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Treating Gambling Disorder: Considerations for the Treatment Provider. Heather A. Chapman, Ph.D , NCGCII, BACC Louis Stokes Cleveland VA Medical Center Case Western Reserve University School of Medicine.
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Treating Gambling Disorder: Considerations for the Treatment Provider Heather A. Chapman, Ph.D, NCGCII, BACC Louis Stokes Cleveland VA Medical Center Case Western Reserve University School of Medicine
THE MEDIA:5 Ways to Overcome a Gambling Addiction:Seattle Post Intelligencer published March 1 2014 • 1. Admit you have a problem. • 2. Join a support group. • 3. Seek professional help. • 4. Consider medication. • 5. Implement regulatory mechanisms.
Griffiths (2005) proposed that all addictions have seven distinctive characteristics: • Salience: This activity has a high level of importance in a persons life. Typically it dominates their thinking. • Mood modification: Change in subjective experiences that people with an addiction report. As a result of the activity they may feel a ‘high or buzz’. • Tolerance: Decreased sensitivity to activity over time, leading to an increase in the amount of the activity to achieve the same buzz. … betting larger amounts over time to get same feeling. • Withdrawal: Unpleasant psychological and/or physical reactions when activity is reduced such as sadness or nausea. • Conflict: Clashes that arise due to addiction that may be intrapersonal (within themselves) or interpersonal (with others) conflicts. • Relapse:After a period of control the recurrence of earlier patterns of behaviour occur. • Impaired self control: Lack the ability to suppress urges.
Griffiths (2005) proposed that all addictions have seven distinctive characteristics: • Salience: This activity has a high level of importance in a persons life. Typically it dominates their thinking. • Mood modification: Change in subjective experiences that people with an addiction report. As a result of the activity they may feel a ‘high or buzz’. • Tolerance: Decreased sensitivity to activity over time, leading to an increase in the amount of the activity to achieve the same buzz. … betting larger amounts over time to get same feeling. • Withdrawal: Unpleasant psychological and/or physical reactions when activity is reduced such as sadness or nausea. • Conflict: Clashes that arise due to addiction that may be intrapersonal (within themselves) or interpersonal (with others) conflicts. • Relapse:After a period of control the recurrence of earlier patterns of behaviour occur. • Impaired self control: Lack the ability to suppress urges.
Griffiths (2005) characteristics specific to gambling: • Salience: money is particularly salient in our culture This activity has a high level of importance in a persons life. Typically it • Mood modification: dissociation/ hyperstimulus/ moneyChangein subjective experiences that people with an addiction report. As a result of the • Tolerance: impact of extreme debt debtDecreasedsensitivity to activity over time, leading to uzz. … betting larger amounts over time to get same feeling. • Withdrawal: sadness and anxiety related to debt, fixing the problem, coping with losses; suicidalityapsychological and/or physicals or nausea. • Conflict: significant issues related to losses/debt/liesClashesthat arise due • Relapse:After a period of control the recurrence of earlier patterns of behaviour occur. • Impaired self control: Lack the ability to suppress urges.
What does the literature say? • Treatment is aimed at • the raising affective and frustration tolerance, • improvement of their social and professional integration, • building (or rebuilding) of adequate family and personal ties • And working on patients values and goals and any discrepancies • Money: Gambling as a solution to problems gambling caused in the first place • Recreational and leisure skill building • Purpose and direction
What do people with gambling problems say? • Problem gamblers aren't only a danger to themselves — the NCPG estimates that the bankruptcies, burglaries, spouse abuse, child neglect, foreclosures, and even suicide associated with gambling addiction costs the U.S. $6 billion each year. • The money gets attention but what about the emotional impact?