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COMMON COMPONENTS IN THE

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COMMON COMPONENTS IN THE TREATMENT OF PATHOLOGICAL GAMBLERS Dr Ang Yong Guan 4 July 2007 ... Correcting the gambler's mistaken understanding of the concept of chance. ... – PowerPoint PPT presentation

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Title: COMMON COMPONENTS IN THE


1
COMMON COMPONENTS IN THE TREATMENT OF
PATHOLOGICAL GAMBLERS
DR ANG YONG GUAN CONSULTANT PSYCHIATRIST
2
Introduction
  • 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.

3
Common Components
  • What is common in these programmes?

4
Core 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
5
1st Component Evaluation
  • The first component is the pre-treatment
    evaluation of the different factors leading to
    the gamblers pathological gambling.

6
Pre-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.

7
2nd 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.

8
More 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.

9
Four 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)

10
3rd 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.

11
Understanding 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)?

12
4th 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.

13
Examples 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)

14
Thoughts 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
15
5th 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.

16
Analysing 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

17
Danger of false beliefs
  • Such false beliefs make the gambler more
    vulnerable to continue gambling.
  • Treatment consists of attacking these erroneous
    thoughts

18
The Gambling Traps
Thinking is focus on Winning
Emotionally aroused
19
Recognising 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.

20
Importance 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.

21
Challenging erroneous beliefs
Erroneous Thinking
Emotional arousal
22
Cognitive 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

23
5 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
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