You’re Addicted To Gambling – Now What?  Part II: Psychological Treatment

This is the 2nd post in our 3-part series on pathological gambling (PG).  (Here’s Post #1.)  Today we’ll look at the treatment for gambling.

Treatment is divided into psychological treatment and medication treatment.  One of the most important interventions before treating the actual gambling problem is figuring out if there are also “co-existing” disorders.

We know that other mental health problems often occur at the same time in people with gambling problems.  These other psychological problems include:

  • – 70% of gamblers have mood problems, for example, depression or bipolar disorder
  • – 60% of gamblers have drug and alcohol problems
  • – 40% of gamblers have anxiety disorders

If you treat the gambling problem, you also have to treat any other mental illness or the gambler won’t get better.

So let’s look at psychological treatment.  Studies show that these treatments work:

  1. 1. Cognitive Therapy
    Cognitive Therapy helps a patient look at his thoughts about gambling to weed out the unrealistic ones.  For example, “I know a big win is coming up.”  Is this realistic or not?  In cognitive therapy, thoughts related to gambling are also looked at, for example, “The only way I’ll be respected is if I have a lot of money.”  How accurate is this?
  2. 2. Behavioral Therapy
    Behavioral Therapy looks at what behaviors fuel the addiction.  Similar to AA, what “people, places and things” are cues to gamble?  After identifying these, you figure out how to avoid them.  If your only socialization is with people who gamble, you may need to find new friends to hang out with.  You may need to come up with new hobbies to do in your free time instead of gambling.  You may need to put away your computer in the evening, so you’re not tempted to go to those online poker sites.
  3. 3. Motivational Interviewing
    This treatment meets people where they in terms of their gambling addiction.  Not sure if you want to stop gambling?  Then a therapist would help you weigh and pros and cons.  Sometimes spelling out the costs of gambling (not just $$, but emotional, relationship, and work costs) help gamblers move to doing something about their problem.

An important part of therapy is helping gamblers identify the good they get from gambling, and then figuring out how to get those goodies without gambling.  Does gambling relax you?  Then work to find other non-gambling ways to do that.  Is gambling what you do when you hang out with your buddies?  Then what other ways can you socialize?

Research hasn’t identified 1 best way to treat all patients with PG , but we do have many options.

Upcoming post #3 in this series:  What are the Drug Treatments for PG?

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