How to facilitate problem gamblers to manage common cognitive biases

1
How to facilitate problem gamblers to manage
common cognitive biases

• Polly Lam
• Clinical Psychologist
• The Resilience Centre
• (Macau Social Welfare Bureau)

2
Gambling and Reasoning

• All forms of gambling involve decision making
• Such decision making processes are conducted in
  uncertain situations
• Three categories of decision-making that bear
  particular relevance to gambling includes
  risk-taking, behavioral persistence and
  self-control

3
Problem Gambling as Problem Reasoning

• Gamblers are motivated by a way of reasoning, not
  by defects of personality, education or social
  environment. (Wagenaar, 1988)
• Several irrational beliefs were identified among
  gamblers the illusion of control, manipulation
  of luck, misunderstanding of randomness, chasing,
  and selective attention to winning experience
  (Toneatto, 1999)
• Deficits in decision making and feedback
  processing were found among PG (larger decision
  making deficits in pathological slot machine
  gamblers than in pathological casino gamblers)
  (Goudriaan et al., 2005)

4
Problem Gambling as Problem Reasoning

• Research has shown that PGs demonstrate
  irrational beliefs or thinking patterns,
  therefore
• 1) It is assumed that these irrational beliefs
  cause gambling problems
• 2) It is assumed that by correcting these
  irrational beliefs, gamblers could reduce their
  gambling behaviors. This is the theoretical
  foundation of cognitive therapy in problem
  gambling

5
Problem Gambling as Problem Reasoning

• The second assumption was supported by
  meta-analysis (Petry, 2005) concerning the
  treatment effectiveness of cognitive therapy and
  cognitive behavioral therapy for problem gambling
• However, the first assumption (the causal
  relationship between irrational beliefs and
  gambling behavior) has been questioned by recent
  research (May et al., 2005, Delfabbro, 2006,
  Steenbergh, 2000, 2001). These findings suggest
  that gambling beliefs may not be related to the
  generation of gambling behaviors among
  non-problem gamblers

6
Possible Explanations

• Irrational beliefs may be generated or reinforced
  during excessive gambling behaviors rather than
  causing PGs to gamble
• Ladouceurs (2001) concept of the distinction
  between objective knowledge vs. personally
  relevant knowledge (PGs may have objective
  knowledge about gambling but may utilize and
  evaluate it differently. During the process of
  gambling, irrational beliefs may override
  objective beliefs)

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Possible Explanations

• Thompson et al., (1998) suggested that peoples
  susceptibility to this illusion appears to vary,
  depending on their motivational and emotional
  states (People who have greater desires toward
  winning may rate their chances of success higher,
  and beliefs in winning skills or future
  success could give PGs the confidence to manage
  their senses of failure or anxiety.)

8
Clinical Implications

• Cognitive processes such as cognitive appraisal,
  monitoring and regulation, maybe more significant
  than the cognitive contents of individual
  thoughts and beliefs (Millar, 2003)
• An individuals emotions and motivations play an
  important role in influencing cognitive processes
  (Thompson, 1998, Langer, 1975)
• Treatment at the meta-cognitive level maybe more
  effective than merely at the cognitive level

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What is Metacognition?

• A theoretical framework describing individuals
  awareness of their own mental state (Millar,
  2003)
• Two dimensions Metacognitive knowledge
  (awareness and understanding of thoughts) and
  metacognitive control strategies (efforts to
  regulate thoughts, emotions and behaviors in
  order to achieve long-term , practical and
  meaningful success)

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Metacognition and Therapy

• From the model of metacognition, clinicians can
  help clients understand how their emotions could
  distort their thinking processes, help them
  monitor their thought processes, and teach them
  how to regulate their emotions and behaviors,
  rather than just teaching them the correct
  information about gambling

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The Information Process Biases That Relate to The
Creation of Irrational Gambling Beliefs

• Using induction to analyze a random situation
• Using intuitive reasoning to judge or control a
  random situation (the basis of superstitious
  beliefs)
• Establishing a singular/linear causality
• Confusing possibility with probability
• Using selective attention
• Adhering to availability heuristic
• Arbitrary inference (jumping to conclusions)

12
Other Illusion of Control Found Among Problem
Gamblers in Playing Casino Table Games (Sundali,
2006)

• Hot Hand (the belief that a particular
  person is hot, and betting with the numbers
  that the person has chosen)
• Stock of Luck (the belief that one has a
  stock, or fixed amount of luck and, once it's
  spent, the probability of winning decreases)
• (What are the underlying meanings of these
  beliefs?)

13
Using Induction to Analyze Random Situations

• Commonly called the Gambler Fallacy
• Within the context of gambling, it manifests as
  follows
• 1) In a random situation, the probability of the
  occurrence of a particular outcome is higher when
  this outcome has not occurred for a long time
• 2) In a random situation, the probability of the
  occurrence of a particular outcome is lower when
  this outcome has not occurred for a long time

14
Gambler Fallacy

• The Gambler Fallacy is related to not
  understanding the following
• The nature of randomness
• The definition of an independent event

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The Nature of Randomness

• Random situation is unpredictable, due to the
  interplay of multiple causal factors which all
  partially contribute to the outcomes. Observers
  cannot know which factors contribute more to the
  outcome in every event within a certain period of
  time (e.g. throwing a coin or a dice)
• Random situation unpredictable due to the
  involvement of the observers and/or participants
  (quantum physic)

16
The Nature of Randomness

• There are four dimensions of causal
  relationships
• Natural Randomness The movement of electrons
• Human-Manipulated Randomness Casino table games,
  slot machines, lottery and other forms of
  gambling (the generation of every outcome is
  designed to be independent and not related to
  previous outcomes)
• Natural Causal Relationships Natural phenomena
• Human Manipulated Causal Relationships
  Scientific inventions, social establishments, art
  creations and human relationships

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The Nature of Randomness

• Only with the first, third and fourth dimensions,
  can we use induction to analyze the underlying
  causal relationships and apply them to generate
  favorable outcomes
• We can never analyze human manipulated
  randomness due to limited time, limited
  resources and the rules of the games (the
  asymmetric warfare between gaming organization
  and gamblers). It is simply a waste of time,
  money and effort.
• If gamblers invest their time, money and effort
  in dimension 1, 3 or 4, the chance of success is
  much higher (They could be prominent scientists,
  artists, businessmen, politicians, or
  professionals, and enjoy lovely family
  relationships.)

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The Asymmetric Warfare between Gaming
Organizations and Gamblers

• Asymmetry in money and capital
• Asymmetry in information
• Asymmetry in organization
• Asymmetry in power
• Question What is the main difference between
  social gambling and commercial gaming?

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Independent Events

• Clinicians found that the concept of independent
  events is the most difficult concept for PGs to
  understand.
• Clinicians can ask PGs to collect all the
  information that could contribute to the outcome
  of throwing a dice and analyze the possible
  results within one second (the process of
  throwing a dice takes about one second)
• In the next throw, the whole process of
  information collection has to be repeated because
  the previous information cannot be applied again

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Independent Events

• When clients refer back to previous records,
  clinicians have to inform them that all the
  contributing factors have changed already, it is
  no use to analyze the past outcomes
• When clients guess the outcome randomly (meaning
  they play the same game with the gaming
  organization), clinicians have to remind them
  that the pay off ratios set by the gaming
  organization always favor the organization. (the
  asymmetric warfare between gaming organization
  and gamblers)

21
Using Intuitive Reasoning to Judge or Control a
Random Situation (the Basis of Superstitious
Beliefs)

• The underlying belief that one can use intuitive
  reasoning and superstitious beliefs to judge a
  random situation is known as the uniqueness of
  discovery and the manipulation of intuitions,
  luck or divine powers
• Belief in intuitions, luck or divine powers is
  not the problem. The real problem is that people
  believe they are the only one in the world who
  can discover and manipulate these powers and use
  them in gambling situations

22
Different Approaches of Clinicians

• Some clinicians will challenge these beliefs
  based on their treatment approaches and models
• Personally, I seldom challenge these beliefs. I
  would rather question the uniqueness of the
  beliefs and ask clients to acknowledge the
  possibility that others may also have the
  ability to recognize and apply intuition, luck
  and divine power to gambling. I ask them to
  imagine what would happen if every one (including
  clients, other players and gaming organizations)
  used the same power at the same time.
• Such questioning helps clients review their
  belief systems from a non-egocentric perspective,
  and helps them move away from a world view of a
  personalized and privatized Natural Law/God

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Beware of Clients Personal Meanings

• Usually, if clients deeply believe in the
  abovementioned intuitive reasoning, clinicians
  have to clarify how the clients personal
  meanings are being projected onto such beliefs
  before they can restructure these beliefs

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Singular/Linear Causality

• Belief in a simple/ singular, linear causality
  that contributes to the outcomes of gambling
  events
• Usually found in gamblers who play sport-betting,
  horse racing or other competition style gaming
  activities

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Singular/Linear Causality

• PGs fail to recognize the following
• Multiple and interactive factors that contribute
  to the result of a game or competition
• Betting behaviors also become part of the
  interactive factors
• Human manipulation of the game results
• The setting of pay-off ratios always benefits the
  gaming organizations

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Singular/Linear Causality

• Clinicians could help clients understand the
  above-mentioned points
• Clinicians could ask clients to list out the
  possible ways to manipulate game/competition
  results
• Clinicians could work with clients to play with
  the multiple and interactive factors that
  contribute to the game/competition results
• Clinicians could help clients understand the
  disadvantages of investing time, money and effort
  in a human manipulated game without much
  transparency

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Confusing Possibility with Probability

• Possibility Whether or not X will happen
• Three types of possibilities
• Technically possible means it is technically
  possible to let X happen
• Empirically possible means although it is
  technically impossible to let X happen at the
  moment, based on empirical evidence, it is
  possible to let X happen in the future
• Logically possible means anything can happen
  provided it is not illogical

28
Confusing Possibility with Probability

• Probability means How likely it is that X will
  happen
• Confusing possibility with probability leads to
  the delusion that chance is 50/50.
• When people are making decisions under
  uncertainty, they are more likely to consider
  possibility than probability (neglect of
  probability bias) (Baron, 2000). This is
  especially true when a decision must be made
  regarding one possible outcome that has a much
  lower or higher utility but a has small
  probability of occurring.

29
Confusing Possibility with Probability

• Rather than challenging the over-estimation of
  the probability of the occurrence of favorable
  outcomes in gambling situations, it is better for
  clinicians to show empathy toward clients
  anxious emotions which predispose them to make
  irrational decisions. It is more effective to
  help clients understand that gambling places
  oneself in emotionally vulnerable situations, and
  in such situations, people are unlikely to make
  rational decisions.

30
Selective Attention

• Research shows that problem gamblers selectively
  recall experiences of winning rather than losing
• What is the meaning of winning? (Discussion)

31
Selective Attention

• To win can be perceived as a sign that ones
  luck is about to turn, a confirmation that good
  things do happen in life, or that one might
  receive things for free in a world where one is
  expected to give in order to receive. Luck in
  this sense is a secular counterpart to the
  religious concept of graceThe Big Win inspires
  imagery of wealth and happiness freely bestowed
  upon the chosen by so high a power that it is
  above and outside all systems of reciprocity.
  (Binde, 2005)

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Selective Attention

• Apart from objectively revealing the losses
  resulting from gambling, clinicians can also
  facilitate clients in understanding the emotional
  meanings of winning and help them discover ways
  other than gambling to pursue these meanings

33
Availability Heuristic and Arbitrary Inference

• Availability Heuristic Overestimating the
  probability of the occurrence of an outcome due
  to imagining about it before hand (Tversky
  Kahneman, 1973)
• Arbitrary Inference Jumping to conclusions
  without examining the situation with logic and
  empirical evidence

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Availability Heuristic and Arbitrary Inference

• Clinicians could show interest in clients
  beliefs and ask them to clarify the origins of
  such beliefs
• Clinicians could provide correct information to
  clients without making them feel foolish

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General Principles of Managing Problem Gamblers
Cognitive Biases

• Understanding the underlying emotional and
  personal meanings of the beliefs
• Helping clients understand that they are
  misusing their intelligence rather than making
  them feel they think stupidly
• Showing empathy toward the emotional
  vulnerabilities that contribute to making
  irrational judgments
• Showing concern that gambling can impair the
  clients ability to make rational judgments (but
  not victimizing the client)
• Facilitating clients in monitoring their emotions
  and thoughts
• Facilitating clients in developing internal
  dialogues that not only respond to their
  cognitive biases, but also respond to their
  emotions

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Question Discussion

• Thank You!