Pathological gambling is a treatable, but complex addiction. Defined as out of control gambling that disrupts relationships, employment and/or education. People from all social, economic and cultural groups are affected. Pathological gambling is a problem throughout this country, and in Oregon 61,000 people are estimated to have this disorder. There is a lack of information and extensive misinformation about gambling; and gambling has, historically, been considered a moral weakness. Treatment for pathological gambling is a recent development, and still is not widely available. Pathological gambling is pervasive, poorly understood, and costly and deserves further study. Existing literature on pathological gambling, both the profile of the disorder and treatment is thoroughly reviewed. The portrait of the pathological gambler is contradictory. The only clear demographic trend is that the majority of pathological gamblers are men. Psychodynamic theories explain pathological gambling through developmental and psychological determinants. Behaviorists and learning theorists delineate a series of environmental and physiological factors which combine to "teach" pathological gambling behavior. Researchers who study pathological gambling have enumerated three to four phases of progression of the disorder. There are a variety of disorders and physical problems correlated to pathological gambling, and depression and dual addictions are clearly an issue for many. GA has a high drop out rate and tends to work better for pathological gamblers who have few or no relapses. The intake interview should: initiate the therapeutic alliance, provide crucial data for assessment and diagnosis, and provide information about the nature and scope of the treatment. Individual therapy has a relatively long and respected history as helpful treatment for pathological gambling. Group therapy is a common and effective mode for treatment of pathological gambling. Psychodynamic treatment of is popular and effective, works at achieving abstinence, and helping the pathological gambler make deeper personality changes. Cognitive-behavioral approaches have a role in helping pathological gamblers change irrational beliefs surrounding gambling and themselves. A program which uses cognitive-behavioral, behavioral and psychodynamic approaches in individual, group and family/marital counseling settings designed by author is presented and discussed. The program has four stages and includes an education component.

Problem gambling is best understood from a biopsychosocial perspective, whereby multifaceted biological, psychological, and socio-environmental factors interact in ways that may lead to individual risk. Reinforcement contingencies and operant conditioning appear to play particularly important etiological roles. Theoretically, operant conditioning approaches should therefore comprise particularly effective treatment strategies. While operant conditioning in the form of contingency management is known to be an effective treatment for alcohol and substance abuse, it has never been applied by clinical practitioners in community-based treatment for problem gambling. The present pilot study explored the utility of adding concrete reward contingencies to community outpatient treatment, from the perspectives of clinical effectiveness and client/counsellor experiences. At 3-month follow-up, clinical outcomes compared well to typical treatment outcomes, and treatment retention appeared to be superior. Participating clients perceived concrete rewards to be moderately effective in the change process, while active therapist acceptance of this technique appeared to be limited. / xi, 186 leaves ; 29 cm. --

This study is an exploration, through ethnographic and auto-ethnographic inquiry, of the personal world, gambling experiences and underlying biopsychosocial vulnerabilities of three individual case studies - one male and two females - each representing a different sub-type of pathological gambler. It comprises the integration and implementation of a psycho-structural stage matching model to explore comorbidity and identify certain biopsychosocial manifestations in the respective stages of pathological gambling. Long term treatment strategies were identified and patient treatment matching was explored. Further, it comprises my personal relationship and therapeutic treatment of these sub-types of gamblers over a period of one year and longer. In this study it is hypothesized that formulating appropriate matching long term treatment strategies should be based on the stage of change, the phase in the psycho-structural model, as well as the gambler's underlying vulnerability. From this a comprehensive gambling disposition profile can be completed with proper intervention matching approaches. A number of other hypotheses emerged from this study that could provide valuable information and serve as a guideline to those working with pathological gamblers. / Psychology / D.Phil.

This study is an exploration, through ethnographic and auto-ethnographic inquiry, of the personal world, gambling experiences and underlying biopsychosocial vulnerabilities of three individual case studies - one male and two females - each representing a different sub-type of pathological gambler. It comprises the integration and implementation of a psycho-structural stage matching model to explore comorbidity and identify certain biopsychosocial manifestations in the respective stages of pathological gambling. Long term treatment strategies were identified and patient treatment matching was explored. Further, it comprises my personal relationship and therapeutic treatment of these sub-types of gamblers over a period of one year and longer. In this study it is hypothesized that formulating appropriate matching long term treatment strategies should be based on the stage of change, the phase in the psycho-structural model, as well as the gambler's underlying vulnerability. From this a comprehensive gambling disposition profile can be completed with proper intervention matching approaches. A number of other hypotheses emerged from this study that could provide valuable information and serve as a guideline to those working with pathological gamblers. / Psychology / D.Phil.