Everybody knows about gambling right? Where you can risk it all to win big or lose everything. It’s a bit of a thrill not knowing whether the next roll, or the next hand, or the next race is going to be the one that sends you packing (assuming you didn’t bet everything you had to pack) or makes you the big winner. Gambling is what Vegas is known for after all. Some people even see it as a quick way to win a few bucks here and there. For some people, though, it isn’t just an occasional and fun (albeit expensive) pastime. These people are what we call pathological gamblers, or problem gamblers. In short, they are addicted to gambling the way Tyrone Biggums is addicted to crack. There have been support programs started for these gambling addicts. However, pathological gambling is a serious addiction and problem that has had a very low success rate for treatment and recovery. Part of it is because the gamblers don’t have the desire to quit. With every addiction, one has to truly want to stop in order to do so. In light of the high relapse rate of problem gamblers new methods are being tried to aid in their recovery. Among these methods are a number of different behavior modification exercises. Some have had a relatively high success rate, while others prove just as ineffective as a slap on the wrist is to a belligerent child.
In these exercises, different types of gamblers were used. For a number of them, the gamblers are horse race betters, while some are slots players, and others still are video poker addicts (video poker? I mean seriously, who has the patience to be addicted to that? You only use like, a quarter each time!). One of the best determinants of the success of the treatment was whether the participants could be contacted after a twelve month period. The first number of tests conducted give little detail other than saying the treatment included desensitization, behavior modification, psychoanalysis, and support and group therapy sessions. In general, those conducting the study noted that there was a low success rate when the numbers were compared to the number of people who started treatment. In reality, there was a high success rate among those that remained in therapy, but the problem was so many people dropped out of therapy.
One of the more specific treatments that seemed effective was a form of motivational interviewing. These interviews were based on Prochaska and DiClemente’s transtheoretical model of change. This model theorized that addicts go through different stages of readiness to change from “precontemplation (I don’t have a problem) to contemplation (Maybe I do have a problem); preparation (I am going to change); action (I am quitting); and maintenance or relapse.” The idea behind the motivational interviewing therapy was to try to give greater problem awareness to the addicts in hopes that this understanding would cause them to change. Of course treatment was only initiated when they were in the contemplation, preparation, and action stages of their addiction cycle. The therapy seemed to have an immediate positive effect on the problem gamblers, but the effect faded over the regular twelve month follow up period that follows all of these recovery treatments (to make sure it was effective, and that the addicts are clean).
The next study, the one this article focused on, was one that involved motivational interviewing as a compliment to gambling-specific cognitive behavior therapy. The cognitive behavior therapy was used for patients retained in treatment for a longer period of time. It dealt largely with the way of thinking that pathological gamblers had, one of which was that they had the ability to control random events (slots). Those conducting the experiment figured they may get better results if they combined the cognitive behavior therapy with the motivational interviewing and gave it the abbreviation CMBT. “The motivational techniques might help clients to resolve their ambivalence about treatment, and the cognitive behavioral techniques would then give them the necessary tools to combat their gambling addiction.” The potential patients were screened, asking them to recount their gambling episodes of the last three months and the amount of money won or lost each time (this is a much easier part of the procedure to go through with for gamblers then with drug addicts, gamblers are at least conscious during their gambling episodes).
During the treatment patients kept records of their daily gambling escapades and their monetary gains and losses. During the first two weeks, there was a treatment session twice a week, but then once a week following that. Also, each session was held individually (a huge difference from group therapy). The first part of treatment was the motivational enhancement, which made them less defensive and more aware of their problem. The goal here was to make them ready to change. Part two’s main idea was to get patients to realize risky situations (getting money in some form) and triggers for their habit ( I’m feeling lucky today), and how to avoid that mindset. This again gets at the fact that they think they can control random events. Part three was all about prevention of relapse and the recognition of things that can lead to it (seeing an old gambling buddy, for example, is a bad idea).
All nine of the people that started in this program saw it through to the end, and each also saw significant positive life changes and managed to seriously reduce their gambling behavior. Remember, these guys were all hardcore gamblers and had been for upwards of ten to fifteen years. The treatment proved successful over the twelve month follow up period and seemed to genuinely work. The result is that this more personal and intensive recovery method is effective and that no matter how long a person has been in a state of mind or way of thinking, it can be changed with the right process.
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