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Section 6
Change Strategies in Gambling

Question 6 | Answer Booklet | Table of Contents

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In the last section, we discussed teen gambling.  We discussed complications unique to teens, such as lack of responsibility.  We also discussed denial and financial motivation.  Finally, we examined prevention. 

In this section, we will discuss breaking the addictive cycle. The five stages of quitting are precontemplation, contemplation, commitment and action, maintenance, and relapse. Next we will discuss types and examples of techniques, and finally we will discuss how a therapist might choose a technique which best fits a client.

As you know, according to disease theory, once a client begins gambling, his addiction becomes an unavoidable cycle.  However, you also know that cognitive, behavioral, and situational techniques can break the cycle. 
Three goals of these techniques are:
--1. dealing with urges so clients can avoid giving in at all through abstinence,
--2. structuring and regulating reactions to gambling, and
--3. avoiding allowing an indulgence to get out of hand entirely by preventing relapse. 

Relapse will be discussed in more detail in the next section.

♦ #1  Five Stages of Quitting
I find that there are five stages regarding quitting for the gambler.  The stages regarding Quitting are:

-- 1.  Precontemplation.  The gambler hasn’t yet identified the behavior as a problem.
-- 2.  Contemplation.  The gambler has become at least ambivalent, saying things like, "I wonder if I’m gambling too much.
-- 3.  Commitment and action.  The gambler decides to change or quit the behavior.
-- 4.  Maintenance.  The gambler puts forth the effort to maintain the change.
-- 5.  Relapse.  The gambler fails or gives up on their change effort. 

Why might it be productive for the family member of your client to be aware of the five stages of quitting?  Could it help the family member identify how to communicate with the gambler knowing what stage he or she is in?

♦ #2  Techniques that Quitters Use
As you know, interventions include cognitive, behavioral, and social or situational techniques.  Let’s review these

♦ Cognitive Techniques for quitting a gambling addiction include consciousness raising.  If the family member of your client provides the client with benefits for quitting gambling, how might that help the gambler stop gambling?  Self liberation, self reevaluation, and environmental reevaluation are other cognitive techniques.  Dramatic relief as a cognitive technique might also benefit your client.  What are some of the dangers associated with pathological gambling that may move your client emotionally?

♦ Behavioral Techniques such as counter conditioning might also be a way the family member of your client might help the gambler. Could he or she suggest the client do something else instead of gambling when the client feels tense? And how might stimulus control be implemented with your client? What information can the family member provide regarding what things remind the gambler of cards, lotto tickets, or the track? 

One effective behavioral technique involves the use of photographs.  How could a photograph help your client?  Rob, age 41, kept a photo of his daughter with him. Rob stated, "Whenever I have the urge to gamble, I just take out Ellie’s picture and look at it.  Her sweet face reminds me of what is really important and keeps me from wanting to gamble my life, and maybe even hers, away." 

If you suggest this technique to your client, would it be productive to make it clear that the photo is not to be used to bring luck, but strictly to break the desire to gamble out of love and respect for the person in the photo?

♦ Social or Situational Techniques, perhaps related to the family may be more limited in scope and practice than cognitive and behavioral techniques, but how might your client benefit from the social liberation associated with stopping gambling?  What ways can the family help the gambler see those benefits?  Also, what relationship benefits can be associated by your client regarding stopping gambling?

In the next section, we will discuss staying stopped.  How can a gambler serious about recovery fend off relapses?  Three simple guidelines to avoiding relapse and staying stopped are using support systems, watching company, and watching where they go. 

Peer-Reviewed Journal Article References:
Albertella, L., Le Pelley, M. E., Chamberlain, S. R., Westbrook, F., Fontenelle, L. F., Segrave, R., Lee, R., Pearson, D., & Yücel, M. (2019). Reward-related attentional capture is associated with severity of addictive and obsessive–compulsive behaviors. Psychology of Addictive Behaviors33(5), Aug 2019, 495–502.

Gavriel-Fried, B., Moretta, T., & Potenza, M. N. (2020). Associations between recovery capital, spirituality, and DSM–5 symptom improvement in gambling disorder. Psychology of Addictive Behaviors34(1), 209–217.

Petry, N. M., Rash, C. J., & Alessi, S. M. (2016). A randomized controlled trial of brief interventions for problem gambling in substance abuse treatment patients. Journal of Consulting and Clinical Psychology, 84(10), 874–886.

Smith, T., Panfil, K., Bailey, C., & Kirkpatrick, K. (2019). Cognitive and behavioral training interventions to promote self-control. Journal of Experimental Psychology: Animal Learning and Cognition45(3), 259–279.

Soberay, A. D., Grimsley, P., Faragher, J. M., Barbash, M., & Berger, B. (2014). Stages of change, clinical presentation, retention, and treatment outcomes in treatment-seeking outpatient problem gambling clients. Psychology of Addictive Behaviors, 28(2), 414–419.

Valdivia-Salas, S., Blanchard, K. S., Lombas, A. S., & Wulfert, E. (2014). Treatment-seeking precipitators in problem gambling: Analysis of data from a gambling helpline. Psychology of Addictive Behaviors, 28(1), 300–306.

What are the five stages of quitting? To select and enter your answer go to Answer Booklet

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Section 7
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