Title: COMMON COMPONENTS IN THE
1COMMON COMPONENTS IN THE TREATMENT OF
PATHOLOGICAL GAMBLERS
DR ANG YONG GUAN CONSULTANT PSYCHIATRIST
2Introduction
- Various treatment programmes have been developed
to help pathological gamblers - overcome their addiction and
- deal with the consequences
- financial,
- social,
- psychological and
- family of their excessive gambling.
3Common Components
- What is common in these programmes?
4Core Components in the Management of the
Pathological Gambler
5. Challenge and Correct Erroneous Beliefs
4. Identify and Cope With High Risk Situations
3. Set Goals and Focus on Motivation
2. Treat Co-morbidity
1.Do pre-treatment Evaluation
51st Component Evaluation
- The first component is the pre-treatment
evaluation of the different factors leading to
the gamblers pathological gambling.
6Pre-treatment Evaluation Topics
- Motives of Consultation
- Factors that lead to a partial or complete lost
of control. - History of gambling habits
- Information on the current gambling problem
- Consequences of the gambling problem
- Presence of suicidal ideation
- Current living conditions / degree of support
- Other present or past addictions
- Presence of prior mental health problems
- Personal strategies and resources available.
72nd Component Co-morbidity
- To detect and treat co-morbid psychological
conditions such as - depression,
- anxiety,
- personality disorders
- suicidal ideation, and
- other addictions such as alcohol.
8More difficult to treat if co-morbidity is
present
- Sometimes, the more severe co-morbidity should be
treated first by another doctor if necessary. - Once the patients co-morbidity is stabilised,
the treatment of the pathological gambling can
begin.
9Four Strategies for treating co-morbidities
- 1. Integrated Treatment
- The same therapist treats all of the identified
problems at the same time. - 2. Parallel Treatment
- Two therapists treat the addictions at the same
time. - 3. Sequential Treatment
- Problems are treated one after another
- 4. Individual treatment
- Only one of the problem is treated.
- (Najavitis, 2003)
103rd Component Motivation
- Clarify the goals of the gambler and
- Focus on his motivation to stop gambling.
- - When the motivation level is high, the gambler
is ready to invest time and effort to solve his
gambling problem and the prognosis will be good.
11Understanding Motivation to Change
- What cause the gambler to modify his gambling?
- Is he ready to make efforts to gamble less or
cease gambling? - What is his objective for change?
- Are the reasons personal (internally motivated)
or from others (externally motivated)?
124th Identifying high-risk situations
- To help the gambler identify high-risk situations
that lead to increased gambling. - Behavioural interventions will then be devised to
help the gambler handle such high-risk
situations and to regain control over his life.
13Examples of Risky Situations
- Exposure to Gambling
- Easy access to gambling place
- Finding oneself near a gambling place
- Financial Situation
- Easy access to money
- Tight financial situation
- Relationship Difficulties
- Lack of trust from family and relatives
- Lack of Occupation and Activities
- Consuming Alcohol and Drugs
- Daily Problems (Frustration, Failure, Rejection)
14Thoughts and Feelings activated (Urge to gamble)
Thinking
Feeling
First bet (start small)
High-Risk Situation
More and bigger bets
Behaviour
LOSSES
Chasing Loses
Problem Gambling Behavioural Chain
155th Identifying Erroneous Beliefs
- To identify erroneous ideas and beliefs the
gambler holds concerning his chances of winning
or beating the system. - The more intensely such erroneous thoughts are
held, the more the gambler will remain hooked to
gambling.
16Analysing thoughts during gambling
- Ask the gambler to express the thoughts that
crossed his mind before, during and after a
recent gambling session. - For example, thoughts about
- his ability to outsmart chance
- his sure-win attitude
- using strategies to win or break the bank
- superstitious beliefs
17Danger of false beliefs
- Such false beliefs make the gambler more
vulnerable to continue gambling. - Treatment consists of attacking these erroneous
thoughts
18The Gambling Traps
Thinking is focus on Winning
Emotionally aroused
19Recognising Gambling Traps
- Gambling traps occur when the gamblers thoughts
take over and tell him that it is possible to
improve his chances. - Such thoughts will lead to betting more and more
money. - Impairment of control sets in and the
pathological gambling begins.
20Importance of correcting the gamblers idea of
chance
- Correcting the gamblers mistaken understanding
of the concept of chance. - Helping them to distinguish between games of
skill and games of chance will hopefully dispel
the various myths and illusions associated with
gambling.
21Challenging erroneous beliefs
Erroneous Thinking
Emotional arousal
22Cognitive Behavioural Programmes
- Various successful cognitive behavioural
programmes have been devised so far for the
treatment of pathological gambling - (Ladouceur et al. 2005)
- Most programmes contain some if not all of these
five components
235 Key Components
Conclusion
1 Do Pre-treatment Evaluation
2 Rule out co-morbid conditions
5 Challenge and correct Erroneous Beliefs
4 Identify and cope with High-risk Situtions
3 Set Goals and Focus on Motivations