Whelan / Meyers / Steenbergh Problem and Pathological Gambling

1. Auflage 2007
ISBN: 978-1-61676-312-1
Verlag: Hogrefe Publishing
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, Band Vol. 8, 124 Seiten

Reihe: Advances in Psychotherapy - Evidence-Based Practice

Over the past 30 years there has been a dramatic increase in the availability of convenient and legal gambling opportunities. Accompanying this proliferation of gambling is a growing understanding that between 5% and 9% of adults experience significant to severe problems due to their gambling activities. These problems have become a real health concern, with substantial costs to individuals, families, and communities.

The objective of this book is to provide the clinician – or graduate student – with essential information about problem and pathological gambling. After placing this behavioral addiction and its co-occurring difficulties in perspective, by describing its proliferation, the associated costs, and diagnostic criteria and definitions, the authors present detailed information on a strategy to assess and treat gambling problems in an outpatient setting.

The Authors

James P. Whelan, PhD, is Associate Professor of Psychology and Director of Clinical Training at the University of Memphis, as well as codirector of the Institute for Gambling Education and Research and the Gambling Clinic. He has also served as Director of Clinical Training and has won awards for his engaged scholarship. Dr. Whelan’s research spans several areas, including efficacy for psychological treatments, problem gambling, and sport and exercise psychology.

Timothy A. Steenbergh, PhD, is Associate Professor of Psychology and Director of the Lilly Student Research Initiative at Indiana Wesleyan University. Dr. Steenbergh’s research on addictive behaviors has focused primarily on problem gambling. In addition to his research, Dr. Steenbergh also enjoys teaching and providing psychotherapy at a small clinical practice in Marion, IN.

Andrew W. Meyers, PhD, is Professor in the Department of Psychology and Vice Provost for Research at the University of Memphis, as well as codirector of the Institute for Gambling Education and Research. Dr. Meyers has served on the editorial boards of the Journal of Consulting and Clinical Psychology, Behavior Therapy, Health Psychology, and Cognitive Therapy and Research, and for the past 25 years has maintained a private practice focused on addictions and health behavior.

Autoren/Hrsg.

Whelan, James P.

Meyers, Andrew W.

Steenbergh, Timothy A.

Fachgebiete

• Sozialwissenschaften Psychologie Psychotherapie / Klinische Psychologie Suchttherapie
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Psychiatrie, Sozialpsychiatrie, Suchttherapie

Inhaltsverzeichnis

1;About the Authors, Preface and Table of Contents;3
2;1 Description of Problem and Pathological Gambling;12
2.1;1.1 Terminology;12
2.1.1;1.1.1 Gambling as Recreation;12
2.1.2;1.1.2 Continuum of Gambling-Related Harm;13
2.2;1.2 Definitions;15
2.2.1;1.2.1 Pathological Gambling;15
2.2.2;1.2.2 Problem Gambling;17
2.3;1.3 Epidemiology;18
2.3.1;1.3.1 Vulnerable Populations;18
2.3.2;1.3.2 Types of Gambling and Gambling Problems;20
2.3.3;1.3.3 Impact of Gambling Availability;20
2.3.4;1.3.4 Demographic Correlates;21
2.4;1.4 Course and Prognosis;22
2.4.1;1.4.1 Negative Effects;23
2.4.2;1.4.2 Natural Recovery;23
2.5;1.5 Differential Diagnosis;24
2.6;1.6 Comorbidity;24
2.6.1;1.6.1 Substance Use Disorders;24
2.6.2;1.6.2 Mood Disorders;25
2.6.3;1.6.3 Anxiety Disorders;26
2.6.4;1.6.4 Axis II Disorders;26
2.7;1.7 Diagnostic Procedures and Documentation;26
2.7.1;1.7.1 Diagnostic Interview for Gambling Severity (DIGS);26
2.7.2;1.7.2 South Oaks Gambling Screen (SOGS);27
2.7.3;1.7.3 Lie/Bet Questionnaire;27
2.7.4;1.7.4 Gambling Timeline Follow-Back (G-TLFB);27
2.7.5;1.7.5 Addiction Severity Index – Gambling Subscale (ASI-G);28
2.7.6;1.7.6 Gamblers Belief Questionnaire (GBQ);29
2.7.7;1.7.7 Gamblers Self-Efficacy Questionnaire (GSEQ);29
3;2 Theories and Models;31
3.1;2.1 Gambling as an Addictive Behavior;31
3.2;2.2 Learning Theories;33
3.3;2.3 Cognitive Theories;35
3.4;2.4 Biological Theories;38
3.4.1;2.4.1 Family and Genetic Studies;38
3.4.2;2.4 2. Neurotransmitter and Neuroanatomical Theories;39
3.5;2.5 Disease Model;40
3.6;2.6 An Integrated Model of Problem Gambling;41
3.7;2.7 Guided Self-Change;42
3.7.1;. .1 Harm Reduction;43
3.7.2;. . Rapid Change Response;43
3.7.3;. .3 Self-Change;44
3.7.4;. . Motivational Approach;45
4;3 Diagnosis and Treatment Indications;46
4.1;3.1 Diagnostic Assessment;46
4.2;3.2 Treatment Indications;46
4.3;3.3 Clinical Assessment;47
4.3.1;3.3.1 Gambling Behavior;48
4.3.2;3.3.2 Assessment of Possible Treatment Mediators;48
4.3.3;3.3.3 Systemic Factors;50
4.3.4;3.3.4 Comorbid Psychopathology;51
4.4;3. Treatments;52
5;4 Treatment;54
5.1;4.1 Method of Treatment;54
5.1.1;.1.1 Basic Principles;54
5.1.2;.1. Phase 1: Running Start Assessment;58
5.1.3;.1.3 Phase : Motivational Feedback;60
5.1.4;.1. Phase 3: Triggers and Consequences;63
5.1.5;.1. Phase : Options and Action Plan;64
5.1.6;.1.6 Phase : Relapse Prevention;66
5.1.7;.1. Follow-Up;67
5.2;4.2 Mechanisms of Action;68
5.3;4.3 Efficacy and Diagnosis;69
5.4;4.4 Variations and Combination Methods;70
5.5;4.5 Problems in Carrying Out Treatment;72
5.6;4.6 Multicultural Issues;73
6;5 Case Vignette;75
6.1;5.1 Phase 1: Running Start Assessment;75
6.2;5.2 Phase 2: Motivation and Feedback;79
6.3;5.3 Phase 3: Functional Analysis of Gambling;87
6.4;5.4 Phase 4: Implementation of Alternative Behaviors;89
6.5;5.5 Phase 5 : Relapse Prevention;90
6.6;5.6 Six Month Follow-up;91
7;6 Further Reading;93
8;References;94
9;Appendices: Tools and Resources;102
9.1;Appendix 1: Instructions for Completing the Gambling Timeline Follow-Back;103
9.1.1;Gambling Calendar;103
9.1.2;Helpful Hints;103
9.1.3;Information to Record on the Calendar;104
9.1.4;Example Week;104
9.2;Appendix 2: Gamblers’ Beliefs Questionnaire (GBQ);105
9.3;Appendix 3: Gambling Self-Efficacy Questionnaire;108
9.4;Appendix 4: Goal Statement;109
9.5;Appendix 5: Exercise 1 – Mount Recovery;111
9.6;Appendix 6: Exercise – Making a Decision About Your Gambling;113
9.6.1;Thinking About Your Gambling;113
9.6.2;The Decision to Change Exercise – Part 1;113
9.6.3;The Decision to Change Exercise – Part;114
9.6.4;Weighing the Positives and Negatives;115
9.6.5;Draw Your Own Change Scale;116
9.7;Appendix 7: Exercise 3 – Understanding Your Gambling Problem;117
9.7.1;Understanding Your Gambling;117
9.7.2;Triggers;118
9.7.3;Consequences;119
9.8;Appendix 8: Exercise – Dealing With Your Gambling Problem;120
9.8.1;Options to Excessive Gambling;120
9.8.2;Comparing Options;121
9.8.3;Options Form;122
9.9;Appendix 9: Exercise – Relapse Prevention;124
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Leseproben

(p. 21-22)

The first chapter provided an overview of problem and pathological gambling including definition, epidemiology, comorbidity, and measurement. With this information in mind, we now turn to a more conceptual focus on explanatory models of gambling problems. Clear and comprehensive theories are necessary to guide successful clinical interventions for addictive behaviors. A good theory is a useful one. Theories or models of psychopathology are judged according to their ability to produce appreciable results.

While the field of substance use disorders has several empirically based models that inform clinical interventions, the existing gambling treatment literature is not as well-established. Several models offer explanations of the etiology of problem gambling, but we believe only those with sufficient empirical support should guide case conceptualization and treatment. In this chapter we provide a review of the primary theories of problem gambling and then offer an integrated model that serves as the foundation for our Guided Self-Change treatment. The chapter concludes with an overview and rationale for this treatment model.

2.1 Gambling as an Addictive Behavior

There is growing support for conceptualizing problem gambling as an addiction (e.g., Dickerson, 2003, Herscovitch, 1999, Klingemann et al., 2001, National Research Council, 1999). The essential element of addiction is that people become completely absorbed in an activity and then pursue it without regard for the negative life outcomes. Problem gambling shares characteristics and consequences with other additive behaviors, including problem drinking, tobacco use, and drug abuse (e.g., National Research Council, 1999, Wickwire et al., 2007). As noted previously, diagnostic criteria for pathological gambling reflect symptoms common to other substance use disorders. Like other addictions, problem gambling includes loss of control, preoccupation, tolerance, withdrawal, escape, cravings, and other concomitant biopsychosocial problems. There is also growing neuroscience evidence from brain imaging studies that compulsive nondrug behaviors share neurobiological commonalities with substance use disorders (Holden, 2001, Koepp et al., 1998).

These parallels between problem gambling and other addictive behaviors indicate that gambling researchers can be informed by addiction treatment literature. Being informed, in this case, does not imply the simple acceptance of alcohol or drug treatments for problem gambling. It suggests that the be havior change principles underlying treatments for these addictive behaviors are worthy of consideration in problem gambling (e.g., Herscovitch, 1999). A promising treatment program for problem gambling should embody the general principles of behavior change while also addressing elements specific to gambling. For example, it is generally accepted that irrational thinking, such as the belief in luck and the illusion of control (e.g., Ladouceur &, Walker, 1996), financial issues, and the highly improbable, but still possible, pot of gold at the end of gambling’s rainbow are either unique to or more prominent in gambling. These phenomena need to be addressed when using general addiction treatment principles with problem gamblers.

Über Autor(innen)

James P. Whelan, PhD, is Associate Professor of Psychology and Director of Clinical Training at the University of Memphis, as well as codirector of the Institute for Gambling Education and Research and the Gambling Clinic. He has also served as Director of Clinical Training and has won awards for his engaged scholarship. Dr. Whelan’s research spans several areas, including efficacy for psychological treatments, problem gambling, and sport and exercise psychology.

Timothy A. Steenbergh, PhD, is Associate Professor of Psychology and Director of the Lilly Student Research Initiative at Indiana Wesleyan University. Dr. Steenbergh’s research on addictive behaviors has focused primarily on problem gambling. In addition to his research, Dr. Steenbergh also enjoys teaching and providing psychotherapy at a small clinical practice in Marion, IN.

Andrew W. Meyers, PhD, is Professor in the Department of Psychology and Vice Provost for Research at the University of Memphis, as well as codirector of the Institute for Gambling Education and Research. Dr. Meyers has served on the editorial boards of the Journal of Consulting and Clinical Psychology, Behavior Therapy, Health Psychology, and Cognitive Therapy and Research, and for the past 25 years has maintained a private practice focused on addictions and health behavior.