Training counsellors in congruence couple therapy: A controlled evaluation study [Final Report]

Congruence Couple Therapy (CCT) is a new, humanistic, systemic model for problem gambling treatment. In the development of empirically supported treatments, counsellor training is a critical step. This study evaluates the effectiveness of CCT training in imparting key concepts, skills, and values of CCT to a sample of problem gambling counsellors (N = 21) from 13 Ontario problem gambling treatment programs. CCT training comprised of a 4-day residential workshop followed by 12 weeks of CCT application, with 1 to 2 clients per counsellor supported by teleconference consultation. Two cycles of training were conducted: Cycle 1 (N = 21) was a randomized controlled trial comparing counsellors with CCT training and a control group. Immediately after the completion of Cycle 1, the control group (n = 9) received identical CCT training in Cycle 2. A within-subjects design compared Cycle 2 counsellors at three points: at baseline, after a 15-week waiting period, and after 15 weeks of CCT Training. Five interrelated levels of CCT training were evaluated: 1) counsellor satisfaction; 2) counsellor outcomes; 3) organizational support and change; 4) counsellor application of CCT; and 5) client satisfaction and outcomes. Triangulated findings indicated that counsellors significantly increased their knowledge of CCT concepts, values, and skills from both training cycles. Areas of high satisfaction were the trainer-supported CCT application, intense residential workshop in retreat setting, safety and collegiality, experiential learning approach, and framing the training in a research context. Further training was desired by all participants to advance their competence in CCT. The timing of the CCT training seemed to coincide with an emerging trend in some Ontario organizations to adopt more couple-focused counselling for problem gamblers, and an interest in linking research and practice. The need for expanded supervision and support for adopting treatment innovations in organizations is a topic for discussion. Client outcomes with CCT counsellor trainees showed significantly reduced problem gambling symptoms, improved couple communication and relationship, increased selfawareness, and positive spin-offs in family and work relationships. Clients rated their CCT treatment and outcomes very highly. These client results support findings from an earlier CCT pilot study; however, with the absence of a control group, client results should be treated as promising but preliminary. Further studies on CCT and CCT training are recommended in light of the positive multilevel results to date. Key words: Congruence Couple Therapy, counsellor, training, evaluation, empirically supported treatment, problem gambling, outcomes, innovationOntario Problem Gambling Research CentreYe