Novel program for problem gamblers
matches the intervention to the
gambler’s reasons for gambling
Opportunities to gamble have proliferated in our society in recent years. Many forms of gambling are now available ranging from video lottery terminals and slot machines, to lotteries, sports betting, casino table games like blackjack, race-track betting, poker, and online gambling. While many people enjoy gambling as an opportunity to socialize and for light entertainment, others become involved in gambling in a much more problematic way. For example, a study conducted inNova Scotiaby Focal Research in 2007 showed that close to 10 per cent of the province’s adult population were moderate to severe problem gamblers or at high risk for gambling problems.
Health professionals see and hear first-hand the impact of problem gambling. If not successfully treated, problem gamblers experience a variety of harmful effects from their gambling which can range from family and relationship stress, to job loss, financial distress, and increased risk for suicide. Any of these negative consequences of gambling can seriously compromise overall health and well being. Unfortunately, problem gamblers rarely seek services. The Focal Research study found that less than 10 per cent of Nova Scotian problem gamblers actively sought assistance. This study found that family physicians, addiction services, Gamblers Anonymous, and a gamblers’ helpline were each accessed by a similar percentage of adults, of which the majority were non-problem gamblers seeking information to assist them in helping someone else like a friend or family member.
The good news is that we do have effective programs available for problem gamblers. Unfortunately though, current programs are only moderately effective. This is possibly due to the tendency to use a ‘one-size-fits-all’ approach to gambling interventions. In problem gambling research, it is becoming increasingly clear that people gamble for a variety of different reasons. Some gamble to socialize, others gamble for the excitement and thrill of a possible win, while still others gamble to distract themselves from worries and concerns. Research from theDalhousieUniversitygambling research lab has shown that certain reasons or “motives” for gambling are riskier than others in terms of their associations with gambling frequency, gambling expenditures, and negative consequences from gambling. While gambling to socialize is relatively risk free, gambling for excitement and gambling to cope appear related to more problematic patterns of gambling. In fact, the two types of gamblers (‘action gamblers’ vs. ‘escape gamblers’) have been repeatedly identified in research on subtypes of problem gamblers. It is possible that these two types of problem gamblers have very different intervention needs and intervention outcomes could be improved by matching interventions to these different needs.
Research in the substance abuse area has found that not all people seem to drink or use drugs for the same reasons. In fact, ‘matched’ interventions have been developed by researchers atDalhousieUniversity,McGillUniversity, and theUniversityofMontrealto meet the particular needs of different types of substance abusers. Research has shown that substance abusers who have undergone matched interventions for substance abuse display superior outcomes after intervention, as compared with substance abusers who have undergone the more traditional non-matched one-size-fits-all interventions.
For several reasons the ‘matched’ approach might be a useful extension from those with substance use disorders to those with gambling problems. As noted, there is increased recognition that pathological gamblers are a heterogeneous group with different intervention needs. Moreover, there is increasing agreement that substance use disorders and gambling disorders should both be considered ‘addictive disorders’ due to their common co-occurrence and many shared features (e.g., symptoms of tolerance and withdrawal). Pathological gambling is currently categorized with impulse control disorders such as kleptomania and pyromania within the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV); however, it is likely to be shifted to sit with the substance use disorders in a new category called “addictive disorders” in the manual’s next revision (DSM-V).
To determine the efficacy of a ‘matched’ intervention for gamblers, the Nova Scotia Department of Health and Wellness has funded research team atDalhousieUniversityto embark on the study of a motivation- matched approach to the intervention of pathological gamblers in collaboration with Capital Health Addiction and Prevention and Treatment Services. The pilot phase has been completed in the past year and we have begun the main testing portion of this new program. The program under study is based on the fact that people gamble for different reasons and ‘matches’ the intervention gamblers receive to their underlying motivations for gambling. Participants choose their own intervention goals in collaboration with the therapist, be it to eliminate all forms of gambling, some forms of gambling, or learning to manage their gambling. Participants spend approximately 16 hours in six one-on-one sessions over three months, with follow-up meetings up to six months later. There is no cost to take part in this program. In fact, participants are compensated for their contribution to the study. The study will determine if these new matched interventions for problem gamblers work as well or better than traditional non-matched interventions presently available to problem gamblers in the community.
We can provide informational materials that can be passed along to those who might benefit from our gambling program. The study at Dalhousie is recruiting a total of 100 people in the Greater Halifax Regional Municipality who gamble to continue with the main testing phase of this innovative program. Please visit http://gamblingstudy.psychology.dal.ca, or contact us confidentially at (902)-494-3201 or via email: firstname.lastname@example.org if you are interested in participating or have someone you would like to refer to the study.