by Peter Chen and Jim Milligan 

In the research literature on treatment effectiveness, group psychotherapy with an insight-oriented, psychodynamic approach has received a low rating (Hester & Miller, 1995). Some people believe that to resolve a problem, the client has to understand the “why” of the behaviour, rather than learning the “how” of doing it differently. This approach neglects external societal and environmental factors. For example, accessibility to gambling venues is a large factor in people deciding to gamble or not. Most North American substance abuse and problem gambling treatment programs have included an insight-oriented approach, but many Canadian problem gambling treatment agencies have moved away from this approach in favour of a more here-and-now approach to problem resolution.

People who choose a solution-focused approach in their therapeutic work have made a philosophical choice to support the positives in their clients’ lives, and to focus on strengths, not pathology. Solution-focused counsellors adopt a “not-knowing,” “one-down” stance, recognizing that the client, not the counsellor, is the expert on his or her life. However, counsellors do assume that their clients will be successful, and tailor their interventions accordingly. There is little current outcome research supporting the efficacy of any of these approaches. However, considering the changing lifestyle patterns at the start of the new millennium, with its increased “busy-ness,” the focus on consumerism (“getting value for my investment”), and a desire for immediate results, a flexible approach that doesn’t demand a long-term involvement might be more appropriate for the gamblers of the twenty-first century.

LifeSkills
The term LifeSkills refers to an adult education model developed through the NewStart program in Saskatchewan in the 1960's. In this model, LifeSkills are defined as “problem-solving behaviours appropriately and responsibly applied in the management of one’s personal affairs (Dynamics of LifeSkills Coaching, ywca, 1995). LifeSkills are not to be confused with “skills for daily living,” such as sewing, cooking or using public transportation. A LifeSkills group will focus on five areas of a person’s life: self, work, leisure, family and community. Lessons are planned based on the self-identified needs of the group participants, called “students.” The leader of the group, the “LifeSkills coach,” is a facilitator, trainer and co-learner, responsible for developing the lessons based on the implied or expressed needs of the students.

However, the emergent needs of the group members always take precedence over the planned lesson, underlining the flexibility of the model, and the empowerment principle on which it is based.

Solution-Focused Brief Therapy (SFBT)
SFBT emerged out of the Brief Family Therapy Clinic in Milwaukee about a decade ago. It is based on the following principles:

• Change is inevitable and constantly occurring.
• You don’t need to know a lot about the problem before being able to solve it.
• People have the strengths and resources to change.
• Meanings are negotiable.
• Choose meanings that lead to change.
• No problem happens all the time. Pay attention to the exceptions.
• There are many ways of looking at a situation, none more correct than others.
• The focus is not on problems or pathology, but on solutions, competencies and capabilities.

There are three rules for interventions in this approach:

• If it isn’t broken, don’t fix it.
• If it works, keep on doing it.
• If it doesn’t work, stop doing it, and do something different. *See Section “Solution-Focused Brief Therapy”

We chose the solution-focused approach as the basis for our program. Practitioners who had worked for many years with problem gamblers told us that the gamblers they worked with wanted a concrete strategy that they could take away with them at the end of the counselling session. They were not interested in exploring their feelings, or dealing with things interpersonally in groups. They wanted answers about how to do things differently, not insights into why they were gambling. The obvious answer to their needs was a solution-focused approach. The program’s outcome data suggest that the program has been very successful over the past three years using this approach.

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