C Steve Chiasson Steve Chiasson BA. CPGC Presentation Objectives To identify unique aspects and critical factors in the treatment of problem gambling.

C Steve Chiasson Steve Chiasson BA. CPGC

Presentation Objectives To identify unique aspects and critical factors in the treatment of problem gambling To provide a comprehensive approach to stabilizing problem gambling and preparing clients for change To present an approach to treatment that is based on the integration of experiential knowledge and empirical evidence

Problem Gambling in Perspective Findings estimate that 332,000-449,000 Ontario adults have moderate to severe gambling problems Only 2% are in the formalized treatment system Clients receiving treatment commonly report numerous failed attempts to control or stop gambling, resulting in feeling perplexed, hopeless and resigned

Problem Gambling in Perspective Actively gambling clients commonly report: Experiencing profoundly altered states both physically and mentally Doing things they would have never believed that they were capable of doing Not grasping the magnitude of the negative consequences to their behaviours associated with gambling

Clinical Experience Clinical experience includes working with over 2,100 clients over 15 years Extensive problem gambling group work, currently providing four therapy groups each week ( 52 clients in group services) Additional group: Mindfulness Meditation Practice

Main Clinical Framework Biopsychosocial perspective Learned behaviour model Collaborative approach Based in principles of Motivational Enhancement (instilling hope and increasing self-efficacy) Externalization of the problem Normalize their experience - they are not alone

Theoretical Comparisons of P.G Two General Perspectives First Perspective Theories that assert the variations in gambling behavior result from variations in the characteristics or make-up of the individual Biological or genetic differences account for problem gambling Black and white distinction, the individual is either a compulsive/pathological gambler or not

Theoretical comparisons contd Second Perspective Theories that attribute excessive/problem gambling to psychological determinants and habitual processes such as Behavioral, Cognitive and Need-State models Some form of psychological mechanism accounts for disordered gambling Emphasize the developmental and habitual nature of gambling rather than pathology

Theoretical comparisons contd Avoids labels such as compulsive or addiction and instead makes reference to impaired control or disorder gambling Central to these theories is the idea that every person who gambles has the potential to become a problem gambler Non-problematic gamblers may experience many of the same processes, but to a lesser degree

Provincial Standard for Problem Gambling Treatment Cognitive - Behavioural Therapy Goals of CBT To identify and raise awareness of cognitive distortions regarding gambling Challenge the distorted thinking, i.e. the evidence that forms beliefs, thinking and expectations

Cognitive Behavioural Model contd Cognitive restructuring, i.e. correcting erroneous perceptions, beliefs and expectations regarding gambling Initiating behavioural change

Behavioural Cognitive Therapy Emphasis on the implementation of behavioural strategies to initiate change and to stabilize gambling behaviour. At this stage clients cognitive problem solving skills are typically not reliable/effective when applied to gambling and can in fact be a risk factor. Rather than a focus on critical thinking skills and correcting cognitive distortions BCT emphasizes behavioural strategies.

Behavioural Cognitive Therapy contd Cognitive strategies become more of a focus after the problem gambling behaviour has stabilized. CBT approach strategies are the core strategies for maintaining change. Central to this approach is a focus on risk management. Identifying and addressing risk behaviours and risk cognitions.

Self Changers: What Worked? N=314 David Hodgins University of Calgary Action% of people New Activities/Change in focus68% Stimulus Control/Avoidance48% Treatment37% Cognitive34% Budgeting31% Willpower/Decision-making/self- control 23% Social Support10% Others confession, no money, non- gambling external factors, self-reward, spiritual, addressing other addictions

C Steve Chiasson Steve Chiasson BA. CPGC Presentation Objectives To identify unique aspects and critical factors in the treatment of problem gambling.

Documents

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gambling clients

treatment of problem

excessiveproblem gambling

disordered gambling

gambling challenge

gambling behavior

problem gambling black