Background: This study aims to test the efficacy of a Cognitive Behavioral Therapy (CBT) combined with an initial therapeutical contract (TC) in a Portuguese  treatment centre for Problem Gamblers (PG) with variables like; gambling abstinence, self-exclusion, limited access to money, psychotherapy sessions for problem gambler and significant others, Gamblers Anonymous attendance, therapeutical exercises, pre-determined consequences if relapse, among others  and a Relapse Prevention Program (RPP). As far as we are aware, this is the first study that evaluates the efficacy of a psychotherapeutic program in the treatment of PG in Portugal.

Methods: The same self-questionnaire assessment data was collected at two different times: moment 1 (N = 150) of pre-treatment was completed after the first session and  moment 2 (N = 30), between the 15th and the 20th psychotherapy session. The protocol focused on socio demographics, gambling behavior’s, relapse questionnaire, gambling disorder assessment and other diagnostics measures.

Results: Preliminary results showed significant differences between moment 1 and moment 2 concerning the improvement of a psychological measure of quality of life; recovery in overall symptomatology (depression, anxiety, sensorial interference, obsession/compulsion and psychoticism) and decrease of motor impulsivity. It is expected that abstinent group will show differences in type/mode of gambling, and respective adherence to different variables of the TC at moment 2. Finally, different motivations seem to appear concerning the relapse process and its treatment and/or prevention.

Conclusion: This study shows how the combination of CBT, TC and RPP helps PG to achieve better results concerning abstinence from their addiction. This study may help clinicians to improve their understanding and intervention with patients and it provides information for responsible gambling interventions.

Pedro Hubert, PhD, Psychologist, specialist in health and clinical psychology, director of Gambler's Support Institute (IAJ) in Lisbon, Portugal. 

Problem gambler 's Helpline Coordinator (I.A.J.) since 2009 and the support line service provided to the Santa Casa Misericórdia Lisboa gambling department since 2015 and Sociedade Apostas Sociais line since 2018.

Clinical care/practice for addictive behaviours and particularly disorder gamblers and families since 2005 as well as clinical supervision.

Collaboration with SICAD National Health System, Universities and other Institutions in the area of gambling and training. Training of responsible gambling to gambling industry, both online and offline

Coordination of the "listening point" for adolescent care in the French school of Lisbon from 2005 to 2016. 

PhD based on Research "characterization and comparison of pathological gamblers Offline and Online in Portugal" under the supervision of Mark Griffiths Contribution to the dissemination of "scientific" information on the problem of gambling in Portugal among the Media.

 Author of the book "Problem gambling: treatment of invisible dependence", Plátano Editora 2016 among other publications.