Photo by: Joelk75
Cha-ching! Everyone likes the sound of winning some money. Sadly, money does not grow on trees. One of the most common ways to win “free” money is to gamble. Merriam-Webster dictionary defines gambling as playing a game for money or property or to bet on an uncertain outcome. When gambling, the thrill of uncertainty draws people to the table. Unfortunately, gambling can have serious consequences. Just like drugs, alcohol, or any other obsession, gambling easily becomes addicting. With addiction, comes the need for treatment. According to University of Connecticut Health Center psychiatrists, David M. Ledgerwood and Nancy M. Petry, gambling treatments exist but many challenges hinder the process.
There are many forms of gambling treatment that are still being tested to determine whether they are helpful for pathological gamblers. There are self-guided approaches and cognitive-behavioral treatments. Hodgins, Currie, and el-Guebaly have tested self-guided approaches for treatment in 2001. They randomly assigned gamblers that were seeking treatment to one of three groups: “(a) self-help workbook”, “(b) workbook plus motivational telephone interview”, or “(c) a no-treatment control (placement on waiting list)”. They found that there were no major differences between the workbook and control groups. On the other hand, the participants who were given the workbook and motivational interview actually reported a steady decrease in their gambling habits, than the participants who just received the workbook. While the data gathered is helpful to the future of gambling treatment, there is still more research that needs to be done to determine how appropriate this form of treatment is. The second form of gambling treatment is cognitive-behavioral therapy or CBT. CBT is the most comprehensively and frequently studied interventions today. In strictly cognitive approaches, the therapist and patient distinguish the distortions of the patient’s gambling. They do this by recognizing modifications of thought and the illusion of winning. In CBT, “behavioral components may be added to reinforce non-gambling behaviors, encourage problem solving, improve social skills, and prevent relapse”. Ladouceur, Sylvain, and Boisvert studied cognitive therapy administered in individuals and groups. Sylvain gathered pathological gamblers and randomly assigned each participant to individual CBT or to the waiting-list (control group). After the treatment, the patients that were put under CBT treatment reported less gambling. This study proves that CBT can be helpful but the data within the experiment is weakened for multiple reasons. Most experiments on gambling have small sample sizes and a lack of follow-up data.
The most current research, by the authors David M. Ledgerwood and Nancy M. Petry, was a CBT study that was based around changing the environment of the gamblers. They believed that changing their environment would make their urges to gamble less likely. They made them develop new hobbies and focus on other things. These patients gained new cognitive skills. Their study included 231 patients that “were randomly assigned to one of the three groups: (a) Gambler Anonymous (GA) referral, (b) GA referral plus an eight-chapter CBT workbook, or (c) GA referral plus eight sessions of individual CBT”. CBT was more helpful that just receiving referral to Gamblers Anonymous. Also, the individual CBT sessions helped greatly in reducing gambling activities by participants. They used an intent-to-treat analysis, “(i.e., we included patients in our analyses even if they did not follow through with treatment”), which ultimately led to a higher outcome in follow-up information than in most studies on gambling.
Many challenges are hindering the progress of treatments for gambling. One of the main problems is that pathological gambling is defined as an impulse-control disorder but is also very similar to substance dependence. Substance dependence is characterized by indications of tolerance and withdrawal. Impulse-control disorders are characterized by the lack of being able to resist destructive impulses or drives. Both of these causes are very different from each other, which makes it very hard to construct treatment that can apply to both. The second problem is that pathological gambling tends to come with other co-occurring psychiatric and substance-use disorders. This makes it even more difficult and raises the question of whether or not gambling treatment should co-occur with treatment for these psychological disorders. If this was the case, each treatment would have to be different to fit the needs of the individual. The third problem, is that pharmacological treatments were supposed to be the most successful way to reduce gambling, just like with many other drugs, but so far there has been no medication approved by the U.S. Food and Drug Administration for treating pathological gambling. Fourth, with so many problems in treatment, there is a high chance that the treatment will fail. If the treatment fails then many of these gamblers will relapse. Also, these participants may relapse even if the treatment is working. The final problem is that there is not enough research to be able to determine what is exactly needed for pathological gambling. Research on gambling is not as advanced as other problems, such as drug addiction. Further research will have to be done, in order to determine the best treatments for pathological gamblers.
The future of gambling treatment has a lot of promise but needs a lot of work. Research in the field of gambling has not reached the excessive standards that it must meet, in order to perfect the efficiency of gambling treatment. Recent research has helped to consider which options may be the most effective. Changing pathological gamblers’ environments and shifting their cognitive distortions are the most effective treatments so far, and currently have the most empirical support. Our society is still not positive on what the best possible treatment for pathological gamblers is. However, we are sure that the more research that is done, the closer we will be to perfecting this terrible addiction.
Work Cited
David M. Ledgerwood and Nancy M. Petry Current Directions in Psychological Science , Vol. 14, No. 2 (Apr., 2005), pp. 89-94
No comments:
Post a Comment