Integrative Couple Treatment for Gambling/Substance Use Disorder

NCT ID: NCT05833503

Last Updated: 2024-04-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-01

Study Completion Date

2026-02-28

Brief Summary

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The aim of the study is to compare couple-based treatment to individual treatment (treatment as usual) for addiction (gambling or substance use disorder).

Detailed Description

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Background:Couple-based intervention is one of the clinical innovations to increase access, retention and effectiveness of treatment in the field of addiction.Couple-based intervention for the treatment of problems related to gambling or substance use disorder (GD/SUD) is more effective than no treatment and the subjective experience of the members of the couple illustrates important clinical gains (better understanding addiction, resolve conflicts, etc.). A study conducted by the research team revealed a better effectiveness of couple-based treatment for GD than the individual treatment usually offered. Despite these positive results, this study highlighted a need to improve the couple intervention model (Integrative Couple Treatment for Pathological Gambling- ICT-PG). First of all, it did not allow to reach people having a SUD. Previous studies conducted by the research team also illustrated the need for more clinical work on serious relationship injuries caused by gambling. The investigators also accentuated their work on the strategies used by the partners and having an impact on the gambler's gambling behaviors.

Goal : Evaluate the effectiveness of a couple-based treatment (Integrative Couple Therapy for Addiction ICT-A; experimental group) compared to the individual treatment usually offer (control group) for people with GD/SUD.

Method/Design : A sample of at least 100 couples will be randomized to either ICT-A (experimental group) or the usual individual treatment (control group). The couple treatment called Integrative Couple Therapy for Addiction (ICT-A) 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 or substance use behaviors, b) helping the partner to stop behaviors facilitating gambling habits or substance use and rise the frequency of behaviors incompatible with gambling habits or substance use c) improve marital components (communication, sharing positive moments, negotiation, mutual support).The control group receives individual treatment as already offered by the specialized centers in addiction. All participants are recruited in Specialized Addiction Treatment Centers in Quebec Province, Canada. Repeated measures will be conducted at admission, 6, 12 and 18 months post-admission on the addiction's severity (primary outcome), on various couples' dimensions (secondary outcome) and various indicators of personal well-being (secondary outcome).In order to compare the effectiveness of the two treatment modalities, a series of regression analyzes will be carried out taking into account the correlation between the observations for the same individual and measurements repeated over time (linear mixed models; PROC MIXED of SAS).

Conditions

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Gambling Disorder Substance Use Disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomized to either Integrative Couple Therapy for Addiction (ICT-A, experimental group) or the usual individual treatment (control group).
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

These are two behavioral treatments.It is therefore impossible to mask the allocation of participants to either treatment, for both participants and clinicians.

Study Groups

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Integrative Couple Treatment for Addiction (ICT-A)

Inspired by the "Alcohol Behavior Couple Therapy" from Epstein \& McCrady, the ICT-A will be offered over 12 to 16 sessions of 90 minutes. Typically, approximately the first half of each session is dedicated to GD/SUD problems,in a predominantly cognitive behavioral model. In the second part of each session, the clinician will help the couple to improve their communication,to reduce the reinforcements (non-voluntary) of the behaviors of GD/SUD and to increase marital pleasure situations incompatible with the use of GD/SUD.Particular attention will also be paid to feelings of betrayal and interpersonal attacks to restore trust. Plus,they will received a sefl-care guide.

Group Type EXPERIMENTAL

Integrative Couple Treatment for Addiction (ICT-A)

Intervention Type BEHAVIORAL

Couple-based intervention called Integrative Couple Treatment for Addiction (ICT-A).

Individual treatment as usually offered

The usual treatment control group will receive individual treatment as already offered by the specialized centres in addiction.

For the person with GD/SUD, this treatment consists of 12 to 16 individual cognitive-behavioral sessions of 60 minutes. In general, the intervention aims to secure financial assets, awareness of erroneous thoughts and improvement of alternative skills to gambling in order to meet the normal demands of psychic and relational life. People undergoing this intervention will receive a self-care guide.

As for the partners randomized in this intervention, they will receive the services that are usually offered to members of the entourage of a person with GD/SUD. In groups or individually, these services are generally aimed at improving the partner's well-being and relationship with their spouse, which includes information about GD/SUD and the recovery process.

Group Type ACTIVE_COMPARATOR

Treatment individual as usually offered

Intervention Type BEHAVIORAL

Individual-based treatment as usually offer by the specialized centres in addiction.

Interventions

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Integrative Couple Treatment for Addiction (ICT-A)

Couple-based intervention called Integrative Couple Treatment for Addiction (ICT-A).

Intervention Type BEHAVIORAL

Treatment individual as usually offered

Individual-based treatment as usually offer by the specialized centres in addiction.

Intervention Type BEHAVIORAL

Other Intervention Names

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Couple therapy Treatment as usual (TAU)

Eligibility Criteria

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Inclusion Criteria

* The Gambler may have a gambling or substance use problem at the beginning of treatment AND is accepted for treatment by addiction rehabilitation centers (CRDs).
* The Gambler has engaged in gambling or substance use behaviors in the past three months (Time Line Follow-Back).
* The Partner may or may not engage in gambling, consume alcohol or other substances of abuse.
* Living in couple for at least six months OR report being in a significant relationship for at least two years.
* Neither member of the couple presents a mental health problem that could hinder their ability to participate in the therapeutic process.

Exclusion Criteria

* The Gambler has been completely abstinent from any gambling or substance use problem for the past three months.
* The Gambler received treatment for gambling disorder or substance abuse disorder during the last six months (excluding Gamblers Anonymous, Alcoholics Anonymous or Narcotics Anonymous).
* Low level of marital commitment between the couple in the past 2 weeks indicating a high risk of short-term separation (Marital Status Inventory, score ≥9)
* Presence of serious acts of violence committed within the past year endangering the safety or life of one of the spouses (Modified Conflict Tactics Scales: Answer YES to any question from Q27-33) OR use of services for victims of domestic violence in the past year.
* Presence of an active mental health disorder in either partner hindering therapeutic participation, such as a psychotic disorder OR a suicide attempt in the last 30 days (Psychological Scale of the Addiction Severity Index) OR severe borderline personality disorder (BSL-23 ≥2.8) OR excessively extreme antisocial behaviors (Conduct Disorder Scale from the GAIN ≥ 9).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Université du Québec a Montréal

OTHER

Sponsor Role collaborator

Université de Sherbrooke

OTHER

Sponsor Role collaborator

Laval University

OTHER

Sponsor Role collaborator

Université de Montréal

OTHER

Sponsor Role collaborator

Université du Québec à Trois-Rivières

OTHER

Sponsor Role lead

Responsible Party

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Joël Tremblay

PhD. Professor to department of psychoeducation

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Joël Tremblay, PhD

Role: PRINCIPAL_INVESTIGATOR

Université du Québec à Trois-Rivières

Locations

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Centre Intégré de Santé et de Services Sociaux de Lanaudière

Joliette, Quebec, Canada

Site Status RECRUITING

Centre intégré de Santé et de Services Sociaux de Chaudière-Appalaches (CISSS-CA)

Lévis, Quebec, Canada

Site Status RECRUITING

Centre Universitaire Intégré de Santé et de Services Sociaux du Centre Sud de l'Ile de Montréal

Montreal, Quebec, Canada

Site Status RECRUITING

Centre Intégré de Santé et de Services Sociaux de la Montérégie-Ouest

Saint-Hubert, Quebec, Canada

Site Status RECRUITING

Centre Intégré de Santé et de Services Sociaux des Laurentides

Saint-Jérôme, Quebec, Canada

Site Status RECRUITING

Centre Universitaire Intégré de Santé et de Services Sociaux de l'Estrie

Sherbrooke, Quebec, Canada

Site Status RECRUITING

Centre Universitaire Intégré de Santé et de Services Sociaux de la Capitale Nationale

Québec, , Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Joël Tremblay, PhD

Role: CONTACT

418-659-2170 ext. 2820

Myriam Beaulieu, M.Sc.

Role: CONTACT

418-659-2170 ext. 2807

Facility Contacts

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Joël Tremblay

Role: primary

4186592170 ext. 2820

Joël Tremblay, Ph.D.

Role: primary

418-659-2170 ext. 2820

Joël Tremblay

Role: primary

4186592170 ext. 2820

Joël Tremblay

Role: primary

4186592170 ext. 2820

Joël Tremblay

Role: primary

4186592170 ext. 2820

Joël Tremblay

Role: primary

4186592170 ext. 2820

Joël Tremblay

Role: primary

418-659-2170 ext. 2820

References

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Mccullough ME, Emmons RA, Tsang JA. The grateful disposition: a conceptual and empirical topography. J Pers Soc Psychol. 2002 Jan;82(1):112-27. doi: 10.1037//0022-3514.82.1.112.

Reference Type BACKGROUND
PMID: 11811629 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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FRQSC-2022-0JUL-307826

Identifier Type: -

Identifier Source: org_study_id

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