree"=4. To compute a total score, all item' score are summed. The total score ranges from 0 to 116.Higher the score is, more it indicates the presence of erroneous beliefs.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Inventory of Erroneous Beliefs Related to Gambling ("Inventaire Des Croyances liées Aux Jeux" - ICROLJ)-Gambler Admission	52.67 score on a scale Standard Deviation 1.38	54.23 score on a scale Standard Deviation 1.53
Inventory of Erroneous Beliefs Related to Gambling ("Inventaire Des Croyances liées Aux Jeux" - ICROLJ)-Gambler 3 months post-admission	39.44 score on a scale Standard Deviation 1.44	44.78 score on a scale Standard Deviation 1.67
Inventory of Erroneous Beliefs Related to Gambling ("Inventaire Des Croyances liées Aux Jeux" - ICROLJ)-Gambler 9 months post-admission	39.11 score on a scale Standard Deviation 1.48	43.26 score on a scale Standard Deviation 1.79
Inventory of Erroneous Beliefs Related to Gambling ("Inventaire Des Croyances liées Aux Jeux" - ICROLJ)-Gambler 18 months post-admission	38.90 score on a scale Standard Deviation 1.56	43.86 score on a scale Standard Deviation 1.94

PRIMARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Gamblers

Short questionnaire of 10 items, assessing to what extent the respondent considers his gambling habits in the last 6 months have harmed various aspects of his life (financial, living conditions, marital, physical health, professional life, social, legal and family). A 5-point Likert-type scale is used "Not at all = 0" to "Extremely = 4". To compute a total score, all item' score are summed. The total score ranges from 0 to 40.Higher the score is, more it's indicate that the respondent is experiencing negative impacts because of his gambling habits.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Negative Gambling Consequences-Gambler 3 months post-admission	6.84 score on a scale Standard Deviation 1.12	8.04 score on a scale Standard Deviation 1.30
Negative Gambling Consequences-Gambler Admission	16.83 score on a scale Standard Deviation 1.06	18.56 score on a scale Standard Deviation 1.17
Negative Gambling Consequences-Gambler 9 months post-admission	4.96 score on a scale Standard Deviation 1.14	5.41 score on a scale Standard Deviation 1.38
Negative Gambling Consequences-Gambler 18 months post-admission	4.40 score on a scale Standard Deviation 1.32	5.22 score on a scale Standard Deviation 1.61

PRIMARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Partners

Short questionnaire of 10 items, assessing to what extent the respondent considers that his partner's gambling habits have harmed various aspects of his life in the last 6 months (financial, living conditions, marital, physical health, professional life, social, legal and family). A 5-point Likert-type scale is used "Not at all = 0" to "Extremely = 4". To compute a total score, all item' score are summed. The total score ranges from 0 to 40. Higher the score is, more it's indicate that the respondent is experiencing negative impacts because of his partner's gambling habits.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Negative Gambling Consequences-Partner 3 months post-admission	8.57 score on a scale Standard Deviation 0.67	9.38 score on a scale Standard Deviation 0.76
Negative Gambling Consequences-Partner 9 months post-admission	5.30 score on a scale Standard Deviation 0.68	5.13 score on a scale Standard Deviation 0.79
Negative Gambling Consequences-Partner 18 months post-admission	5.89 score on a scale Standard Deviation 0.74	6.59 score on a scale Standard Deviation 0.89
Negative Gambling Consequences-Partner Admission	17.65 score on a scale Standard Deviation 0.65	17.77 score on a scale Standard Deviation 0.72

PRIMARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Partners

This questionnaire measures people's beliefs about gambling. The ICROLJ has 29 items and uses a 4-point Likert-type scale ranging from "Strongly disagree" = 0 to "Strongly agree"=4.

To compute a total score, all item' score are summed. The total score ranges from 0 to 116. Higher the score is, more it indicates the presence of erroneous beliefs.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Inventory of Erroneous Beliefs Related to Gambling ("Inventaire Des Croyances liées Aux Jeux" - ICROLJ)-Partner 3 months post-admission	35.03 score on a scale Standard Deviation 0.99	43.22 score on a scale Standard Deviation 1.12
Inventory of Erroneous Beliefs Related to Gambling ("Inventaire Des Croyances liées Aux Jeux" - ICROLJ)-Partner 9 months post-admission	37.12 score on a scale Standard Deviation 1.01	42.84 score on a scale Standard Deviation 1.13
Inventory of Erroneous Beliefs Related to Gambling ("Inventaire Des Croyances liées Aux Jeux" - ICROLJ)-Partner Admission	40.74 score on a scale Standard Deviation 0.98	41.05 score on a scale Standard Deviation 1.08
Inventory of Erroneous Beliefs Related to Gambling ("Inventaire Des Croyances liées Aux Jeux" - ICROLJ)-Partner 18 months post-admission	37.38 score on a scale Standard Deviation 1.02	41.08 score on a scale Standard Deviation 1.19

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row..

Outcome Measure for Partners

This questionnaire measure the quality of the support received and given perceived by the two members of the couple. It consists of a total of 8 questions, with a 5-point Likert scale (1 = never; 5 = always).

The total score shows support received and support gave, higher is the result, more it indicates that the member of the couple gave support and receives it (score min = 0 and score max=40).

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Conjugal Support Questionnaire (CSQ)-Partner 9 months post-admission	30.83 score on a scale Standard Deviation 0.47	31.09 score on a scale Standard Deviation 0.54
Conjugal Support Questionnaire (CSQ)-Partner Admission	29.93 score on a scale Standard Deviation 0.46	29.90 score on a scale Standard Deviation 0.51
Conjugal Support Questionnaire (CSQ)-Partner 3 months post-admission	32.05 score on a scale Standard Deviation 0.47	29.46 score on a scale Standard Deviation 0.53
Conjugal Support Questionnaire (CSQ)-Partner 18 months post-admission	31.85 score on a scale Standard Deviation 0.49	30.99 score on a scale Standard Deviation 0.58

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Partners

This instrument is used to measure psychological distress, including symptoms of depression and anxiety. We used the version of the questionnaire with 14 items. A Likert-type scale ranging from "never = 1" to "very often = 3" is used and the respondent must respond according to their condition during the last seven days. To compute a total score, all item' score are summed. The total score ranges from 0 to 42. A score of 26 and above indicates a high level of psychological distress.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Psychological Distress Index (IDPESQ-14)-Partner 3 months post-admission	12.76 score on a scale Standard Deviation .99	16.4 score on a scale Standard Deviation 1.13
Psychological Distress Index (IDPESQ-14)-Partner 18 months post-admission	13.45 score on a scale Standard Deviation 1.04	16.96 score on a scale Standard Deviation 1.25
Psychological Distress Index (IDPESQ-14)-Partner Admission	23.75 score on a scale Standard Deviation .97	22.38 score on a scale Standard Deviation 1.08
Psychological Distress Index (IDPESQ-14)-Partner 9 months post-admission	11.94 score on a scale Standard Deviation 1.01	17.03 score on a scale Standard Deviation 1.16

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Partners

This instrument is used to measure depressive symptoms in an individual. It measures these symptoms as defined in the American Psychiatric Association Diagnostic and Statistical Manual (DSM-IV) for depressive episodes.This questionnaire has 20 items and it assesses how the psychological well-being of the person during the last week. A 4-point Likert-type scale is used ranging from "0 = Never, very rarely (less than a day)" to a rating of "3 = Frequently, all the time (5 to 7 days)" The score can therefore vary from 0 to 60, the higher it is the higher the risk of depression. For a man, a threshold of 17 indicates a risk of depression and for a woman the same threshold is 23.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Center for Epidemiologic Studies Depression Scale (CES-D)-Partner Admission	16.71 score on a scale Standard Deviation .76	15.67 score on a scale Standard Deviation .85
Center for Epidemiologic Studies Depression Scale (CES-D)-Partner 3 months post-admission	8.81 score on a scale Standard Deviation .78	11.63 score on a scale Standard Deviation .89
Center for Epidemiologic Studies Depression Scale (CES-D)-Partner 9 months post-admission	8.37 score on a scale Standard Deviation .79	12.46 score on a scale Standard Deviation .92
Center for Epidemiologic Studies Depression Scale (CES-D)-Partner 18 months post-admission	8.07 score on a scale Standard Deviation .82	11.81 score on a scale Standard Deviation .99

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Gamblers

This instrument is used to measure psychological distress, including symptoms of depression and anxiety. We used the version of the questionnaire with 14 items. A Likert-type scale ranging from "never = 1" to "very often = 3" is used and the respondent must respond according to their condition during the last seven days. To compute a total score, all item' score are summed. The total score ranges from 0 to 42. A score of 26 and above indicates a high level of psychological distress.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Psychological Distress Index (IDPESQ-14)-Gambler Admission	18.83 score on a scale Standard Deviation 1.43	20.58 score on a scale Standard Deviation 1.58
Psychological Distress Index (IDPESQ-14)-Gambler 3 months post-admission	14.45 score on a scale Standard Deviation 1.48	14.04 score on a scale Standard Deviation 1.73
Psychological Distress Index (IDPESQ-14)-Gambler 9 months post-admission	10.19 score on a scale Standard Deviation 1.53	15.26 score on a scale Standard Deviation 1.84
Psychological Distress Index (IDPESQ-14)-Gambler 18 months post-admission	12.24 score on a scale Standard Deviation 1.59	13.43 score on a scale Standard Deviation 2.04

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Gamblers

This instrument is used to measure depressive symptoms in an individual. It measures these symptoms as defined in the American Psychiatric Association Diagnostic and Statistical Manual (DSM-IV) for depressive episodes.This questionnaire has 20 items and it assesses how the psychological well-being of the person during the last week. A 4-point Likert-type scale is used ranging from "0 = Never, very rarely (less than a day)" to a rating of "3 = Frequently, all the time (5 to 7 days)" The score can therefore vary from 0 to 60, the higher it is the higher the risk of depression. For a man, a threshold of 17 indicates a risk of depression and for a woman the same threshold is 23.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Center for Epidemiologic Studies Depression Scale (CES-D)-Gambler Admission	14.88 score on a scale Standard Deviation 1.03	15.56 score on a scale Standard Deviation 1.14
Center for Epidemiologic Studies Depression Scale (CES-D)-Gambler 3 months post-admission	9.08 score on a scale Standard Deviation 1.06	11.86 score on a scale Standard Deviation 1.24
Center for Epidemiologic Studies Depression Scale (CES-D)-Gambler 9 months post-admission	8.29 score on a scale Standard Deviation 1.10	10.96 score on a scale Standard Deviation 1.33
Center for Epidemiologic Studies Depression Scale (CES-D)-Gambler 18	9.01 score on a scale Standard Deviation 1.15	10.22 score on a scale Standard Deviation 1.48

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Gamblers

This questionnaire makes it possible to measure the quality of the support received and given perceived by the two members of the couple. It consists of a total of 8 questions, with a 5-point Likert scale (1 = never; 5 = always).

The total score shows support received and support gave, higher is the result, more it indicates that the member of the couple gave support and receives it (score min = 0 and score max=40).

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Conjugal Support Questionnaire(CSQ)-Gambler Admission	31.10 score on a scale Standard Deviation .46	30.68 score on a scale Standard Deviation .51
Conjugal Support Questionnaire(CSQ)-Gambler 3 months post-admission	32.65 score on a scale Standard Deviation .48	30.77 score on a scale Standard Deviation .56
Conjugal Support Questionnaire(CSQ)-Gambler 9 months post-admission	33.30 score on a scale Standard Deviation .49	30.64 score on a scale Standard Deviation .59
Conjugal Support Questionnaire(CSQ)-Gambler 18 months post-admission	33.67 score on a scale Standard Deviation .54	29.66 score on a scale Standard Deviation .67

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Partners

The MSI is used to measure marital stability in a couple. It comprises a series of 14 items (with inverted items) in a "true" or "false" format thus aiming to assess the risk of separation in this couple (e.g., I very often have ideas of divorce, until once a week or more). Marital distress is measured in terms of concrete actions taken by members of the couple in order to end their union. The total score is between 0 and 14. The higher the scores, the higher the risk of separation and marital distress. A threshold of 8 is considered to be a severe indicator of separation.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Marital Status Inventory (MSI)-Partner Admission	4.14 score on a scale Standard Deviation 0.23	4.10 score on a scale Standard Deviation 0.26
Marital Status Inventory (MSI)-Partner 3 months post-admission	2.19 score on a scale Standard Deviation 0.24	3.59 score on a scale Standard Deviation 0.27
Marital Status Inventory (MSI)-Partner 9 months post-admission	2.26 score on a scale Standard Deviation 0.24	2.15 score on a scale Standard Deviation 0.28
Marital Status Inventory (MSI)-Partner 18 months post-admission	2.17 score on a scale Standard Deviation 0.25	3.33 score on a scale Standard Deviation 0.31

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Gamblers

The MSI is used to measure marital stability in a couple.

It comprises a series of 14 items (with inverted items) in a "true" or "false" format thus aiming to assess the risk of separation in this couple (e.g., I very often have ideas of divorce, until once a week or more). Marital distress is measured in terms of concrete actions taken by members of the couple in order to end their union. The total score is between 0 and 14. The higher the scores, the higher the risk of separation and marital distress. A threshold of 8 is considered to be a severe indicator of separation.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Marital Status Inventory (MSI)-Gambler 18 months post-admission	1.27 score on a scale Standard Deviation .30	3.63 score on a scale Standard Deviation .38
Marital Status Inventory (MSI)-Gambler Admission	2.02 score on a scale Standard Deviation 0.25	2.18 score on a scale Standard Deviation 0.28
Marital Status Inventory (MSI)-Gambler 3 months post-admission	1.48 score on a scale Standard Deviation 0.26	1.91 score on a scale Standard Deviation 0.30
Marital Status Inventory (MSI)-Gambler 9 months post-admission	1.90 score on a scale Standard Deviation 0.27	1.65 score on a scale Standard Deviation 0.32

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Partners

The Dyadic Adjustment Scale is an ultra-brief measure degree of marital satisfaction within the couple.

The short version is made up of only 4 items (considered divorce, estimation of the quality of the relation, confide to mate, degree of happiness): three of which are on a 6-point Likert scale ranging from 0 (all the time) to 5 (never) , while the final item is on a 7-point scale ranging from 0 (extremely happy) to 6 (perfect).

Theoretically possible maximum score of 21, and minimum 0. Scores lower than 11 indicating relationship distress, scores between 12 and 14 corresponding to medium satisfaction and scores upper 15 indicating good marital satisfaction.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Dyadic Adjustment Scale (DAS-4)-Partner 18 months post-admission	15.05 score on a scale Standard Deviation 0.35	12.38 score on a scale Standard Deviation 0.41
Dyadic Adjustment Scale (DAS-4)-Partner Admission	11.67 score on a scale Standard Deviation 0.32	11.29 score on a scale Standard Deviation 0.35
Dyadic Adjustment Scale (DAS-4)-Partner 3 months post-admission	15.42 score on a scale Standard Deviation 0.32	13.28 score on a scale Standard Deviation 0.37
Dyadic Adjustment Scale (DAS-4)-Partner 9 months post-admission	15.35 score on a scale Standard Deviation 0.34	14.76 score on a scale Standard Deviation 0.38

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Gamblers

The Dyadic Adjustment Scale is an ultra-brief measure degree of marital satisfaction within the couple.

The short version is made up of only 4 items (considered divorce, estimation of the quality of the relation, confide to mate, degree of happiness): three of which are on a 6-point Likert scale ranging from 0 (all the time) to 5 (never) , while the final item is on a 7-point scale ranging from 0 (extremely happy) to 6 (perfect).

Theoretically possible maximum score of 21, and minimum 0. Scores lower than 11 indicating relationship distress, scores between 12 and 14 corresponding to medium satisfaction and scores upper 15 indicating good marital satisfaction.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Dyadic Adjustment Scale (DAS-4)-Gambler Admission	11.96 score on a scale Standard Deviation 0.48	11.20 score on a scale Standard Deviation 0.53
Dyadic Adjustment Scale (DAS-4)-Gambler 3 months post-admission	15.09 score on a scale Standard Deviation 0.49	14.29 score on a scale Standard Deviation 0.58
Dyadic Adjustment Scale (DAS-4)-Gambler 9 months post-admission	16.08 score on a scale Standard Deviation 0.51	14.49 score on a scale Standard Deviation 0.61
Dyadic Adjustment Scale (DAS-4)-Gambler 18 months post-admission	15.43 score on a scale Standard Deviation 0.55	12.30 score on a scale Standard Deviation 0.70

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Gamblers

The psychological violence suffered is a subscale of the CTS-2 questionnaire which aims to assess the manifestations of psychological violence committed against the Gambler in the last 3 months. It is made up of 14 items that are rated on a 7-point Likert scale (never happened = 0, 1 time = 1, 2 times = 2, 3 to 5 times = 3, 6 to 10 times = 4, 11 to 20 = 5, more than 20 times = 6). To compute a total score, all item' score are summed. The total score ranges from 0 to 84. The higher it is, more it indicates that the respondent has suffered episodes of violence.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Conflict Tactics Scale-2_Psychological Violence Issued by the Partner 18 months post-admission	7.96 score on a scale Standard Deviation 2.05	14.52 score on a scale Standard Deviation 2.58
Conflict Tactics Scale-2_Psychological Violence Issued by the Partner Admission	19.64 score on a scale Standard Deviation 1.78	19.17 score on a scale Standard Deviation 1.95
Conflict Tactics Scale-2_Psychological Violence Issued by the Partner 3 months post-admission	13.38 score on a scale Standard Deviation 1.84	14.16 score on a scale Standard Deviation 2.12
Conflict Tactics Scale-2_Psychological Violence Issued by the Partner 9 months post-admission	8.65 score on a scale Standard Deviation 1.94	12.46 score on a scale Standard Deviation 2.32

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Partners

This lists of skills consist of 17 items that expressed in statements representing observable verbal behaviors.Participants were asked to report frequency estimates of their own use of such verbal behaviors using a 4 point likert scale (0 = almost never, 4 = almost always). To compute a total score, all item' score are summed. The total score ranges from 0 to 68. The higher the score is, more it indicates the presence of good communication skills.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Interpersonal Communication Skills Inventory-self _Partner Admission	37.39 score on a scale Standard Deviation .53	36.99 score on a scale Standard Deviation .58
Interpersonal Communication Skills Inventory-self _Partner 3 months post-admission	38.69 score on a scale Standard Deviation .54	38.45 score on a scale Standard Deviation .61
Interpersonal Communication Skills Inventory-self _Partner 9 months post-admission	39.73 score on a scale Standard Deviation .54	38.42 score on a scale Standard Deviation .62
Interpersonal Communication Skills Inventory-self _Partner 18 months post-admission	39.82 score on a scale Standard Deviation .57	39.24 score on a scale Standard Deviation .67

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Gamblers

This instrument has 9 items, using a 7-point Likert-type scale. It is used in order to better understand the negotiation and conflict resolution skills that the couple members have used within their marital relationship in the last three months.

The score varies between 9 and 63. A high score indicates a greater degree of perceived problem-solving skill within the marital relationship.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Marital Problem Solving Scale (MPSS)-Gambler Admission	45.95 score on a scale Standard Deviation .95	44.67 score on a scale Standard Deviation 1.05
Marital Problem Solving Scale (MPSS)-Gambler 3 months post-admission	48.53 score on a scale Standard Deviation .98	46.63 score on a scale Standard Deviation 1.15
Marital Problem Solving Scale (MPSS)-Gambler 9 months post-admission	48.3 score on a scale Standard Deviation 1.02	44.75 score on a scale Standard Deviation 1.23
Marital Problem Solving Scale (MPSS)-Gambler 18 months post-admission	48.29 score on a scale Standard Deviation 1.12	44.7 score on a scale Standard Deviation 1.4

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Gamblers

This questionnaire is used to identify the coping strategies used to cope with gambling's habits in the last three months. The subscale is made up of 6 items marked from 0 to 3 (0 = not used; 3 = used a lot). To compute a total score, all item' score are summed. The total score ranges from 0 to 18. Higher the score is, more it indicates the respondent's tendency to adopt the behaviors described by the subscale when he is in a stressful situation.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Coping Skills _Social Support Sub-scale_Gambler Admission	5.24 score on a scale Standard Deviation .62	5.60 score on a scale Standard Deviation .69
Coping Skills _Social Support Sub-scale_Gambler 3 months post-admission	9.33 score on a scale Standard Deviation .64	6.92 score on a scale Standard Deviation .76
Coping Skills _Social Support Sub-scale_Gambler 9 months post-admission	5.36 score on a scale Standard Deviation .68	4.76 score on a scale Standard Deviation .80
Coping Skills _Social Support Sub-scale_Gambler 18 months post-admission	4.12 score on a scale Standard Deviation .77	3.00 score on a scale Standard Deviation .89

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome measure for Gamblers

Number of alcohol standard units (Canada, 1 unit = 13,6g of alcohol) per week during the last three months.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Standard Units of Alcoholic Drinks Per Week _Gambler Admission	5.46 standard units of alcoholic drinks Standard Deviation 1.10	4.96 standard units of alcoholic drinks Standard Deviation 1.22
Standard Units of Alcoholic Drinks Per Week _Gambler 3 months post-admission	7.35 standard units of alcoholic drinks Standard Deviation 1.14	4.15 standard units of alcoholic drinks Standard Deviation 1.33
Standard Units of Alcoholic Drinks Per Week _Gambler 9 months post-admission	3.70 standard units of alcoholic drinks Standard Deviation 1.18	4.28 standard units of alcoholic drinks Standard Deviation 1.43
Standard Units of Alcoholic Drinks Per Week _Gambler 18 months post-admission	3.99 standard units of alcoholic drinks Standard Deviation 1.25	7.47 standard units of alcoholic drinks Standard Deviation 1.59

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome measure for Gamblers

Frequency of cannabis use per week in the last three months with a 5-point Likert-type scale (never = 0, 3 times a week or more = 4). Higher the score is, more it indicates a high frequency of cannabis use.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Frequency of Cannabis Use Per week_Gambler 18 months post-admission	.36 score on a scale Standard Deviation .08	.54 score on a scale Standard Deviation .09
Frequency of Cannabis Use Per week_Gambler Admission	.46 score on a scale Standard Deviation .07	.41 score on a scale Standard Deviation .08
Frequency of Cannabis Use Per week_Gambler 3 months post-admission	.31 score on a scale Standard Deviation .07	.41 score on a scale Standard Deviation .08
Frequency of Cannabis Use Per week_Gambler 9 months post-admission	.33 score on a scale Standard Deviation .07	.41 score on a scale Standard Deviation .09

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome measure for Gamblers

The physical violence suffered is a subscale of the CTS-2 questionnaire which aims to assess the manifestations of physical violence committed against the Gambler in the last 3 months. It is made up of 18 items that are rated on a 7-point Likert scale (never happened = 0, 1 time = 1, 2 times = 2, 3 to 5 times = 3, 6 to 10 times = 4, 11 to 20 = 5, more than 20 times = 6). The total score corresponds to the average obtained on the 18 items, the higher it is, more it indicates that the respondent has suffered episodes of violence.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Conflict Tactics Scale-2 _ Physical Violence Issued by the Partner 3 months post-admission	0.82 score on a scale Standard Deviation .42	1.34 score on a scale Standard Deviation .38
Conflict Tactics Scale-2 _ Physical Violence Issued by the Partner 9 months post-admission	.87 score on a scale Standard Deviation .56	1.55 score on a scale Standard Deviation .46
Conflict Tactics Scale-2 _ Physical Violence Issued by the Partner 18 months post-admission	.38 score on a scale Standard Deviation .45	1.68 score on a scale Standard Deviation .40
Conflict Tactics Scale-2 _ Physical Violence Issued by the Partner Admission	0.47 score on a scale Standard Deviation .49	1.21 score on a scale Standard Deviation .42

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for the Partner

The physical violence suffered is a subscale of the CTS-2 questionnaire which aims to assess the manifestations of physical violence committed against the partner in the last 3 months. It is made up of 18 items that are rated on a 7-point Likert scale (never happened = 0, 1 time = 1, 2 times = 2, 3 to 5 times = 3, 6 to 10 times = 4, 11 to 20 = 5, more than 20 times = 6). The total score corresponds to the average obtained on the 18 items, the higher it is, more it indicates that the respondent has suffered episodes of violence.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Conflict Tactics Scale-2_ Physique Violence Issued by the Gambler 9 months post-admission	.94 score on a scale Standard Deviation .32	.79 score on a scale Standard Deviation .38
Conflict Tactics Scale-2_ Physique Violence Issued by the Gambler 18 months post-admission	.46 score on a scale Standard Deviation .34	1.56 score on a scale Standard Deviation .40
Conflict Tactics Scale-2_ Physique Violence Issued by the Gambler Admission	1.42 score on a scale Standard Deviation .31	1.69 score on a scale Standard Deviation .35
Conflict Tactics Scale-2_ Physique Violence Issued by the Gambler 3 months post-admission	1.23 score on a scale Standard Deviation .32	1.71 score on a scale Standard Deviation .36

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Partners

The psychological violence suffered is a subscale of the CTS-2 questionnaire which aims to assess the manifestations of psychological violence committed against the partner in the last 3 months. It is made up of 14 items that are rated on a 7-point Likert scale (never happened = 0, 1 time = 1, 2 times = 2, 3 to 5 times = 3, 6 to 10 times = 4, 11 to 20 = 5, more than 20 times = 6). To compute a total score, all item' score are summed. The total score ranges from 0 to 84. The higher it is, more it indicates that the respondent has suffered episodes of violence.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Conflict Tactics Scale-2 _ Psychological Violence Issued by the Gambler 9 months post-admission	14.91 score on a scale Standard Deviation 1.46	16.52 score on a scale Standard Deviation 1.66
Conflict Tactics Scale-2 _ Psychological Violence Issued by the Gambler 18 months post-admission	11.09 score on a scale Standard Deviation 1.54	17.00 score on a scale Standard Deviation 1.81
Conflict Tactics Scale-2 _ Psychological Violence Issued by the Gambler Admission	21.50 score on a scale Standard Deviation 1.40	23.44 score on a scale Standard Deviation 1.53
Conflict Tactics Scale-2 _ Psychological Violence Issued by the Gambler 3 months post-admission	17.44 score on a scale Standard Deviation 1.43	18.36 score on a scale Standard Deviation 1.61

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome measure for Gamblers

This questionnaire is used to identify the coping strategies used to cope with gambling's habits in the last three months. The subscale is made up of 9 items marked from 0 to 3 (0 = not used; 3 = used a lot). To compute a total score, all item' score are summed. The total score ranges from 0 to 27. Higher the score is, more it indicates the respondent's tendency to adopt the behaviors described by the subscale when he is in a stressful situation.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Coping Skills _Positive Reevaluation/Problem Solving Sub-scale_Gambler Admission	10.08 score on a scale Standard Deviation 1.08	9.90 score on a scale Standard Deviation 1.21
Coping Skills _Positive Reevaluation/Problem Solving Sub-scale_Gambler 3 months post-admission	15.48 score on a scale Standard Deviation 1.12	13.12 score on a scale Standard Deviation 1.33
Coping Skills _Positive Reevaluation/Problem Solving Sub-scale_Gambler 18 months post-admission	9.25 score on a scale Standard Deviation 1.34	8.52 score on a scale Standard Deviation 1.55
Coping Skills _Positive Reevaluation/Problem Solving Sub-scale_Gambler 9 months post-admission	10.69 score on a scale Standard Deviation 1.19	10.79 score on a scale Standard Deviation 1.40

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome measure for Gamblers

This questionnaire is used to identify the coping strategies used to cope with gambling's habits in the last three months. The subscale is made up of 6 items marked from 0 to 3 (0 = not used; 3 = used a lot). To compute a total score, all item' score are summed. The total score ranges from 0 to 18.Higher the score is, more it indicates the respondent's tendency to adopt the behaviors described by the subscale when he is in a stressful situation.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Coping Skills _Distancing / Withdrawal Sub-scale_Gambler Admission	8.14 score on a scale Standard Deviation .48	9.22 score on a scale Standard Deviation .54
Coping Skills _Distancing / Withdrawal Sub-scale_Gambler 3 months post-admission	4.85 score on a scale Standard Deviation .50	5.3 score on a scale Standard Deviation .59
Coping Skills _Distancing / Withdrawal Sub-scale_Gambler 9 months post-admission	2.78 score on a scale Standard Deviation .53	4.72 score on a scale Standard Deviation .62
Coping Skills _Distancing / Withdrawal Sub-scale_Gambler 18 months post-admission	2.11 score on a scale Standard Deviation .6	2.49 score on a scale Standard Deviation .69

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Partners This instrument has 9 items, using a 7-point Likert-type scale. It is used in order to better understand the negotiation and conflict resolution skills that the couple members have used within their marital relationship in the last three months.The score varies between 9 and 63. A high score indicates a greater degree of perceived problem-solving skill within the marital relationship.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Marital Problem Solving Scale (MPSS)-Partner 18 months post-admission	48.75 score on a scale Standard Deviation .73	48.54 score on a scale Standard Deviation .88
Marital Problem Solving Scale (MPSS)-Partner Admission	44.14 score on a scale Standard Deviation .67	43.53 score on a scale Standard Deviation .74
Marital Problem Solving Scale (MPSS)-Partner 3 months post-admission	48.58 score on a scale Standard Deviation .68	47.02 score on a scale Standard Deviation .77
Marital Problem Solving Scale (MPSS)-Partner 9 months post-admission	47.9 score on a scale Standard Deviation .69	48.62 score on a scale Standard Deviation .8

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Gamblers

This lists of skills consist of 17 items that expressed in statements representing observable verbal behaviors.Participants were asked to report frequency estimates of their own use of such verbal behaviors using a 4 point likert scale (0 = almost never, 4 = almost always). To compute a total score, all item' score are summed. The total score ranges from 0 to 68.The higher the score is, more it indicates the presence of good communication skills.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Interpersonal Communication Skills Inventory-self _Gambler Admission	34.34 score on a scale Standard Deviation .9	33.48 score on a scale Standard Deviation 1.00
Interpersonal Communication Skills Inventory-self _Gambler 3 months post-admission	38.57 score on a scale Standard Deviation .94	34.48 score on a scale Standard Deviation 1.09
Interpersonal Communication Skills Inventory-self _Gambler 9 months post-admission	37.41 score on a scale Standard Deviation .97	35.66 score on a scale Standard Deviation 1.17
Interpersonal Communication Skills Inventory-self _Gambler 18 months post-admission	39.68 score on a scale Standard Deviation 1.06	35.86 score on a scale Standard Deviation 1.32

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Partners

This questionnaire is used to identify coping strategies to cope with stressful situations caused by their spouse's gambling habits in the last three months. The subscale is made up of 6 items marked from 0 to 3 (0 = not used; 3 = used a lot). To compute a total score, all item' score are summed. The total score ranges from 0 to 18.Higher the score is, more it indicates the respondent's tendency to adopt the behaviors described by the subscale when he is in a stressful situation.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Coping Skills _Social Support Sub-scale_Partner Admission	8.54 score on a scale Standard Deviation 0.61	8.50 score on a scale Standard Deviation 0.67
Coping Skills _Social Support Sub-scale_Partner 3 months post-admission	8.71 score on a scale Standard Deviation 0.62	6.02 score on a scale Standard Deviation 0.70
Coping Skills _Social Support Sub-scale_Partner 9 months post-admission	6.40 score on a scale Standard Deviation 0.63	5.63 score on a scale Standard Deviation 0.71
Coping Skills _Social Support Sub-scale_Partner 18 months post-admission	7.10 score on a scale Standard Deviation 0.70	8.11 score on a scale Standard Deviation 0.80

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Partners

This questionnaire is used to identify coping strategies to cope with stressful situations caused by their spouse's gambling habits in the last three months. The subscale is made up of 6 items marked from 0 to 3 (0 = not used; 3 = used a lot). To compute a total score, all item' score are summed. The total score ranges from 0 to 18.Higher the score is, more it indicates the respondent's tendency to adopt the behaviors described by the subscale when he is in a stressful situation.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Coping Skills _Distancing / Withdrawal Sub-scale_Partner Admission	5.38 score on a scale Standard Deviation 0.31	5.69 score on a scale Standard Deviation 0.34
Coping Skills _Distancing / Withdrawal Sub-scale_Partner 3 months post-admission	2.95 score on a scale Standard Deviation 0.32	3.30 score on a scale Standard Deviation 0.36
Coping Skills _Distancing / Withdrawal Sub-scale_Partner 9 months post-admission	2.50 score on a scale Standard Deviation 0.32	3.39 score on a scale Standard Deviation 0.36
Coping Skills _Distancing / Withdrawal Sub-scale_Partner 18 months post-admission	2.48 score on a scale Standard Deviation 0.36	3.30 score on a scale Standard Deviation 0.42

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome Measure for Partners

This questionnaire is used to identify coping strategies to cope with stressful situations caused by their spouse's gambling habits in the last three months. The subscale is made up of 9 items marked from 0 to 3 (0 = not used; 3 = used a lot). To compute a total score, all item' score are summed. The total score ranges from 0 to 27.Higher the score is, more it indicates the respondent's tendency to adopt the behaviors described by the subscale when he is in a stressful situation.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Coping Skills_Positive Reevaluation/Problem Solving Sub-scale_Partner 3 months post-admission	8.71 score on a scale Standard Deviation 0.62	6.02 score on a scale Standard Deviation 0.70
Coping Skills_Positive Reevaluation/Problem Solving Sub-scale_Partner 9 months post-admission	6.40 score on a scale Standard Deviation 0.63	5.63 score on a scale Standard Deviation 0.71
Coping Skills_Positive Reevaluation/Problem Solving Sub-scale_Partner 18 months post-admission	7.10 score on a scale Standard Deviation 0.70	8.11 score on a scale Standard Deviation 0.80
Coping Skills_Positive Reevaluation/Problem Solving Sub-scale_Partner Admission	8.54 score on a scale Standard Deviation 0.61	8.50 score on a scale Standard Deviation 0.67

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome measure for Partners

Number of alcohol standard units (Canada, 1 unit = 13,6g of alcohol) per week during the last three months.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Standard Units of Alcoholic Drinks Per Week _Partner 18 months post-admission	3.40 standard units of alcoholic drinks Standard Deviation 0.42	3.47 standard units of alcoholic drinks Standard Deviation 0.49
Standard Units of Alcoholic Drinks Per Week _Partner Admission	4.04 standard units of alcoholic drinks Standard Deviation 0.40	3.89 standard units of alcoholic drinks Standard Deviation 0.44
Standard Units of Alcoholic Drinks Per Week _Partner 3 months post-admission	3.98 standard units of alcoholic drinks Standard Deviation 0.40	3.87 standard units of alcoholic drinks Standard Deviation 0.45
Standard Units of Alcoholic Drinks Per Week _Partner 9 months post-admission	4.08 standard units of alcoholic drinks Standard Deviation 0.41	3.69 standard units of alcoholic drinks Standard Deviation 0.46

SECONDARY outcome

Timeframe: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)

Population: Analysis Population is based on all participants (n= 80 couples) enrolled in the study. Over the 18 months of follow-up, a slight attrition of participants can be observed, explaining the difference between the overall number of participants analyzed and the number of participants analyzed per row.

Outcome measure for Partners

Frequency of cannabis use per week in the last three months with a 5-point Likert-type scale (never = 0, 3 times a week or more = 4). Higher the score is, more it indicates a high frequency of cannabis use.

Outcome measures

Measure	Integrative Couple Treatment for Pathological Gambling (ICT-PG) n=44 Participants Couple therapy: The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Treatment for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).	Usual Individual/Group Treatment n=36 Participants Usual individual/group treatment: The control group receive individual or group treatment as already offered by the specialized centers in addiction.Their partner can receive individual intervention if desired.
Frequency of Cannabis Use Per week_Partner Admission	0.24 score on a scale Standard Deviation 0.05	0.22 score on a scale Standard Deviation 0.06
Frequency of Cannabis Use Per week_Partner 3 months post-admission	0.29 score on a scale Standard Deviation 0.05	0.32 score on a scale Standard Deviation 0.06
Frequency of Cannabis Use Per week_Partner 9 months post-admission	0.21 score on a scale Standard Deviation 0.06	0.29 score on a scale Standard Deviation 0.06
Frequency of Cannabis Use Per week_Partner 18 months post-admission	0.21 score on a scale Standard Deviation 0.06	0.35 score on a scale Standard Deviation 0.07

Adverse Events

Integrative Couple Treatment for Pathological Gambling (ICT-PG)

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Usual Individual/Group Treatment

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Joël Tremblay

Université du Québec à Trois-Rivières

Phone: 4186592170

Email: joel.tremblay@uqtr.ca

Results disclosure agreements

• Principal investigator is a sponsor employee
• Publication restrictions are in place