The nature and treatment of excessive gambling

Abstract

Satisfactory models of the nature and treatment of excessive gambling must incorporate behavioural, cognitive, emotional and physiological findings. The acquisition of gambling behaviour is apparently influenced by social exposure and financial reinforcement. Continuation is promoted by partial reinforcement schedules and biased cognitions. Excessive gambling also involves changes in the individual's internal state, including physiological arousal, euphoria, distraction and perceived control. These effects might depend on the prior characteristics of the individual. Treatment should remove conditioned triggers, establish alternative means of financial and internal regulation, and reduce the individual's need for the financial and subjective rewards provided by gambling. Treatment goals and resources are discussed.

An innovative cognitive strategy to assist problem gamblers

“…Regardless of the stimuli, the counsellor, with the active input of the client, develops the range of activities that the latter can undertake to remove or reduce the conditioned stimuli to gamble (Coman & Burrows, 1999;Legg England & Gotestam, 1991).…”

“…They may utilise alternative mechanisms for the payment of bills to ensure they do not hold large amounts of money at any given time. Automatic deductions from bank accounts to pay bills can often be arranged, which also limits the individual's handling of money and the temptation to gamble (Coman & Burrows, 1999;Legg England & Gotestam, 1991).…”

“…The approach underlying behaviour therapy is that the maladaptive behaviour can be unlearnt through the use of learning principles. Most behaviour treatment programmes use techniques to reverse the association between gambling behaviour and the arousal and excitement associated with it (Blaszczynski & Silove, 1995;Bujold et al, 1994;Legg England & Gotestam, 1991;Maurer, 1994;Sharpe & Tarrier, 1993;Walker, 1992Walker, , 1993. Three behavioural techniques described in the literature are imaginal, in-vivo desensitisation and stimulus-response modification.…”

Group counselling for problem gambling

“…Stimulus-response techniques help clients identify the moods or activities that usually stimulate gambling behaviour and alternative responses which can be implemented to replace the gambling behaviour. The use of contracts is a behavioural technique used to assist individuals overcome problem gambling behaviour (Blaszczynski & Silove, 1995;Bujold et al, 1994;Legg England & Gotestam, 1991;Maurer, 1994;Sharpe & Tarrier, 1993;Walker, 1992Walker, , 1993.…”

Pathologisch gokken: problemen in en rondom de behandeling

“…Gokkers zelf rapporteren evenwel vooraf een rusteloos en negatief gevoel (England & Gotestam, 1991 ). Jansen (1992) haalt in haar publikatie over cue-exposure bij bulimia nervosa een verklaring aan uit het verslavingsonderzoek over de stimulusafhankelijke aard van drang en tolerantie.…”