A systematic review «Edgren R, Pörtfors P, Raisamo S ym. Treatment for ...»1 examined interventions for concerned significant others (CSOs) of gamblers evaluated potential benefits, and thematically described treatment processes. The authors used the Stress-Strain-Coping-Support model (SCCS) as a theoretical framework.

Nine interventions were utilized: 3 CSO directed, 4 for couples, and 2 low threshold online interventions. 4/9 interventions were online interventions (online Cognitive Behavioral Therapy (CBT), Behavioral Couples Therapy (BCT), Efa "Don't gamble away my life– Support for Affected Others") Gambling help online (GHO)). 5/9 interventions were directed at CSOs alone (CRAFT, online CBT, 5-step method, Efa, GHO), and 4 were directed towards couples/dyads (BCT, CCT, Integrative Couple Treatment for Pathological Gambling [ICT-PG], and standard treatment). 5 studies were RCTs, 4 were case studies and 2 were explorative surveys, 2 were based on post-treatment follow-up interviews, one study was utilized a mixed method approach, one within-subject quantitative data and one was feasibility study.

A quantitative synthesis (N = 7 studies) of effect size estimates for depression and anxiety measures didn't indicate any intervention to have better outcomes than others. Core themes in the treatment process identified in the qualitative synthesis (N = 7) included: information and understanding, social support, coping skills, communication, and strain. Several interventions were identified, yet no specific interventions appeared more beneficial than others. Using the SSCS model, commonalities and differences in intervention content were identified, along with themes that influence treatment processes.

• Study quality: high
• Applicability: In Finland there are no manualised treatments for conserned significant others of gamblers. However, support services for those in need are offered by for example Tiltti, Sosped, where persons with lived experience are taking part of the support groups. THL has provided a guidance (Tiedä ja Toimi – kortti «https://www.julkari.fi/handle/10024/145344»1) for professionals, where the main components of the review «Edgren R, Pörtfors P, Raisamo S ym. Treatment for ...»1 has been introduced as a guideline when meeting CSOs. Moreover, THL has implemented a short harm screen with psycho-educative information to the Peluuri webpage ( «https://www.peluuri.fi/hae-apua/testi-rahapelaajan-laheiselle»2).

Comments: Recent systematic review and meta-analysis «Merkouris SS, Rodda SN, Dowling NA. Affected other...»2 investigated treatments for CSOs across all addictions. In their review four interventions of 20 studies were for CSO's with gambling specific interventions, however meta-analysis for any of these treatments could not be conducted due the treatment design.