Cognitive behavioral therapy for problem gamblers

The cognitive behavioral therapy (CBT) approach used within the unit for the treatment of problem gambling is based on the same principles used to treat clients with anxiety disorders and depression. This approach is based on the work of Isaac Marks (Marks, 1986) and was introduced by Battersby (Tolchard and Battersby, 2000) to South Australia in 1996. The service is part of the Break Even network funded by the South Australian government Department of Families and Communities and is integrated with the Mental Health Sciences postgraduate courses in cognitive-behavioral therapy for health professionals at Flinders University, Adelaide, Australia. This chapter provides an outline of the theoretical framework, assessment process, specific treatment methods, and measurement of treatment outcomes of the Flinders Therapy Service for Problem Gamblers. A case example and outcome data are provided to demonstrate the treatment model and its effectiveness. An overview of treatment outcomes for problem gambling assessing different modalities is discussed. Cognitive therapy is used initially to dispute irrational beliefs related to gambling, and to help recognize and modify the negative automatic thought processes that clients may have that can cause and maintain psychological distress. The behavioral approach aims to extinguish the client's urge to gamble. This treatment enables mastery over and elimination of the urge to gamble, which facilitates recovery both in gambling behavior and functional recovery in the person's life. Once mastery of the urge to gamble has occurred, secondary control measures become unnecessary. The treatment process is described in this chapter, with the main focus being on gaming machine addiction. This approach can be used for other forms of gambling such as horse race betting, casino games, and sports betting.