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. --

The first of January 2018 an amendment of the Socialtjänstlag accrued stating that municipalities now have to provide care and treatment for individuals with a pathological gambling disorder. However in the spring of 2017 only 17 percent of the municipalities offered a specific treatment for gambling disorder. An assumed aftermath of the amendment is an increase of the workload for current gambling therapists and furthermore a rise in educating new additional gambling therapists. The aim of this study is to analyze what knowledge and which models of operation are fundamental factors that are required in managing a gambling treatment. The studies selection consisted of a total of five currently active gambling therapists employed in Region Skåne and Malmö Stad. The empirical material has been collected through thematic semi-structured interviews that took about 60 minutes each. Then a thematic analysis of the transcribed interviews was performed. The result in this study showed that a gambling therapist should have knowledge concerning risk- and protective factors in relation to the gambling disorder, this to prevent the client from a possible relapse and to make the client aware about the risk factors directly connected to the gambling game-layout. Furthermore the results showed that one of the fundamental models of operation is to normalize the addiction to the client and raise the clients awareness of the patterns of behavior and consequences regarding the gambling. One model of operation that is also found to be fundamental is for the gambling therapist to have a pedagogical approach towards the client. Thus for the results of this study and former research have shown that people with a gambling disorder have an impaired metacognitive capability regarding their decisions.

Psychological interventions can improve outcomes and reduce symptom severity for individuals with gambling disorder. This chapter provides an overview of current evidence from moderate- to large-scale randomized controlled trials of psychotherapy interventions for the treatment of gambling problems. Interventions include full-length professionally delivered therapies (behavior therapy, cognitive therapy, and cognitive-behavioral therapy), as well as self-directed workbooks and computer-facilitated programs. Motivational interventions, including motivational interviewing, motivational enhancement therapy, and personalized feedback, are also reviewed. This chapter highlights gambling-related treatment outcomes and comparisons between conditions for randomized trials, with an emphasis on treatment dropout. Attrition rates are generally high across all multi-session intervention modalities and formats. Overall, findings suggest that no specific treatment consistently outperforms other active treatments, but cognitive-behavioral therapy does have the most empirical support for the treatment of gambling disorder. In addition, brief motivational interventions are sufficient for some gamblers to change their behavior, particularly those experiencing only a few adverse symptoms from their gambling involvement. Future research efforts will benefit from further refining existing treatments to improve retention, which in turn may enhance effectiveness.

Syftet med studien var att undersöka hur behandlare inom spelmissbruk beaktar hjälpsökandes behov, upplever verksamhetens behandling och förutsättningar att hjälpa, samt vilka hinder och möjligheter som finns i behandlarens arbete. De teoretiska begrepp som användes i analysen var stigma, handlingsutrymme, behandlingsidealet, samverkan och behandlingstankar. I studien användes en kvalitativ forskningsansats där data insamlades genom semistrukturerade intervjuer. Studiens intervjupersoner bestod av sex behandlare som arbetar med spelmissbruk. Behandlarna är verksamma inom verksamheter som drivs av kommunen och regionen. Studiens resultat visade att kartläggning är en förutsättning för att kunna beakta den hjälpsökandes behov. Vidare framkom att det ofta finns skam- och skuldkänslor hos individer med spelmissbruk, vilket kan påverka behandlingsarbetet. Studien visade även att de flesta behandlarna upplevde en frihet vid utformningen av behandlingen trots att det fanns riktlinjer att följa. Behandlarna upplevde att de har adekvata behandlingsmetoder mot spelmissbruk. Dessutom visade studien att samverkan kan bidra till att beakta hjälpsökandes behov. Ytterligare resultat i studien visade att spelreklam och tillgängligheten till spel beskrivs som hinder i behandlingsarbetet. Studien visade även att det är vanligt att spelmissbrukare döljer sitt missbruk och undviker att söka hjälp, vilket kan medföra hinder i behandlingsarbetet. / The purpose of the study was to investigate how counselors in the field of gambling addiction consider the needs of help seekers, experience the organization's treatment and conditions for helping, and what obstacles and opportunities exist in the counselor’s work. The theoretical concepts used in the analysis were stigma, room for maneuver, the treatment ideal, collaboration and treatment thoughts. The study used a qualitative research approach where data was collected through semi-structured interviews. The study's interviewees consisted of six counselors who work with gambling addiction. The counselors are working in organizations run by the municipality and the region. The results of the study showed that mapping is a prerequisite for considering the needs of the person seeking help. Furthermore, it emerged that there are often feelings of shame and guilt among individuals with gambling addiction, which can affect the treatment work. The study also showed that most of the counselors experienced freedom in the design of the treatment, even though there were guidelines to follow. The counselors felt that they have adequate treatment methods for gambling addiction. In addition, the study showed that collaboration can be helpful to take into account the needs of those seeking help. Further results in the study showed that gambling advertising and the availability of gambling are described as obstacles in the treatment work. The study also showed that it is common for gambling addicts to conceal their addiction and avoid seeking help, which can cause obstacles in the treatment work.

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.

The objectives of this study were to provide a detailed biopsychosocial description of the characteristics of a sample of 100 individuals screened and referred by the National Responsible Gaming Programme helpline for their outpatient treatment programme over an eighteen month period, and, importantly, to measure the success of this specific treatment programme at set intervals, up to a one year follow-up period. While 80% of the sample did not relapse during the six-week treatment programme, the number of treatment seekers without any gambling relapses during each follow-up period declined, and those falling back into gambling increased as time went on. After one year 47% of treatment seekers managed not to revert back to gambling – total abstinence. A further 28% reported having relapsed once or twice or that their gambling was controlled. 25% of treatment seekers reported that they reverted back to gambling fulltime which leaves the success rate of the treatment at 75%. Treatment seekers reported an overall reduction in gambling participation, debt and expenditure and an overall improvement in social and vocational functioning. There is evidence in this study to support the perspective that pathological gambling is a multidimensional disorder and that certain sub-groups of gamblers have distinct gambling behaviour. / Psychology / M.Soc.Sc.

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.

The objectives of this study were to provide a detailed biopsychosocial description of the characteristics of a sample of 100 individuals screened and referred by the National Responsible Gaming Programme helpline for their outpatient treatment programme over an eighteen month period, and, importantly, to measure the success of this specific treatment programme at set intervals, up to a one year follow-up period. While 80% of the sample did not relapse during the six-week treatment programme, the number of treatment seekers without any gambling relapses during each follow-up period declined, and those falling back into gambling increased as time went on. After one year 47% of treatment seekers managed not to revert back to gambling – total abstinence. A further 28% reported having relapsed once or twice or that their gambling was controlled. 25% of treatment seekers reported that they reverted back to gambling fulltime which leaves the success rate of the treatment at 75%. Treatment seekers reported an overall reduction in gambling participation, debt and expenditure and an overall improvement in social and vocational functioning. There is evidence in this study to support the perspective that pathological gambling is a multidimensional disorder and that certain sub-groups of gamblers have distinct gambling behaviour. / Psychology / M.Soc.Sc.