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Helping Professionals

Therapeutic Approaches to Problem Gambling

Roger Horbay

Treatment of pathological gambling is promising. Outcome data from studies examining treatment effectiveness indicate that often up to two-thirds of clients show a significant reduction in gambling (Lopez, 1998). In most cases, elements of each approach are combined to meet the various needs of problem gamblers. Multi-modal combinations include high-risk situational coping strategies, assertiveness training, cognitive restructuring, problem solving skills, increasing social support, coping with urges and relapses, and decreasing arousal. In addition, education, family and group therapy are also paired with individual counselling. However, the problem remains that while all appear useful, specific treatment components that are the most therapeutic are ill-defined.

Solution-based brief therapy , behavioural therapy and cognitive therapy are three therapeutic approaches that have significantly contributed to the treatment of problem gambling. These three approaches address pathway 1 development of problem gambling (see “The Pathways Model of Problem Gambling”). Behavioural techniques are commonly found in combination with solution-focused and cognitive therapy. Therefore, the coverage of behavioural therapy in this section will be integrated into the presentation of each approach, and most extensively covered in the section on client skills and relapse prevention .


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