13 - Cognitive-Behavioural Treatment of Problem Gambling

Abstract

This chapter discusses the cognitive-behavioral treatment of problem gambling. Pathological gambling can be diagnosed when patients have “persistent or recurrent maladaptive gambling behavior" characterized by five out of ten possible criteria. Some of them include (1) a preoccupation with gambling, (2) a need to continually increase the amount of money gambled in order to achieve the same level of excitement, (3) failed efforts to reduce or stop gambling, (4) restlessness or irritability if unable to gamble, (5) lying to significant people with the intent of hiding the extent of involvement in gambling behavior, and (6) relying on others to provide finances to salvage a desperate financial situation which arose as a result of gambling. In assessing problem gamblers for a cognitive behavioral approach to treatment, it is necessary to conduct a cognitive-behavioral analysis of the behavior. However, there are specific issues which need to be considered when dealing with this population. These issues deal with (1) the functions of gambling; (2) the adaptive and maladaptive coping skills which the patient has; (3) the presence and nature of urges to gamble; (4) any irrational beliefs which the gambler holds in relation to the probability of winning; (5) the presence of other difficulties; 6) their level of motivation; and (7) the patient's treatment goal.