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Expert Gambling Addiction Treatment Online
A subgroup of people unable to control their gambling can develop Gambling Disorder, with potentially severe financial, emotional, relationship, occupational, and possible legal consequences.
DSM-5 Diagnostic Criteria for Gambling Disorder
A. Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or
distress, as indicated by the individual exhibiting four (or more) of the following in a 12month period:
a. Needs to gamble with increasing amounts of money in order to achieve the desired excitement.
b. Is restless or irritable when attempting to cut down or stop gambling.
c. Has made repeated unsuccessful efforts to control, cut back, or stop gambling.
d. Is often preoccupied with gambling (e.g., having persistent thoughts of reliving past gambling
experiences, handicapping or planning the next venture, thinking of ways to get money with
which to gamble).
e. Often gambles when feeling distressed (e.g., helpless, guilty, anxious, depressed).
f. After losing money gambling, often returns another day to get even (“chasing” one’s losses).
g. Lies to conceal the extent of involvement with gambling.
h. Has jeopardized or lost a significant relationship, job, or educational or career opportunity
because of gambling.
i. Relies on others to provide money to relieve desperate financial situations caused by gambling.
Specify if:
Episodic: Meeting diagnostic criteria at more than one time point, with symptoms subsiding
between periods of gambling disorder for at least several months.
Persistent: Experiencing continuous symptoms, to meet diagnostic criteria for multiple years.
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Specify if:
In early remission: After full criteria for gambling disorder were previously met, none of the criteria
for gambling disorder have been met for at least 3 months but for less than 12 months.
In sustained remission: After full criteria for gambling disorder were previously met, none of the
criteria for gambling disorder have been met during a period of 12 months or longer.
Specify current severity:
Mild: 4–5 criteria met.
Moderate: 6–7 criteria met.
Severe: 8–9 criteria met.
From the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (section 312.31).
Gambling problems impact 0.2%-4.0% of the population, and research related to treating gambling has burgeoned in the last decades. This paper reviews trials for psychosocial treatments of gambling problems. Using Preferred Reporting Items for Systematic reviews and MetaAnalyses standards, we identified 21 randomized trials.
Moreover, eleven studies evaluated interventions delivered via multi-session, in-person therapy: cognitive therapies, cognitive-behavioral (CB)
therapies, and motivational interventions (MI) alone or with CB therapies. An additional ten studies used approaches that involved one or fewer in-person sessions; these included workbooks with CB exercises alone or in combination with MI and brief feedback or advice interventions.
Although most studies found some benefits of CB therapy (alone or combined with MI) and brief feedback or advice relative to the control condition in the short term, only a handful of studies demonstrated any long-term benefits. Nearly half the studies used waitlist controls, precluding an understanding of long-term efficacy, and standardized outcomes measures are also lacking.
Populations also differ
Populations also differ markedly across studies, from non-treatment seeking persons who screened positive for gambling problems to those with severe gambling disorder, and these discrepant populations may require different interventions.
Although problem gamblers with less pronounced symptoms may benefit from very minimal interventions, therapist contact generally improved outcomes relative to entirely self-directed interventions, and at least some therapist contact may be necessary for patients with more severe gambling pathology to benefit from CB interventions. As treatment services for gambling continue to grow, this review provides timely information on best practices for gambling treatment
Gamblers Anonymous
Founded in the 1950s, Gamblers Anonymous (GA) is a mutual help fellowship based on the 12-step program of AA. With meetings in most North American communities, GA is established worldwide as a resource for people struggling with gambling problems. GA groups are peer-led and abstinence-focused and represent the most widely available option for recovery from gambling disorder.
Some GA meetings welcome family and friends to attend “open meetings,” recognizing the impact of disordered gambling often extends far beyond the patient and that support from non-gambling family and friends can be integral to recovery.
http://www.gamblersanonymous.org/ga/content/about-us
GA
GA has a unique culture of recovery, distinct from AA and NA in specific areas. For example, GA recognizes that for many new members, addressing the crippling financial consequences is vitally important for their recovery. Senior members who confronted and resolved their own financial consequences guide and support the new members through these challenges.
GA members tend to have more severe gambling symptoms, are more motivated for treatment, and have greater involvement with professional gambling treatment.
GA can be used alone or combined with other interventions. Individuals who engage in GA and professional treatment have better gambling outcomes than those who receive professional care alone. GA is also a valuable resource if remitted gambling problems recur in the future.
Consequencies
The potentially severe consequences of gambling disorder elevate the need to identify factors that support gambling abstinence. In a study of GA members, the greatest predictors of gambling abstinence were participation and involvement in GA, support from family and friends, and connections with other GA members. High gambling urges and erroneous gambling cognitions strongly predicted relapse.
Of note, GA meeting attendance may be helpful, but involvement with GA meetings and members carried the greatest protection from relapse. GA and CBT are the two most widely used approaches for gambling disorder. A review of published evidence concluded that combining GA and CBT may enhance therapy engagement and reduce relapse risk.
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