Treatment of Pathological Gamblers - Pathological Gambling - NCBI Bookshelf

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Pathological gambling (US) Committee on the Social and Economic impact of pathological gambling: A Critical Review (Pathological Gambling: a Critical Review). Washington DC: National Academies Pres (USA); 1999.

Pathological Gambling: A Critical Review.

The United States Academic Council (USA) on social and economic impact of pathological gambling. Washington (DC): US Academic Publishing Bureau (USA); 1999.

Content
US Academic Academy Publishing Printing Version

6 Treatment of Pathological Gamblers

The treatment and intervention of pathological gambling, which has been developed and reported in literature, is very similar to other treatments for other disabilities and addiction. There is no substantial progress in understanding the treatment of this obstacle and the characteristics of those who seek help for this disability, and there is no research base for matching clients and treatments. Most of the research that has been published is a research on case studies or smal l-group samples, and such a client may not be generalized in a larger group (Knapp and Lech, 1987. ; MURRAY, 1993). Furthermore, the treatment approach has not been strictly and detailed (Blaszczynski and Silove, 1995). Considering the low nationwide interest in the treatment of pathological gambling, it is difficult to evaluate the range of intervention services available in the United States.

First, we will explain the definition of treatment and the issues of dealing with disability such as pathological gambling. Next, I will explain that it is known about the characteristics of the person seeking the treatment of pathological gambling. Next, what is understood about the treatment model implemented to support the pathological gambler, the effectiveness of treatment, whether the treatment is justified, the use, funding, and treatment of treatment in the United States. I will explain the issues related to the provider. He has also revealed priority on research, such as the effectiveness of treatment, cos t-effective, the method of matching patients and treatment, and preventive strategies. NCBI shelf. Service of the National Institute of Health in the United States.

Defining Treatment and Challenges to Treatment

Functionality of Addictive Behaviors

The United States Academic Council (USA) on social and economic impact of pathological gambling.

Washington (DC): US Academic Publishing Bureau (USA); 1999.

Preventing Relapse

Content

Characteristics of Treatment Seekers 1

US Academic Academy Publishing Printing Version

Demographics

Gambling Severity

First, we will explain the definition of treatment and the issues of dealing with disability such as pathological gambling. Next, I will explain that it is known about the characteristics of the person seeking the treatment of pathological gambling. Next, what is understood about the treatment model implemented to support the pathological gambler, the effectiveness of treatment, whether the treatment is justified, the use, funding, and treatment of treatment in the United States. I will explain the issues related to the provider. He has also revealed priority on research, such as the effectiveness of treatment, cos t-effective, the method of matching patients and treatment, and preventive strategies. NCBI shelf. Service of the National Institute of Health in the United States.

Legal and Financial Consequences

Other Characteristics

The United States Academic Council (USA) on social and economic impact of pathological gambling.

Comorbidity

Washington (DC): US Academic Publishing Bureau (USA); 1999.

Treatment Approaches and Effectiveness

Content

Psychoanalytic/Psychodynamic

US Academic Academy Publishing Printing Version

First, we will explain the definition of treatment and the issues of dealing with disability such as pathological gambling. Next, I will explain that it is known about the characteristics of the person seeking the treatment of pathological gambling. Next, the treatment models implemented to support the pathological gambler, what to know about the effectiveness of treatment, whether the treatment is justified, the use, funding, and treatment of treatment in the United States. I will explain the issues related to the provider. He has also revealed priority on research, such as the effectiveness of treatment, cos t-effective, the method of matching patients and treatment, and preventive strategies.

According to the committee's view, the definition of treatment should be wide. We (1) We have (1) activities for individuals to reduce issues related to gambling and pathological gambling, and (2) individual groups (2) gambling problems (2) For example, it is defined as an activity for). Integrated treatment ends through three stages: acute intervention, rehabilitation, and maintaining. These three stages may vary depending on the provider's philosophy, the environment where treatment is performed, and the specific approach used. The systematic collection of pathological gambling treatment services in the United States has not been collected. Outpatient treatment is probably the most common, but treatment is performed in various ways in various ways. A single treatment approach does not dominate this field. In fact, in most clinical sites, it seems that it is common to combine an approach. It is also important to recognize that recovery from pathological gambling can occur without formal treatment. Such people are classified in various descriptions, such as s o-called natural recovery and physical recovery (Wynne, Personal Communication, 1998). The problem of physical recovery from mental action substances such as alcohol and opium has so far

All addictions cause special problems for the providers for their nature. Like other human intentional actions, addictive or functional value is often adapted or functional, and as a result, attempts to change these actions often fail. According to the committee's view, the definition of treatment should be extensive. We (1) We have (1) activities for individuals to reduce issues related to gambling and pathological gambling, and (2) individual groups (2) gambling problems (2) For example, it is defined as an activity for). Integrated treatment ends through three stages: acute intervention, rehabilitation, and maintaining. These three stages may vary depending on the provider's philosophy, the environment where treatment is performed, and the specific approach used. The systematic collection of pathological gambling treatment services in the United States has not been collected. Outpatient treatment is probably the most common, but treatment is performed in various ways in various ways. A single treatment approach does not dominate this field. In fact, in most clinical sites, it seems that it is common to combine an approach. It is also important to recognize that recovery from pathological gambling can occur without formal treatment. Such people are classified in various descriptions, such as s o-called natural recovery and physical recovery (Wynne, Personal Communication, 1998). The problem of physical recovery from mental action substances such as alcohol and opium has so far

All addictions cause special problems for the providers for their nature. Like other human intentional actions, addictive or functional value is often adapted or functional, and as a result, attempts to change these actions often fail. According to the committee's view, the definition of treatment should be wide. We (1) We have (1) activities for individuals to reduce issues related to gambling and pathological gambling, and (2) individual groups (2) gambling problems (2) For example, it is defined as an activity for). Integrated treatment ends through three stages: acute intervention, rehabilitation, and maintaining. These three stages may vary depending on the provider's philosophy, the environment where treatment is performed, and the specific approach used. The systematic collection of pathological gambling treatment services in the United States has not been collected. Outpatient treatment is probably the most common, but treatment is performed in various ways in various ways. A single treatment approach does not dominate this field. In fact, in most clinical sites, it seems that it is common to combine an approach. It is also important to recognize that recovery from pathological gambling can occur without formal treatment. Such people are classified in various descriptions, such as s o-called natural recovery and physical recovery (Wynne, Personal Communication, 1998). The problem of physical recovery from mental action substances such as alcohol and opium has so far

All addictions cause special problems for the providers for their nature. As with other human intentional actions, habitual behavior is also adaptive or functional, and as a result, attempts to change these actions often fail.

Behavioral

Duality is the core of addiction (Shaffer, 1997). Those who are thinking about changing with addiction want to be released from addiction. At the same time, he is eager to the satisfaction of addiction. As he realizes the harm of addiction, he begins to say that he wants to stop addiction. Of course, it is not the same as wanting to stop doing a certain action or expressing it. Despite the obvious consequences, people who are involved in the vortex of addiction include their favorite experiences, that is, the first adaptive and painful emotions. Stirming to the parts that may have been mad (KHANTZIAN et al, the key to change is when the pathological gambler recognizes that gambling is a factor in destroying his life At this point, when you start to realize that the price is higher, you will often be able to help people who are trusted. The point is only the first step in a complex and dynamic process, including the possibility of a drug discontinuation or recurrence over a certain period of time (Marlatt and Gordon, 1985).

One of the issues in the treatment of pathological gambling is to prevent recurrence. For example, even if the use of drugs is discontinued, few people have continued to be discontinued. Marlatt and Gordon examined how slip, that is, how a single episode made of drugs could lead to a complete recurrence (Marlatt and Gordon, 1985). Many personal and environmental factors have influenced the risk of individuals trying to recover from addiction. In order to succeed in recovery, it is necessary to acquire new skills and lifestyle patterns that promote positive behavior patterns. Incorporating these actions into your daily life is the essence of recurrence prevention (Brownell et al., 1986). Successful people have replaced their previous lives using drugs with various behavioral patterns. For example, many people are exercising. Some people make a mental change. Depending on the patient, new actions can be excessive and almost different poisoning. I don't know if the pathetic gambler, who decided to stop, would have a similar alternative. Duality is the heart of addiction (Shaffer, 1997). Those who are thinking about changing with addiction want to be released from addiction. At the same time, he is eager to the satisfaction of addiction. As he realizes the harm of addiction, he begins to say that he wants to stop addiction. Of course, it is not the same as wanting to stop doing a certain action or expressing it. Despite the obvious consequences, people who are involved in the vortex of addiction include their favorite experiences, that is, the first adaptive and painful emotions. Stirming to the parts that may have been mad (KHANTZIAN et al, the key to change is when the pathological gambler recognizes that gambling is a factor in destroying his life At this point, when you start to realize that the price is higher, you will often be able to help people who are trusted. The point is only the first step in a complex and dynamic process, including the possibility of a drug discontinuation or recurrence over a certain period of time (Marlatt and Gordon, 1985).

One of the issues in the treatment of pathological gambling is to prevent recurrence. For example, even if the use of drugs is discontinued, few people have continued to be discontinued. Marlatt and Gordon examined how slip, that is, how a single episode made of drugs could lead to a complete recurrence (Marlatt and Gordon, 1985). Many personal and environmental factors have influenced the risk of individuals trying to recover from addiction. In order to succeed in recovery, it is necessary to acquire new skills and lifestyle patterns that promote positive behavior patterns. Incorporating these actions into your daily life is the essence of recurrence prevention (Brownell et al., 1986). Successful people have replaced their previous lives using drugs with various behavioral patterns. For example, many people are exercising. Some people make a mental change. Depending on the patient, new actions can be excessive and almost different poisoning. I don't know if the pathetic gambler, who decided to stop, would have a similar alternative. Duality is the core of addiction (Shaffer, 1997). Those who are thinking about changing with addiction want to be released from addiction. At the same time, he is eager to the satisfaction of addiction. As he realizes the harm of addiction, he begins to say that he wants to stop addiction. Of course, it is not the same as wanting to stop doing a certain action or expressing it. Despite the obvious consequences, people who are involved in the vortex of addiction include their favorite experiences, that is, the first adaptive and painful emotions. Stirming to the parts that may have been mad (KHANTZIAN et al, the key to change is when the pathological gambler recognizes that gambling is a factor in destroying his life At this point, when you start to realize that the price is higher, you will often be able to help people who are trusted. The point is only the first step in a complex and dynamic process, including the possibility of a drug discontinuation or recurrence over a certain period of time (Marlatt and Gordon, 1985).

Understanding the characteristics of people seeking help for certain disabilities helps to develop effective treatments. As already mentioned, most of the clinical research in this field is a study using a case study or a small sample that may not be able to generalize data in a larger group. Therefore, it is difficult to create an accurate profile of the applicant. But some can be said.

Treatments tend to have many white middl e-aged men (Blackman et al. Most of them are in their 30s and 40s, and they tend to graduate from high school and go to some universities (1989? MOORE, 1998? Yaffee et al. STINCHFIELD and WINTERS, 1996).

According to most clinical studies, pathological gamblers are gambling every day or every week before coming to the hospital (Moore, 1998; STINCHFIELD and WINTERS, 1996). At this time, it is hardly understood about gambling types. One of the factors that can affect your preference is that a specific game is close to a player. For example, according to a study, the gamblers in Maryland prefer a horse racing at a racetrack in Maryland (Yaffee et al., 1993), and for Oregon customers, video pokers are widely used. (MOORE, 1998). Whether the game can be used does not simply lead to preference. Gamblers in Minnesota prefer to play at a casino that may be far from the house rather than buying a lottery that can be bought almost anywhere in the state (STINGINCHFIELD and WINTERS, 1996). Understanding the characteristics of people seeking help for a certain disability can help develop effective treatment. As already mentioned, most of the clinical research in this field is a study using a case study or a small sample that may not be able to generalize data in a larger group. Therefore, it is difficult to create an accurate profile of the applicant. But some can be said.

Cognitive and Cognitive-Behavioral

According to most clinical studies, pathological gamblers are gambling every day or every week before coming to the hospital (Moore, 1998; STINCHFIELD and WINTERS, 1996). At this time, it is hardly understood about gambling types. One of the factors that can affect your preference is that a specific game is close to a player. For example, according to a study, the gamblers in Maryland prefer a horse racing at a racetrack in Maryland (Yaffee et al., 1993), and for Oregon customers, video pokers are widely used. (MOORE, 1998). Whether the game can be used does not simply lead to preference. Gamblers in Minnesota prefer to play at a casino that may be far from the house rather than buying a lottery that can be bought almost anywhere in the state (STINGINCHFIELD and WINTERS, 1996). Understanding the characteristics of people seeking help for certain disabilities helps to develop effective treatments. As already mentioned, most of the clinical research in this field is a study using a case study or a small sample that may not be able to generalize data in a larger group. Therefore, it is difficult to create an accurate profile of the applicant. But some can be said.

Pharmacological

Although clients may be reluctant to fully disclose their legal involvement, most clinical studies report significant reports of pending criminal charges resulting from involvement in illegal activities to finance gambling or to repay debts (Yaffee et al., 1993; Stinchfield and Winters, 1996; some have reported that half to two-thirds of pathological gamblers have engaged in illegal activities to obtain funds for gambling (Dickerson, 1989; Dickerson et al., 1990; Lesieur et al., 1986). Large amounts of debt, often in the tens of thousands of dollars, are also a part of this (Blackman et al., 1989; Moore, 1998; Stingchfield and Winters, 1996). In one study, 10% of 128 gamblers aged 20-68 years treated as outpatients at a gambling treatment clinic reported having debts of more than $100, 000 (Blackman et al., 1999). al.)

This may be due to skipping work to gamble or engaging in gambling-related activities during work hours. There may also be family discord and alienation resulting from cheating, lying, and stealing associated with gambling (Ciarrocchi and Richardson, 1989; Ladouceur et al., 1994; Lorenz and Yaffee, 1988; Stinchfield and Winters, 1996).

As mentioned in Chapter 4, several studies have found significantly higher rates of comorbid psychiatric disorders and symptoms in pathological gamblers. Studies have shown evidence that pathological gambling coexists with substance use disorders, depression, suicidal thoughts and attempts, and various personality disorders.

The treatment of pathological gambling includes psychoanalytical approaches, psychosal approaches, behavioral therapy approaches, cognitive therapy approaches, pharmacological approaches, mult i-modal approaches, and sel f-help approaches. 。 Most treatment programs and counseling are often combined with some different degrees. In the following considerations, each method is briefly explained and that empirical research is understood by empirical research. At that time, other literature reviews (for example, Blaszczynski and Silove, 1995; decaria et al; MURRAY, 1993; Al Communication to the Committee, 1998). A table that summarizes the documents for treatment results examined by the committee is published in the appendix D.

Psychoanalysis is trying to understand the basics of all human actions by examining the power of motivation arising from unconscious mental processes (Wong, 1989). Psychiatric dynamics is "the spirit that affects human behavior and motivation, its cognitive process, and emotional components (FREEDMAN et al. The first systematic attempt was made (Rabow et al., 1984; Rosenthal, 1987).

Addiction-based and Multimodal

The validity of the psychoanalysis and mental mental treatment approach is not indicated by evaluation research. At this time, it is the most common treatment for pathological gambling, so I will briefly explain it here. These approaches are based on the principle that all human behavior is meaningful and functional. Even the most sel f-destructive actions can fulfill their defense or adaptive purposes. This perspective suggests that pathological gambling is a fundamental psychological condition or expression. In this approach, some people do not need to understand the reason for gambling to quit gambling, but many people have experienced it as a wasteful and hopeless thing that has not improved his life after cutting off. (Rosenthal and Rugle, 1994). He develops serious depression, returns to gambling, or seeks other addictive and sel f-destructive behavior for distraction.

Psychoanalytical and psychological therapy tries to understand the pathological gambler under the root cause of discomfort and deal with it. Clinicians have found that mental dynamic psychotherapy is useful for the treatment of several concomitant disorders and personality pathology seen in pathological gamblers, especially for the treatment of narcissistic and masochistic subtypes. There is. Some other people point out the value of mental therapy for habitual behavior (Boyd and Bolen, 1970; Kaufman, 1994; Khantzian, 1981; Shaffer, 1995; WURMSER, 1978) There is no contrast or randomization research that investigates the effectiveness of this approach.

The psychoanalysis understanding of gambling addiction is based on the foundation established by Freud (1928). He thought that gambling addiction was playing for excitement, not for money. In fact, Freud thought that some betting to lose. He believed that this trend was rooted in the need for sel f-destruction, eliminating guilt, and in the case of male gamblers. Bergler (1936, 1943, 1958) has expanded the concept of this masochism and emphasized the opposition of the parent of the pathological gambler, especially the rebellion against the real authority symbolized by parents.

Dating back to Jimmel in 1920, many of the early psychoanalysis emphasized the need to deny narcissistic fancy, rights, pseud o-independence, smallness and helplessness. Other analysts (GREENSON, 1947; Galdston, 1960) stated that their parents were stripped of their early parents and said that the players were seeking the denied affection, acceptance, and approval from the goddess of fate and luck. Some analysts (Greenson, 1947; COMESS, 1960; NIEDERLAND, 1967) thought that obsessiv e-compulsive gambling was an attempt to prevent imminent depression. BOYD and Bolen (1970) regard the obsessiv e-compulsive gambling as a manic defense measure to the helplessness and secondary depression due to loss. Furthermore, emphasis emphasizes problems with parents (WeissMan, 1963), the central role of al l-ability (von hattingberg, 1914), the central role of the almighty (Simmel, 1936; GREENSON, 1947; Lindner, 1950). There were people. Recently, analysts are studying sel f-adjustment defects related to gambling and other dependence disorder (Krystal and Raskin, 1970; WURMSER, 1974; 1998).

The psychoanalytic literature contains individual cases of players who were successfully treated (Lindner, 1950; Harkavy, 1954; Reider, 1960; Comess, 1960; Harris, 1964; Laufer, 1966). The only analyst to publish information on the number of gamblers treated is Bergler (1958). Of 200 referrals, 80 were serious cases, of which 60 continue treatment. According to Bergler, 45 were cured and 15 experienced symptomatic remission. Cured means not only that they stopped gambling, but that they dealt with underlying conflicts and abandoned self-destructive patterns. There is no information on whether "cured" patients received follow-up after treatment.

There is a great need for randomized trials of treatment outcomes, as well as clinical vignettes and case histories that discuss for what purposes clinicians are using these treatments. It is necessary to deconstruct psychoanalytically and psychodynamically oriented interventions and techniques to see what specific elements contribute to a good therapeutic outcome. And of course there are differences between therapists and therapists in terms of their empathic, scheduling, tactical, role modeling and supportive abilities, which complicate research on the effectiveness of treatment in general and psychodynamic treatment in particular.

Behavioral therapy methods are based on the principles of classical conditioning and operational theory and actively seek to modify pathological gambling behavior. Currently, there are several variations of behavioral therapy, which are often used in combination. Aversion therapy involves the application of unpleasant stimuli, such as small electric shocks, while the patient reads phrases that describe gambling behavior. In the final phrase of the procedure, the patient reads about alternative gambling behaviors, such as going home, but does not receive a shock (McConaghy et al., 1991). Imaginative desensitization consists of two steps. The patient first performs a relaxation procedure. Then, he or she is instructed to imagine a series of gambling-related scenes that he or she finds difficult. In the process, the patient learns to relax when given the opportunity to gamble, instead of following the desire. An extension of imaginal desensitization is in vivo exposure, where relaxation techniques are applied while the patient actually experiences a gambling situation.

Self-Help

Gambler's Anonymous

Behavioral counseling has been used in both individual and group treatment. Subjects receive reinforcement for desired gambling behavior, such as reducing their level of gambling or reducing the amount of money they bet. Specific treatment goals can be further emphasized in the form of contingency contracts, in which certain aspects of behavior are given as rewards or punishments. Other behavioral techniques have also been reported in the gambling treatment literature. Two of these, behavioral counseling (in which verbal reinforcement is given for behavior with a desired outcome) and in vivo exposure (in which subjects are exposed to gambling behavior but are not allowed to gamble), have been reported in the literature but have not been empirically tested.

Behavioral treatments have been used and evaluated, but such studies have generally had small sample sizes and few control groups. Case studies using various combinations of behavioral treatments are common (e. g., Dickerson and Weeks, 1979; Cotler, 1971; McConaghy, 1991; Rankin, 1982; Greenberg and Marks, 1982; Greenberg and Rankin, 1982). However, findings from these limited studies are not consistent enough to draw conclusions about treatment effectiveness. Early efficacy studies of behavioral treatments for pathological gamblers focused on aversion therapy. Studies with individual patients provided little evidence of treatment success (e. g., Barker and Miller, 1966; Goorney, 1968). Subsequent studies of aversion therapy using electric shocks for pathological gamblers had only slightly larger samples (e. g., Seager, 1970; Koller, 1972; Seager et al., 1966; Salzman, 1982) and similarly questionable results.

Other Self-Help

Larger outcome studies have been conducted, providing more evidence of the effectiveness of treatment. In his study of 110 German pathological gamblers, Ivor Hand (1998) described a behavioral treatment that began with an extensive assessment of the client's motivation for treatment, symptoms, gambling consequences, and social competence. This evaluation is followed by training in emotion recognition, coping with negative emotions, social skills, and problem-solving skills. Uncontrolled evaluations of this approach have shown good outcomes (Hand, 1998).

Natural Recovery

The most strict studies on the behavioral therapy of pathological players have been published in a series of research reports by McConaghy and Blaszczynski (McConaghy and 1983, 1991; Blaszczynski and others, 1991). In previous studies by this group, imag e-like remedy is compared with disgusting therapy and behavioral approaches. In 1988 research (McConaghy, 1988), the effectiveness of imaging recked work was compared with image relaxation (teaching clients a general relaxation method). The group's early studies showed that the number of samples was relatively small, but other reliable methodology revealed that treatment technology was successful one and one year after treatment.

McConaghy and others (1991) use larg e-scale samples to expand the comparison of behavioral approaches, to 120 participants, disgusting therapy, image reconnection, image relaxation, and revealed in Vivo. I assigned any of the. A total of 63 clients r e-contacted in two to nine years (tracking survey response rate 53%). When combined with abstinence and controlled gambling as a result variable, the group that received an imag e-like feeling has benefited from the groups that have received the other three action approaches. (The author defined the controlled gambling as a gambling with a subjective control or economic adverse effect, based on sel f-evaluation and verification by a spouse or important person). Considering only abstinence, the imaginative detection was equivalent to the total abstinence rate of other treatments (30 %, 27 %, respectively). The strictest research on the behavioral therapy of pathological players has been published in a series of research reports by McConaghy and Blaszczynski (McConaghy and 1983, 1991; Blaszczynski, 1991). In previous studies by this group, imag e-like remedy is compared with disgusting therapy and behavioral approaches. In 1988 research (McConaghy, 1988), the effectiveness of imaging recked work was compared with image relaxation (teaching clients a general relaxation method). The group's early studies showed that the number of samples was relatively small, but other reliable methodology revealed that treatment technology was successful one and one year after treatment.

McConaghy and others (1991) use larg e-scale samples to expand the comparison of behavioral approaches, to 120 participants, disgusting therapy, image reconnection, image relaxation, and revealed in Vivo. I assigned any of the. A total of 63 clients r e-contacted in two to nine years (tracking survey response rate 53%). When combined with abstinence and controlled gambling as a result variable, the group that received an imag e-like feeling has benefited from the groups that have received the other three action approaches. (The author defined the controlled gambling as a gambling with a subjective control or economic adverse effect, based on sel f-evaluation and verification by a spouse or important person). Considering only abstinence, the imaginative detection was equivalent to the total abstinence rate of other treatments (30 %, 27 %, respectively). The most strict studies on the behavioral therapy of pathological players have been published in a series of research reports by McConaghy and Blaszczynski (McConaghy and 1983, 1991; Blaszczynski and others, 1991). In previous studies by this group, imag e-like remedy is compared with disgusting therapy and behavioral approaches. In 1988 research (McConaghy, 1988), the effectiveness of imaging recked work was compared with image relaxation (teaching clients a general relaxation method). The group's early studies showed that the number of samples was relatively small, but other reliable methodology revealed that treatment technology was successful one and one year after treatment.

Health Care Services and Prevention

Availability and Access of Treatment Services 2

In a further survey of this sample, BLASZCZYNSKI and colleagues (1991) have a gambler controlled as a shadowed gambler, and the level of awakening, anxiety, and depression is significant during the tracking period than those who could not control gambling. I found that it has decreased. Research on the controlled gamblers is also important. The gambling model suggested that the controlled gambling is not necessarily a temporary reaction, but then a more heavy gambling (Blaszczynski et al., 1991: 299). The sample size of McConaghy and Blaszczynski research was relatively small, and only half of the first sample was contacted for follo w-up (although it can be evaluated that the follo w-up period was long), so these results. Should be interpreted carefully.

Several clinicians and researchers have a persuasive assertion (see). See BLASZCZYNSKI AND SILOVE, 1995; WALKER, 1992; GABOURY and LADOUCEUR, 1989). The pathological gamblers and the problem gamblers have the same unusual core beliefs, such as the dangers of gambling, the illusion of control, the biased evaluation of the results of gambling, and the belief that gambling is an economic problem solution. (Ladouceur et al., 1994; TONEATTO, Personal Communication to the Committee, 1998). Cognitive therapy aims to cancel unreasonable beliefs and attitudes about gambling, which is considered to cause and maintain unreasonable behavior (GABOUURY and LADOUCEUR, 1989). In treatment, the client usually teaches a strategy to correct incorrect ideas. For example, many people do not understand the probability and the concept of coincidence, and can control to some extent to win or lose. In a further survey of this sample, Blaszczynski and their colleagues (1991) have a gambler with a shadowed gambler, and the gambler that has been controlled by the tracking period is compared to those who could not control gambling. I found that the level has decreased significantly. Research on the controlled gamblers is also important. The gambling model suggested that the controlled gambling is not necessarily a temporary reaction, but then a more heavy gambling (Blaszczynski et al., 1991: 299). The sample size of McConaghy and Blaszczynski research was relatively small, and only half of the first sample was contacted for follo w-up (although it can be evaluated that the follo w-up period was long), so these results. Should be interpreted carefully.

Several clinicians and researchers have a persuasive assertion (see). See BLASZCZYNSKI AND SILOVE, 1995; WALKER, 1992; GABOURY and LADOUCEUR, 1989). The pathological gamblers and the problem gamblers have the same unusual core beliefs, such as the dangers of gambling, the illusion of control, the biased evaluation of the results of gambling, and the belief that gambling is an economic problem solution. (Ladouceur et al., 1994; TONEATTO, Personal Communication to the Committee, 1998). Cognitive therapy aims to cancel unreasonable beliefs and attitudes about gambling, which is considered to cause and maintain unreasonable behavior (GABOUURY and LADOUCEUR, 1989). In treatment, the client usually teaches a strategy to correct incorrect ideas. For example, many people do not understand the probability and the concept of coincidence, and can control to some extent to win or lose. In a further survey of this sample, BLASZCZYNSKI and colleagues (1991) have a gambler controlled as a shadowed gambler, and the level of awakening, anxiety, and depression is significant during the tracking period than those who could not control gambling. I found that it has decreased. Research on the controlled gamblers is also important. The gambling model suggested that the controlled gambling is not necessarily a temporary reaction, but then a more heavy gambling (Blaszczynski et al., 1991: 299). The sample size of McConaghy and Blaszczynski research was relatively small, and only half of the first sample was contacted for follo w-up (although it can be evaluated that the follo w-up period was long), so these results. Should be interpreted carefully.

The effectiveness of cognitive treatments has received limited attention from researchers, and like other treatment success studies, most have small sample sizes and control groups (e. g., Gaboury and Ladouceur, 1989; Sylvain and Ladouceur, 1992), and therefore few have been completed. However, the push for more comprehensive models to explain the origins of problem gambling (Sharpe and Tarrier, 1993) has prompted research into the effectiveness of combining cognitive and behavioral approaches. These combined treatment studies include case studies (Bannister, 1977; Sharpe and Tarrier, 1992), small, uncontrolled studies (Arribas and Martinez, 1991), and controlled studies with large samples (Echeburura et al., 1994). Cognitive-behavioral approaches have been used successfully in combination with both adolescent problem gamblers (Ladouceur et al., 1994) and adult pathological gamblers (Bujold et al., 1994; Sylvain et al., 1997). Sylvain's (1997) study is notable for extending cognitive-behavioral therapy to a wait-list control group. The study found that the cognitive-behavioral group improved significantly more than the control group. However, 11 of the original 40 subjects dropped out, and follow-up data suffered from considerable attrition.

Help-Line Services 3

Echeburura et al. (1994) compared the effectiveness of cognitive-behavioral therapy in 64 Spanish men and women who met DSM-III-R criteria for pathological gambling. Participants were randomly assigned to one of four treatments: stimulus control, in vivo exposure with response prevention; group cognitive restructuring-a combination of the first two; and a wait-list control group. At six-month follow-up, the first two groups performed best. They performed significantly better than the control group, with treatment success rates (one or two episodes of abstinence or gambling that did not exceed the amount gambling in the previous week) reported as 75% and 63%, respectively. However, the combined treatment and group therapy condition performed significantly worse than the other treatment groups.

Pharmacotherapy is a relatively new approach to treat pathological gambling. There are few research reports in terms of literature. Immediately before the DSM-III was introduced, MOSKOWITZ (1980) reported that three obsessive-compulsive gamblers were treated with carbonated lithium. All three cases have achieved a significant abstinence, and lon g-term follo w-ups have been recognized. However, two of the three were clearly manic depression, and the third was a bipolar spectrum disorder. Twelve years later, Hollander et al. Reported on the treatment of one patient by Chrome Plamin. The patient had been gambling two or three times a week since six or five years ago, although he had cut off his gambling in the past. The test design was 10 weeks in each phase, with a doubl e-blind placebo contrast. He had a minimal improvement in placebo, but later became a drug discontinuation and did not bet during the test period. Except for the recurrence in the 17th week, he continued abstinence for another seven months with no n-blind maintenance therapy. The compulsive features, such as perfectionism and storage, and the history of social phobia, which responded well to drugs like chromiplamin, were important in her personality.

Haller and HinterHuber (1994) have published a doubl e-blind test (each phase 12 weeks) of players treated with Calvamazepin. The patient's gambling continued in placebo and no improvement was seen, but he left Calvamazepin by the second week and did not gamble during the test. In fact, he did not gamble for two years and five months in open maintenance therapy (600 mg/ day). This result is particularly impressive, given the history of treatment failure so far. Despite the years of behavioral therapy, psychoanalysis, and anonymous players, his last longest period of medicine was three months. Calvaramazepine is an ant i-natural drug, especially as a moo d-stabilized drug for bipolar disorder patients. There is no description of emotional instability in the report. It is only reported that the patient played roulette to relieve anxiety and depression. The authors speculate that the effectiveness of the drug may be due to an infringement acceptance or the action on the noradrenaline system. Pharmacotherapy is a relatively new approach to treat pathological gambling. There are few research reports in terms of literature. Immediately before the DSM-III was introduced, MOSKOWITZ (1980) reported that three obsessive-compulsive gamblers were treated with carbonated lithium. All three cases have achieved a significant abstinence, and lon g-term follo w-ups have been recognized. However, two of the three were clearly manic depression, and the third was a bipolar spectrum disorder. Twelve years later, Hollander et al. Reported on the treatment of one patient by Chrome Plamin. The patient had been gambling two or three times a week since six or five years ago, although he had cut off his gambling in the past. The test design was 10 weeks in each phase, with a doubl e-blind placebo contrast. He had a minimal improvement in placebo, but later became a drug discontinuation and did not bet during the test period. Except for the recurrence in the 17th week, he continued abstinence for another seven months with no n-blind maintenance therapy. The compulsive features, such as perfectionism and storage, and the history of social phobia, which responded well to drugs like chromiplamin, were important in her personality.

Haller and HinterHuber (1994) have published a doubl e-blind test (each phase 12 weeks) of players treated with Calvamazepin. The patient's gambling continued in placebo and no improvement was seen, but he left Calvamazepin by the second week and did not gamble during the test. In fact, he did not gamble for two years and five months in open maintenance therapy (600 mg/ day). This result is particularly impressive, given the history of treatment failure so far. Despite the years of behavioral therapy, psychoanalysis, and anonymous players, his last longest period of medicine was three months. Calvaramazepine is an ant i-natural drug, especially as a moo d-stabilized drug for bipolar disorder patients. There is no description of emotional instability in the report. It is only reported that the patient played roulette to relieve anxiety and depression. The authors speculate that the effectiveness of the drug may be due to an infringement acceptance or the action on the noradrenaline system. Pharmacotherapy is a relatively new approach to treat pathological gambling. There are few research reports in terms of literature. Immediately before the DSM-III was introduced, MOSKOWITZ (1980) reported that three obsessive-compulsive gamblers were treated with carbonated lithium. All three cases had achieved significant abstinence, and lon g-term follo w-up was recognized. However, two of the three were clearly manic depression, and the third was a bipolar spectrum disorder. Twelve years later, Hollander et al. Reported on the treatment of one patient by Chrome Plamin. The patient had been gambling two or three times a week since six or five years ago, although he had cut off his gambling in the past. The test design was 10 weeks in each phase, with a doubl e-blind placebo contrast. He had a minimal improvement in placebo, but later became a drug discontinuation and did not bet during the test period. Except for the recurrence in the 17th week, he continued abstinence for another seven months with no n-blind maintenance therapy. The compulsive features, such as perfectionism and storage, and the history of social phobia, which responded well to drugs like chromiplamin, were important in her personality.

More recently, Hollander et al. (1998) has announced the results of a singl e-hearted placebo test (eight weeks of each phase). Of the nineteen pathogen, nine people dropped out of the placebo group. Seven out of the remaining ten have shown significant improvements measured by significant decrease in craving and achieving abstinence. Two of the three who did not respond were emotional unstable. Furboxamine and other selective serotonin r e-incorporation inhibitors (SSRIs) can turn depressed patients into manic and bring out the basics, so the maximum dosage (250 mg/ day) is particularly high (250 mg/ day). There was concern that drugs would worsen emotional instability. This was especially true at the highest dose (250 mg/ day). The authors advised that in the future study of administering SSRI to the pathological gambler, patients with bipolar disorder should be excluded. As a whole, these results suggest that drug therapy has some effect, but it is clear that a more systematic randomization test is needed. A lon g-term tracking survey (1-2 years) is also recommended.

Gambling Counseling Certification and Services 4

Neurological research (and explained in Chapter 4) suggests that pathological gambling is involved in serotonin, noruepinefrins and dopamine. The drugs used in these studies target one or more of these neurotransography. Noruepinefrin is related to awakening and new track, dopamine is rewarded and motivated, and serotonin is relevant to impulsivity and compulsive (Hollander et al., 1998). Another approach suggested in these studies is to use drugs to treat concomitant diseases. In fact, this is probably the most frequently listed reasons for drug therapy to players. Generally, a combined disease prescribed by drugs includes depression, bipolar disorder, and attention deficit hyperactivity disorder. From , recently Hollander et al. (1998) has announced the results of a singl e-hearted placebo test (eight weeks each). Of the nineteen pathogen, nine people dropped out of the placebo group. Seven out of the remaining ten have shown significant improvements measured by significant decrease in craving and achieving abstinence. Two of the three who did not respond were emotional unstable. Furboxamine and other selective serotonin r e-incorporation inhibitors (SSRIs) can turn depressed patients into manic and bring out the basics, so the maximum dosage (250 mg/ day) is particularly high (250 mg/ day). There was concern that drugs would worsen emotional instability. This was especially true at the highest dose (250 mg/ day). The authors advised that in the future study of administering SSRI to the pathological gambler, patients with bipolar disorder should be excluded. As a whole, these results suggest that drug therapy has some effect, but it is clear that a more systematic randomization test is needed. A lon g-term tracking survey (1-2 years) is also recommended.

Neurological research (and explained in Chapter 4) suggests that pathological gambling is involved in serotonin, noruepinefrins and dopamine. The drugs used in these studies target one or more of these neurotransography. Noruepinefrin is related to awakening and new track, dopamine is rewarded and motivated, and serotonin is relevant to impulsivity and compulsive (Hollander et al., 1998). Another approach suggested in these studies is to use drugs to treat concomitant diseases. In fact, this is probably the most frequently listed reasons for drug therapy to players. Generally, a combined disease prescribed by drugs includes depression, bipolar disorder, and attention deficit hyperactivity disorder. More recently, Hollander et al. (1998) has announced the results of a singl e-hearted placebo test (eight weeks of each phase). Of the nineteen pathogen, nine people dropped out of the placebo group. Seven out of the remaining ten have shown significant improvements measured by significant decrease in craving and achieving abstinence. Two of the three who did not respond were emotional unstable. Furboxamine and other selective serotonin r e-incorporation inhibitors (SSRIs) can turn depressed patients into manic and bring out the basics, so the maximum dosage (250 mg/ day) is particularly high (250 mg/ day). There was concern that drugs would worsen emotional instability. This was especially true at the highest dose (250 mg/ day). The authors advised that in the future study of administering SSRI to the pathological gambler, patients with bipolar disorder should be excluded. As a whole, these results suggest that drug therapy has some effect, but it is clear that a more systematic randomization test is required. A lon g-term tracking survey (1-2 years) is also recommended.

Prevention

Rosenthal (1997) discusses evidence of drug use in the treatment of pathological players. Some patients experience withdrawal symptoms, including remarkable physical symptoms (WRAY and DICKERSON, 1981; Meer, 1989; Rosenthal and Lesieur, 1992), but there is no need to pickle them. Also, some players report frequent and strong desires. Rosenthal (1997) has outline some approaches to drug therapy of desire. One of the most promising ones is a drug that blocks the excitement and pleasure of toxic drugs. The bes t-known blocking drug is Narutoxon, an opioid antagonist used to treat alcoholism. It is also used to treat cocaine and heroin addicts. The effectiveness of this drug in the treatment of pathological gamblers is currently being studied under the management conditions by SUCK-Won Kim of Minnesota University (Kim, 1998).

However, pharmacotherapy is meaningful only for patients to take. It is estimated that 50 % of all patients will not take the medicine given by doctors. Greenstein et al. (1981) stated that less than 10 % of the patients who started treatment by Narutrexon for opioid dependence were taking two months later. In the case of a pathological gambler, no matter how effective it is, compliance is a problem because it often takes two optional attitudes to stop gambling or change lon g-term treatment patterns. When you stop gambling, you often feel something deprived (TABER, 1985). Rosenthal (1997) discusses evidence of drug use in the treatment of pathological players. Some patients experience withdrawal symptoms, including remarkable physical symptoms (WRAY and DICKERSON, 1981; Meer, 1989; Rosenthal and Lesieur, 1992), but there is no need to pickle them. Also, some players report frequent and strong desires. Rosenthal (1997) has outline some approaches to drug therapy of desire. One of the most promising ones is a drug that blocks the excitement and pleasure of toxic drugs. The bes t-known blocking drug is Narutoxon, an opioid antagonist used to treat alcoholism. It is also used to treat cocaine and heroin addicts. The effectiveness of this drug in the treatment of pathological gamblers is currently being studied under the management conditions by SUCK-Won Kim of Minnesota University (Kim, 1998).

Conclusions

However, pharmacotherapy is meaningful only for patients to take. It is estimated that 50 % of all patients will not take the medicine given by doctors. Greenstein et al. (1981) stated that less than 10 % of the patients who started treatment by Narutrexon for opioid dependence were taking two months later. In the case of a pathological gambler, no matter how effective it is, compliance is a problem because it often takes two optional attitudes to stop gambling or change lon g-term treatment patterns. When you stop gambling, you often feel something deprived (TABER, 1985). Rosenthal (1997) discusses evidence of drug use in the treatment of pathological players. Some patients experience withdrawal symptoms, including remarkable physical symptoms (WRAY and DICKERSON, 1981; Meer, 1989; Rosenthal and Lesieur, 1992), but there is no need to pickle them. Also, some players report frequent and strong desires. Rosenthal (1997) has outline some approaches to drug therapy of desire. One of the most promising ones is a drug that blocks the excitement and pleasure of toxic drugs. The bes t-known blocking drug is Narutoxon, an opioid antagonist used to treat alcoholism. It is also used to treat cocaine and heroin addicts. The effectiveness of this drug in the treatment of pathological gamblers is currently being studied under the management conditions by SUCK-Won Kim of Minnesota University (Kim, 1998).

This category treatment, which has a relatively long tradition, includes a wide range of technologies used in hospitalization programs and outpatient programs. The first i n-hospital game program, which began in 1972 at a hospital management hospital in Ohio, is based on an existing program for alcoholic patients. The similarities with the drug abuse program continue, and there are educational elements related to addiction, including the use of recovered players as a piercouncer, emphasizing anonymous or other 1 2-stage meetings, and addiction, including recurrence. , Personal Communication to the Committee, 1998). The latter element focuses on how to avoid hig h-risk situations, how to identify specific gambling triggers, and how to solve problems solving to deal with triggers and desires. McCormick (1994) believes that morbid gamblin g-related people lack the number of skills they have and the ability to flexibly select the most appropriate skills according to the encounter. In comparison with drug abuse, it has been found that gamblin g-addicted drug abuse uses quite a lot of avoidance and impulsive treatment styles.

There are other treatment materials often used in addictio n-based programs. One is autobiography (Adkins et al., 1985). Patients write their gambling problems into the story of important events in life, and read them to the treatment team. Feedback focuses on the role that gambling plays in that person's life and how the person's actions and perceptions contribute to the occurrence of the problem. Reading autobiography is often a very emotional experience, and many people believe that it is a passing ritual to the treatment program and a turning point of recovery (Adkins et al., 1985. ). This category treatment, which has a relatively long tradition, includes a wide range of technologies used in hospitalization programs and outpatient programs. The first i n-hospital game program, which began in 1972 at a hospital management hospital in Ohio, is based on an existing program for alcoholic patients. The similarities with the drug abuse program continue, and there are educational elements related to addiction, including the use of recovered players as a piercouncer, emphasizing anonymous or other 1 2-stage meetings, and addiction, including recurrence. , Personal Communication to the Committee, 1998). The latter element focuses on how to avoid hig h-risk situations, how to identify specific gambling triggers, and how to solve problems solving to deal with triggers and desires. McCormick (1994) believes that morbid gamblin g-related people lack the number of skills they have and the ability to flexibly select the most appropriate skills according to the encounter. In comparison with drug abuse, it has been found that gamblin g-addicted drug abuse uses quite a lot of evasion and impulsive treatment styles.

There are other treatment materials often used in addictio n-based programs. One is autobiography (Adkins et al., 1985). Patients write their gambling problems into the story of important events in life, and read them to the treatment team. Feedback focuses on the role that gambling plays in that person's life and how the person's actions and perceptions contribute to the occurrence of the problem. Reading autobiography is often a very emotional experience, and many people believe that it is a passing ritual to the treatment program and a turning point of recovery (Adkins et al., 1985. ). This category treatment, which has a relatively long tradition, includes a wide range of technologies used in hospitalization programs and outpatient programs. The first i n-hospital game program, which began in 1972 at a hospital management hospital in Ohio, is based on an existing program for alcoholic patients. The similarities with the drug abuse program continue, and there are educational elements related to addiction, including the use of recovered players as a piercouncer, emphasizing anonymous or other 1 2-stage meetings, and addiction, including recurrence. , Personal Communication to the Committee, 1998). The latter element focuses on how to avoid hig h-risk situations, how to identify specific gambling triggers, and how to solve problems solving to deal with triggers and desires. McCormick (1994) believes that morbid gamblin g-related people lack the number of skills they have and the ability to flexibly select the most appropriate skills according to the encounter. In comparison with drug abuse, it has been found that gamblin g-addicted drug abuse uses quite a lot of avoidance and impulsive treatment styles.

There are other treatment materials often used in addictio n-based programs. One is an autobiography (Adkins et al., 1985). Patients write their gambling problems into the story of important events in life, and read them to the treatment team. Feedback focuses on the role that gambling plays in that person's life and how the person's actions and perceptions contribute to the occurrence of the problem. Reading autobiography is often a very emotional experience, and many people believe that it is a passing ritual to the treatment program and a turning point of recovery (Adkins et al., 1985. ).

Cultural or family therapy is another treatment element of addictio n-based treatment. This element is important when dealing with a pathological gambler because families often desperate to allow gamblers. According to clinical wisdom, my family gets angry after gambling. This may be because gambling is easy to hide, economic and interpersonal damage in a short period of time. People who are close to gamblers continue to be angry to protect themselves with distrust. Franklin and Thomas (1989) point out that gamblin g-addicts are often resentful and resistant when they return to their families. Spousal and children are often depressed and have problems that need treatment. Alternatively, gambling has intermittent rewards (Heineman, 1994), so families may get angry at the patient's gambling.

Another important aspect of addictio n-based approach is the after care. This includes confirmation of support systems, continuous membership of Gamblaz Annimus, budget and plan for economic recovery, planning for legal issues, continuous individual or group therapy, Includes family therapy, drug management, etc.

The literature includes some results research on addictio n-based treatments. According to a study that reported the result data for 6 months and one year, the contact rate of the contact was about 50 % (Russo et al., 1984; Taber et al., 1987; And Winters, 1996). In all studies, it has been reported that gambling has improved interpersonal and interpersonal functions more than those who have returned to some gambling. Some studies have recognized the decrease in drug use during tracking (Lesieur and Bloom, 1991; TABER ET AL., 1987; STINCHFIELD and WINTERS, 1996). joint therapy or family therapy is another treatment factor in addiction. This element is important when dealing with a pathological gambler because families often desperate to allow gamblers. According to clinical wisdom, my family gets angry after gambling. This may be because gambling is easy to hide, economic and interpersonal damage in a short period of time. People who are close to gamblers continue to be angry to protect themselves with distrust. Franklin and Thomas (1989) point out that gamblin g-addicts are often resentful and resistant when they return to their families. Spousal and children are often depressed and have problems that need treatment. Alternatively, gambling has intermittent rewards (Heineman, 1994), so families may get angry at the patient's gambling.

The literature includes some results research on addictio n-based treatments. According to a study that reported the result data for 6 months and one year, the contact rate of the contact was about 50 % (Russo et al., 1984; Taber et al., 1987; And Winters, 1996). In all studies, it has been reported that gambling has improved interpersonal and interpersonal functions more than those who have returned to some gambling. Some studies have recognized the decrease in drug use during tracking (Lesieur and Bloom, 1991; TABER ET AL., 1987; STINCHFIELD and WINTERS, 1996). Cultural or family therapy is another treatment element of addictio n-based treatment. This element is important when dealing with a pathological gambler because families often desperate to allow gamblers. According to clinical wisdom, my family gets angry after gambling. This may be because gambling is easy to hide, economic and interpersonal damage in a short period of time. People who are close to gamblers continue to be angry to protect themselves with distrust. Franklin and Thomas (1989) point out that gamblin g-addicts are often resentful and resistant when they return to their families. Spousal and children are often depressed and have problems that need treatment. Alternatively, gambling has intermittent rewards (Heineman, 1994), so families may get angry at the patient's gambling.

References

Most research is small, but Minnesota's research reports hundreds of clients for six diversity programs that have been funded by the state (STINGHFIELD and WINTERS, 1996). According to this study, the interruption rate was 43 % (6 months), 42 % (12 months), and the frequency of gambling was less than once a month (6 months). And 24 % (12 months). Interestingly, the gamblers who have started treatment but have not been completed, and gamblers who have received only intake evaluation have reported almost all variables on gambling and psychological functions, but the degree of changes is the degree of changes. , It was not dramatic than the person who completed the treatment (Rhodes et al., 1997; Stinchfield and Winters, 1996).

Some approaches in multiple methods are evaluated for lon g-term effectiveness. Hudac et al. (1989) evaluated 26 male gamblers four years after treatment. Of the 26 people, eight were discontinued, and others decreased gambling compared to before treatment. However, the gambler, who came into contact during the fou r-year tracking survey, was only about on e-third of the first treatment samples from 99 pathological gamblers. SchWartz and Linder (1992) revealed that 13 out of 25 clients were inaccessible after two years of hospitalization with a clien t-centered approach. I have not been able to contact 33 people). Most studies have a small number of samples, but Minnesota's research reports hundreds of clients for six diversity programs (STINGHFIELD and WINTERS, 1996). According to this study, the interruption rate was 43 % (6 months), 42 % (12 months), and the frequency of gambling was less than once a month (6 months). And 24 % (12 months). Interestingly, the gamblers who have started treatment but have not been completed, and gamblers who have received only intake evaluation have reported almost all variables on gambling and psychological functions, but the degree of changes is the degree of changes. , It was not dramatic than the person who completed the treatment (Rhodes et al., 1997; Stinchfield and Winters, 1996).

Some approaches in multiple methods are evaluated for lon g-term effectiveness. Hudac et al. (1989) evaluated 26 male gamblers four years after treatment. Of the 26 people, eight were discontinued, and others decreased gambling compared to before treatment. However, the gambler, who came into contact during the fou r-year tracking survey, was only about on e-third of the first treatment samples from 99 pathological gamblers. SchWartz and Linder (1992) revealed that 13 out of 25 clients were inaccessible after two years of hospitalization with a clien t-centered approach. I have not been able to contact 33 people). Most research is small, but Minnesota's research reports hundreds of clients for six diversity programs that have been funded by the state (STINGHFIELD and WINTERS, 1996). According to this study, the interruption rate was 43 % (6 months), 42 % (12 months), and the frequency of gambling was less than once a month (6 months). And 24 % (12 months). Interestingly, the gamblers who have started treatment but have not been completed, and gamblers who have received only intake evaluation have reported almost all variables on gambling and psychological functions, but the degree of changes is the degree of changes. , It was not dramatic than the person who completed the treatment (Rhodes et al., 1997; Stinchfield and Winters, 1996).

Gamblaz Anonimus (GA) is considered to be most commonly used among all approaches to treat pathological gambling and is generally included in mult i-modal strategies (Lesieur,). 1998). According to the data, the recurrence rate of participants tends to be quite high. Stewart and Brown (1988) reported that the overall abstinence was only 8%and two years later in a survey one year after his first participation. Comparing the gambling and those who left the Gamblers Anonimus, Brown (1987) tends to recognize that there are few gambling problems, and there is a personality collision with the participants. He reported that Gamblaz Annimus's only abstinence was very strict. Other researchers have investigated the role of Gamblaz Annimus to maintain abstinence. TAber et al. (1987) said that 74 % of the sample gamblers attended at least three meetings last month, while only 42 % of the gambling continued.

The therapeutic effect of anonymous gamblers is also investigated in connection with the involvement of gambler spouses. Johnson and Nora (1992) discovered that gamblers, whose spouses are participating in meetings, tend to have a higher drug rate than gamblers where their spouses are not participating. Although it was not statistically significant, 20 of the 44 gamblers who participated in the meeting had stopped gambling for at least four years, but the spouse did not participate in the meeting. 13 of the gamblers of the human stopping gambling. In short, the popularity of Gamblers Annimas may be growing (Lopez Viets and Miller, 1997), but it is not yet known whether attending the meeting will have an important and permanent impact (Brown, 1985; Rosecrance, 1988). Gamblaz Annimus (GA) is considered to be most commonly used among all approaches to treat pathological gambling and is generally included in multimodal strategies. (Lesieur, 1998). According to the data, the recurrence rate of participants tends to be quite high. Stewart and Brown (1988) reported that the overall abstinence was only 8%and two years later in a survey one year after his first participation. Comparing the gambling and those who left the Gamblers Anonimus, Brown (1987) tends to recognize that there are few gambling problems, and there is a personality collision with the participants. He reported that Gamblaz Annimus's only abstinence was very strict. Other researchers have investigated the role of Gamblaz Annimus to maintain abstinence. TAber et al. (1987) said that 74 % of the sample gamblers attended at least three meetings last month, while only 42 % of the gambling continued. The therapeutic effect of anonymous gamblers is also investigated in connection with the involvement of gambler spouses. Johnson and Nora (1992) discovered that gamblers, whose spouses are participating in meetings, tend to have a higher drug rate than gamblers where their spouses are not participating. Although it was not statistically significant, 20 of the 44 gamblers who participated in the meeting had stopped gambling for at least four years, but the spouse did not participate in the meeting. 13 of the gamblers of the human stopping gambling. In short, the popularity of Gamblers Annimas may be growing (Lopez Viets and Miller, 1997), but it is not yet known whether attending the meeting will have an important and permanent impact (Brown, 1985; Rosecrance, 1988). Gamblaz Anonimus (GA) is considered to be most commonly used among all approaches to treat pathological gambling and is generally included in mult i-modal strategies (Lesieur,). 1998). According to the data, the recurrence rate of participants tends to be quite high. Stewart and Brown (1988) reported that the overall abstinence was only 8%and two years later in a survey one year after his first participation. Comparing the gambling and those who left the Gamblers Anonimus, Brown (1987) tends to recognize that there are few gambling problems, and there is a personality collision with the participants. He reported that Gamblaz Annimus's only abstinence was very strict. Other researchers have investigated the role of Gamblaz Annimus to maintain abstinence. TAber et al. (1987) said that 74 % of the sample gamblers attended at least three meetings last month, while only 42 % of the gambling continued.

Related to the Anonymous Gamblers approach is the use of self-help and psychoactive literature for pathological gamblers. Dickerson et al. (1990) conducted a pilot study comparing the use of a self-help manual alone with the use of the manual in combination with interviews with an experienced therapist. The manual focused on the definition and underlying causes of problem gambling, and how to monitor and replace problematic behaviors with incompatible but healthy behaviors. The manual-interview group showed faster improvement at the first 3-month follow-up, but the improvement was not sustained at the 6-month follow-up. An interesting aspect of this study is that most clients chose abstinence, rather than reduction, as their goal.

Recovery from pathological gambling does not require formal treatment. It is important to understand how physical recovery occurs. First, factors associated with such physical recovery can be incorporated into treatment services. Second, policymakers need to know how many problem gamblers physically recover when assessing the social costs associated with gambling disorder. The rate and process of physical recovery provide a benchmark for judging social costs and treatment outcomes and effectiveness. Thus, estimates of the social impact (Prochaska, 1996) or cost-effectiveness of treatment cannot be calculated unless the rate of natural recovery from pathological gambling is calculated. For example, some economists calculate estimates of social costs assuming no recovery in the absence of treatment (Institute of Medicine, 1996). If some assumption is made about the natural rate of recovery for pathological gamblers, the social costs of gambling will be lower than estimates that assume no possibility of natural recovery.

Since Winick (1962) first described the "maturation" process of drug use, the idea of natural recovery has captured the imagination of many clinical researchers. Related to the Anonymous Gamblers approach is the use of self-help and psychoactive literature with pathological gamblers. Dickerson et al. (1990) conducted a pilot study comparing the use of a self-help manual alone with a manual combined with interviews with an experienced therapist. The manual focused on the definition and underlying causes of problem gambling, and ways to monitor and replace problem behaviors with incompatible but healthy behaviors. The manual-interviewed group received initial Although there was a faster improvement at the 3-month follow-up, the improvement was not sustained at the 6-month follow-up. An interesting aspect of this study is that most clients chose abstinence as their goal, rather than reduction in gambling.

Recovery from pathological gambling does not require formal treatment. It is important to understand how physical recovery occurs. First, factors related to such physical recovery can be incorporated into treatment services. Second, policymakers need to know how many problem gamblers physically recover when assessing the social costs associated with gambling disorders. The rate and process of physical recovery are the benchmark for judging social costs and the outcomes and effectiveness of treatment. Thus, estimates of the social impact (Prochaska, 1996) or cost-effectiveness of treatment cannot be calculated unless the natural rate of recovery from pathological gambling is calculated. For example, some economists calculate estimates of social costs as if there was no recovery without treatment (Institute of Medicine, 1996). If we make some assumption about the rate of natural recovery for pathological gamblers, the social costs of gambling will be lower than estimates that assume no possibility of natural recovery.

The idea of natural recovery has captured the imagination of many clinical researchers since Winick (1962) first described the process of "maturity" in drug use (1996; Prochaska, 1982), cocaine use (Shaffer and Jones, 1989; Toneatto et al. Related to the Anonymous Gamblers approach is the use of self-help and psychoactive literature for pathological gamblers. Dickerson et al. (1990) conducted a pilot study comparing the use of a self-help manual alone with the use of the manual in combination with interviews with an experienced therapist. The manual focused on the definition and underlying causes of problem gambling, and how to monitor and replace problem behaviors with incompatible but healthy behaviors. The manual-interview group showed faster improvement at the first 3-month follow-up, but the improvement was not sustained at the 6-month follow-up. An interesting aspect of this study is that most clients chose abstinence, rather than reduction in gambling, as their goal.

Recovery from pathological gambling does not require formal treatment. It is important to understand how physical recovery occurs. First, factors related to such physical recovery can be incorporated into treatment services. Second, policymakers need to know how many problem gamblers physically recover when assessing the social costs associated with gambling disorders. The rate and process of physical recovery are the benchmark for judging social costs and the outcomes and effectiveness of treatment. Thus, estimates of the social impact (Prochaska, 1996) or cost-effectiveness of treatment cannot be calculated unless the rate of natural recovery from pathological gambling is calculated. For example, some economists calculate estimates of social costs as if there was no recovery in the absence of treatment (Institute of Medicine, 1996). Making some assumptions about the natural rate of recovery for pathological gamblers results in lower social costs of gambling than estimates that assume no possibility of natural recovery.

Since Winick (1962) first described the "maturation" process of drug use, the idea of natural recovery has captured the imagination of many clinical researchers.

Some researchers suggest that prevalence studies provide indirect evidence of natural recovery from gambling problems. Volberg (1995) observed that the difference between higher rates of gambling disorders among youth and lower rates among adults suggests the existence of natural recovery, but prospective longitudinal studies are needed to confirm this conclusion. In a Canadian community survey conducted by Wynne (1994), 36% of respondents who reported having had a gambling problem in the past reported that they had not had a gambling problem in the past year. In a more direct study of natural recovery, Hodgins and el-Guebaly (1998) recruited problem gamblers who had resolved their gambling problems with or without treatment. In their sample, about half reported recovery without treatment. The only variable that significantly differentiated those who received treatment from those who did not was the number of DSM-IV gambling pathology symptoms. Those who received treatment reported about two more symptoms than those who did not receive treatment (about eight versus six). However, although research over the past decade has improved knowledge of physical recovery from psychoactive substances to some extent, physical recovery from gambling has not been examined.

Although the effectiveness of various treatment approaches has not been fully documented, it is the opinion of the committee that treatment is probably justified for most, if not all, pathological gamblers. This view is based on three premises: first, pathological gambling is a serious disorder with several negative consequences; second, evidence that self-help groups alone are not very effective (Brown, 1987); third, that pathological gambling is a chronic relapsing disorder that often continues indefinitely, even with periods of remission. However, these hypotheses require validation by substantial and rigorous research. At present, it is not known which treatments are most effective, why they work, or to what extent players are able to recover naturally.

While substance abuse has attracted policymakers' attention, the need for treatment for pathological gambling has not been widely recognized. It is difficult to know the extent to which insurance coverage exists for the disorder because there is a lack of consistent reporting by treatment providers and jurisdictions on the amount spent on treating pathological gamblers. For example, in a study conducted for the Commission, Svendsen (1998) contacted 20 major U. S. insurance companies to find out how much they spent on gambling treatment. The companies reportedly did not disclose information about reimbursement for specific disorders, stating that such information was provided only to subscribers or their physicians. However, in the same study, affiliates of the National Council on Problem Gambling in all 34 states found that most health insurance companies and managed care providers did not reimburse individuals for receiving treatment for pathological gambling (Svendsen, 1998). This exclusion from reimbursement occurs even though pathological gambling has been recognized as a mental health disorder by the American Psychiatric Association since 1980 (American Psychiatric Association, 1980). This practice not only prevents many people from receiving treatment, but also keeps patients who need it away from treatment.

Current treatment of pathological gambling in the United States is in many ways similar to treatment of substance use disorders (Blume, 1986). Although many approaches have been implemented for pathological gamblers, most treatment is outpatient. Inpatient treatment is generally limited to patients with severe acute episodes, treatment failures, and severe comorbid disorders, especially depression (Lesieur, 1998; Blume, 1986). Although there has been a growing trend of treatment programs focusing on pathological gambling, many still serve as niche components of existing substance abuse programs (Lesieur, 1998). Furthermore, despite a growing trend in the United States toward harm reduction strategies and control behavior approaches to addiction problems (Marlatt and Tapert, 1993), most gambling treatment programs, like those treating substance abuse, advocate abstinence. However, some programs, especially those dealing with early-stage problem gamblers, aim to reduce and control gambling rather than stop it (Lesieur, 1998). It is important to keep in mind that gambling treatment is most likely to be provided by a combination of professionals and non-professionals, i. e., some who treat primarily gambling problems and others who provide general counseling but may also work with problem gamblers. In some cases, non-professionals provide the majority of addiction treatment services. As a complement or alternative to primary treatment, treatment providers often refer gamblers to Gamers Anonymous or Gam-Anon (Lesieur, 1998; Stinchfield and Winters, 1996). In fact, Gamblers Anonymous is the most readily available help for problem gamblers, and its cost is virtually zero. Based on a review of its international services, Internet website, and archival records (Svendsen, 1998), Gamblers Anonymous holds meetings in all 50 states, with an average of 26 annual meetings per state, a median of 14, and a 36% increase from 1995 to 1998 (see Appendix E).

As already mentioned, as the consensus of each of the US Gamble On Problem Gambling, most medical insurance in the United States has been treated as a pathological gambling. Not paid (SVENDSEN, 1998). Nevertheless, funding for gambling treatment is small. Many of the 34 stat e-related organizations and the national institutions themselves have received a lot of funding from states or gambling industrial organizations (Letson, 1998; SVENDSEN, 1998). Approximately half of them have reported that they have received public funding to support the treatment of the gambling (SVENDSEN, 1998). The income arising from gambling in the state is used for the cost of such services. The amount of money on gambling addiction treatment services is quite wide ($ 100, 000 to $ 1. 5 million), but most states are low. Naturally, the partner committee believes that this amount is not enough (Letson, 1998: 53). Even in a state, which is spending a lot of expenditures on pathological gambling, the amount is small compared to the legalized gambling income. For example, the amount of the New York State allocated to the Gambling addiction Countermeasures Committee is small compared to the amount distributed by the Gambling addiction Countermeasures Committee to the Gambling addiction Countermeasures Committee. As already mentioned, as the consent of each state organization of the National Council On Problem Gambling, most medical insurance in the United States is the person who has been treated for pathological gambling. I did not pay insurance (SVENDSEN, 1998). Nevertheless, funding for gambling treatment is small. Many of the 34 stat e-related organizations and the national institutions themselves have received a lot of funding from states or gambling industrial organizations (Letson, 1998; SVENDSEN, 1998). Approximately half of them have reported that they have received public funding to support the treatment of the gambling (SVENDSEN, 1998). The income arising from gambling in the state is used for the cost of such services. The amount of money on gambling addiction treatment services is quite wide ($ 100, 000 to $ 1. 5 million), but most states are low. Naturally, the partner committee believes that this amount is not enough (Letson, 1998: 53). Even in a state, which is spending a lot of expenditures on pathological gambling, the amount is small compared to the legalized gambling income. For example, the amount of the New York State allocated to the Gambling addiction Countermeasures Committee is small compared to the amount distributed by the Gambling addiction Countermeasures Committee to the Gambling addiction Countermeasures Committee. As already mentioned, as the consensus of each of the US Gamble On Problem Gambling, most medical insurance in the United States has been treated as a pathological gambling. Not paid (SVENDSEN, 1998). Nevertheless, funding for gambling treatment is small. Many of the 34 stat e-related organizations and the national institutions themselves have received a lot of funding from states or gambling industrial organizations (Letson, 1998; SVENDSEN, 1998). Approximately half of them have reported that they have received public funding to support the treatment of the gambling (SVENDSEN, 1998). The income arising from gambling in the state is used for the cost of such services. The amount of money on gambling addiction treatment services is quite wide ($ 100, 000 to $ 1. 5 million), but most states are low. Naturally, the partner committee believes that this amount is not enough (Letson, 1998: 53). Even in a state, which is spending a lot of expenditures on pathological gambling, the amount is small compared to the legalized gambling income. For example, the amount of the New York State allocated to the Gambling addiction Countermeasures Committee is small compared to the amount distributed by the Gambling addiction Countermeasures Committee to the Gambling addiction Countermeasures Committee.

If the number of pathological gamblers in the United States and the actual number of patients who have been treated with this disorder are not correctly estimated, it is almost impossible to evaluate the gap between the need for treatment services and use. In the field of pathological gambling, there are five reasons for the need for treatment and treatment (Letson, 1998): (1) Many gambling addiction patients have been treated. No must. (2) The perception that pathological gambling and problem gambling have a significant impact on health have not spread to the public. (3) The medical insurer shall not recognize the general public and treatment specialists recognized by the recognized country or state organizations as eligible providers for pathological gambling treatment. (5) Recognition that treatment may not be effective or may not be effective.

According to a survey conducted and implemented for the Committee To Problem Gambling HelPlines In the United States Currently, gambling is legal in some way It has been reported that it is operated in 35 of the 47 states (Wallisch, 1998). In addition, the National Council On Problem Gambling, Inc. has a nationwide toll-free (1-800-522-4700) and is used as a state of the whole state. In some cases, some states advertise them separately from the entire state number.

Approximately 60-70%of the inquiry to the helpline is due to a player seeking help for himself, and the rest is about problematic gamblers, such as spouses, family, friends, therapists, and employers. It is estimated. A typical service provided by a helpline is usually provided by an experienced graduate school graduate counselor (although many helplines do not have specialized staff and take care of their responsibilities). (Survey on gambling, etc.), introduction of treatment institutions, introduction of credit and debt advice, crisis intervention (some are transferred to the Crisis Line directly). There are also programs that provide gambling education, enlightenment activities, preventive activities, vocational training, etc.

About 60% of helplines receive most or all of their funding from the state in which they operate. Gambling helplines are funded by a variety of sources, including the gambling industry, corporate and other equity interests, private donations, and in-kind donations. Helplines advertise their call numbers in a variety of ways, including banners on video calling terminals during non-playing hours (South Dakota), stickers, posters, and pens (Delaware), and billboards (Delaware and Louisiana); on bus routes (Delaware), pending social service department phone records (Delaware), targeted mailings to professionals, clergy, and correctional staff (Minnesota), on the backs of grocery store receipts (Minnesota), and on official New York Yankees signs outside ballparks (New York); in collateral material provided by other organizations (Texas); in church newsletters (Texas); in Alcoholics Anonymous meeting rooms (Texas); in Card Players magazine (California); and prominent posters in casinos. Most helplines cover the entire state and have no restrictions on the area or population they serve. Because national telephone numbers attempt to find help for everyone in the United States, theoretically, no state is completely uncovered. However, this diversity in approaches to helplines does not mean that all callers receive equally effective service, and it can lead to confusion. For example, a person with a gambling problem in Rhode Island might call the Rhode Island gambling helpline and speak to a counselor from Travelers' Aid, but he or she might also speak to a counselor from the Connecticut council (because the Connecticut gambling helpline is advertised as covering Rhode Island). Depending on how frequently these organizations share and update information, they may refer you to different sets of counseling or use different counseling techniques. This can be bothersome for callers and confusing.

Hellpline, which reports data on the number of calls received, distinguishes the legitimate call from the gambler or a gambler, and the inappropriate calls that require information on the gambling method and the winning lottery number. I am. This data was calculated to the committee from the responding to our min i-hearts, or on a weekly basis from the data already reported in the form of a helpline report or data sheet. 。 It is important to note that only several states report the number of calls created by the population statistics and may not represent all helplin e-related calls. Considering such precautions, the number of calls per week was about 10 to hundreds. 1-800-Gambler number, like New Jersey, has been published nationwide, and has signed a contract to cover many states, such as the state of calling from all over the country and Texas. Then, hundreds of weeks are reported. New England and Maryland reported more than 100 cases a week, and 50 to 100 of the other six states (Florida, Minnesota, New York, Iva, Penchlvania, Wisconsin). Hellpline, which reports data on the number of calls received, is an inappropriate call that requires information about a legitimate call from a problem gambler or a gambler, a gambling method and a lottery number. Is distinguished. This data was calculated to the committee from the responding to our min i-hearts, or on a weekly basis from the data already reported in the form of a helpline report or data sheet. 。 It is important to note that only several states report the number of calls created by the population statistics and may not represent all helplin e-related calls. Considering such precautions, the number of calls per week was about 10 to hundreds. 1-800-Gambler number, like New Jersey, has been published nationwide, and has signed a contract to cover many states, such as the state of calling from all over the country and Texas. Then, hundreds of weeks are reported. New England and Maryland reported more than 100 cases a week, and 50 to 100 of the other six states (Florida, Minnesota, New York, Iva, Penchlvania, Wisconsin). Hellpline, which reports data on the number of calls received, distinguishes the legitimate call from the gambler or a gambler, and the inappropriate calls that require information on the gambling method and the winning lottery number. I am. This data was calculated to the committee from the responding to our min i-hearts, or on a weekly basis from the data already reported in the form of a helpline report or data sheet. 。 It is important to note that only several states report the number of calls created by the population statistics and may not represent all helplin e-related calls. Considering such precautions, the number of calls per week was about 10 to hundreds. 1-800-Gambler number, like New Jersey, has been published nationwide, and has signed a contract to cover many states, such as the state of calling from all over the country and Texas. Then, hundreds of weeks are reported. New England and Maryland reported more than 100 cases a week, and 50 to 100 of the other six states (Florida, Minnesota, New York, Iva, Penchlvania, Wisconsin).

Some helplines develop calling systems and customer information systems. These systems have a big variation. There are various questions, and there are various questions that are reported, not necessarily all telephone users. There are also programs that regularly publish detailed information in the form of mail, annual report, publishing on the Internet site. Some report information only if necessary. Because of the variety of data format and content, it is difficult to derive reliable conclusions. However, three systematic surveys on assistance data are noteworthy. First, a study by WalliskH and COX (1997) compares the population statistical distribution of Helprine callers in Texas and the population of gamblers in the general population of Texas. The authors have discovered that the proportion of gamblers of a specific group of the helpline is low. Specifically, young, women, and Hispanic players were less likely to call than expected from the number of gambler groups. Considering the increase in the number of cases conducted by the state as a whole, it is necessary to expand this type of study that compares the provisions of the provisions of the help of the helpline with the general group's disease rate data. Some helplines develop calling systems and customer information systems. These systems have a big variation. There are various questions, and there are various questions that are reported, not necessarily all telephone users. There are also programs that regularly publish detailed information in the form of mail, annual report, publishing on the Internet site. Some report information only if necessary. Because of the variety of data format and content, it is difficult to derive reliable conclusions. However, three systematic surveys on assistance data are noteworthy. First, a study by WalliskH and COX (1997) compares the population statistical distribution of Helprine callers in Texas and the population of gamblers in the general population of Texas. The authors have discovered that the proportion of gamblers of a specific group of the helpline is low. Specifically, young, women, and Hispanic players were less likely to call than expected from the number of gambler groups. Considering the increase in the number of cases conducted by the state as a whole, it is necessary to expand this type of study that compares the provisions of the provisions of the help of the helpline with the general group's disease rate data. Some helplines develop calling systems and customer information systems. These systems have a big variation. There are various questions, and there are various questions that are reported, not necessarily all telephone users. There are also programs that regularly publish detailed information in the form of mail, annual report, publishing on the Internet site. Some report information only if necessary. Because of the variety of data format and content, it is difficult to derive reliable conclusions. However, three systematic surveys on assistance data are noteworthy. First, a study by WalliskH and COX (1997) compares the population statistical distribution of Helprine callers in Texas and the population of gamblers in the general population of Texas. The authors have discovered that the proportion of gamblers of a specific group of the helpline is low. Specifically, young, women, and Hispanic players were less likely to call than expected from the number of gambler groups. Considering the increase in the number of cases conducted by the state as a whole, it is necessary to expand this type of study that compares the provisions of the provisions of the help of the helpline with the general group's disease rate data.

Although encouraging, this result is only hypothetical. The apparent improvement over time is expected since the helpline was called during a crisis, and the follow-up time was chosen by the researchers.

The general purpose of certifying health care professionals is to provide a form of recognition based on their contributions to the profession and their particular expertise in clinical practice. Such certification does not confer legal status on the certified, but is a means for professionals, legislative and regulatory bodies, private companies, third-party payers, and the public to identify individuals who have demonstrated particular expertise. (1) The American Academy of Health Care Providers in Addictive Disorders, founded in 1989, offers certification for certified addiction specialists in the areas of alcoholism, drug addiction, eating disorders, compulsive gambling, and sexual addiction. (2) The National Council on Problem Gambling, founded in 1972 to provide information on gambling problems, began certifying gambling problem counselors in 1989. Further, although encouraging, the results are only hypothetical. The apparent improvement over time is expected since the helpline was called during a crisis, and the follow-up time was chosen by the researchers.

The general purpose of certifying health care professionals is to provide a form of recognition based on their contributions to the profession or specific expertise in clinical practice. Such certification does not confer legal status on the certified, but is a means for professionals, legislative and regulatory bodies, private companies, third-party payers, and the public to identify individuals who have demonstrated a particular expertise. (1) The American Academy of Health Care Providers in Addictive Disorders, founded in 1989, offers certification for certified addiction specialists in the areas of alcoholism, drug addiction, eating disorders, compulsive gambling, and sexual addiction. (2) The National Council on Problem Gambling, founded in 1972 to provide information on gambling problems, began certifying gambling problem counselors in 1989. Although encouraging, the results are only hypothetical. The apparent improvement over time is expected since the helpline was called during a crisis, and the follow-up time was chosen by the researchers.

The general purpose of certifying health care professionals is to provide a type of recognition based on their contributions to the profession and their specific expertise in clinical practice. Such certification does not confer legal status on the certified, but is a means for professionals, legislative and regulatory bodies, private companies, third-party payers, and the general public to identify individuals who have demonstrated a particular expertise. (1) The American Academy of Health Care Providers in Addictive Disorders, founded in 1989, offers certification for certified addiction specialists in the areas of alcoholism, drug addiction, eating disorders, compulsive gambling, and sexual addiction. (2) The National Council on Problem Gambling, founded in 1972 to provide information on gambling problems, began certifying gambling problem counselors in 1989. In addition,

The current debate over the difference between certification and licensure is an area that deserves attention. There is a trend to license health professionals who treat alcohol and drug addiction. Unlike certification, licensure gives the recipient legal status. Such a process suggests that substance abuse treatment is a profession in its own right, rather than a specialty within another field. Many associations have stated that such licensure is too narrow and would unnecessarily limit or prevent other qualified professionals with backgrounds in, for example, mental health, marriage and family counseling, social work, or psychology, from practicing addiction counseling. Individuals from any of these specialties may have expertise in treating addictive disorders and may wish to obtain professional certification in recognition of their excellence and competence.

In the field of pathological gambling, there have been many prevention efforts, including educating players on the potential of the games they play, providing support services, and developing public and youth awareness campaigns about the potential risks associated with gambling (American Gaming Association, 1998). However, nothing is known yet about the effectiveness of these efforts.

A clear challenge in developing an effective way to prevent gambling is lack of recognition of excessive gambling risks. In a way, drug abuse prevention program is easy. The risk of using illegal drugs can be identified relatively easily. Gambling is not so easy. With a bet, it is hard to get a bad effect immediately. Families may find the influence of excessive gambling of loved ones compared to drug use and smoking. State lottery and casino ads suggest that gambling is a harmless entertainment. The Youth Program has earned money from gambling programs such as bingo and raffle, further backing on the idea that gambling is a useful activity (Wynne et al., 1996). Many states are promoting gambling acceptance using advertising and advertising campaigns. This is (1) drawing gambling as a family entertainment or social recreation, (2) emphasizing the needs of the local community to obtain tax revenue, and (3) changing the rules surrounding the acts so that it does not deviate. , (4) A clear issue in developing an effective way to prevent gambling gambling is lacking in recognition of excessive gambling risks. In a way, drug abuse prevention program is simple. The risk of using illegal drugs can be identified relatively easily. Gambling is not so easy. With a bet, it is hard to get a bad effect immediately. Families may find the influence of excessive gambling of loved ones compared to drug use and smoking. State lottery and casino ads suggest that gambling is a harmless entertainment. The Youth Program has earned money from gambling programs such as bingo and raffle, further backing on the idea that gambling is a useful activity (Wynne et al., 1996). Many states are promoting gambling acceptance using advertising and advertising campaigns. This is (1) drawing gambling as a family entertainment or social recreation, (2) emphasizing the needs of the local community to obtain tax revenue, and (3) changing the rules surrounding the acts so that it does not deviate. , (4) A clear task in developing an effective way to prevent gambling advertisements gambling is the lack of perception of excessive gambling risks. In a way, drug abuse prevention program is simple. The risk of using illegal drugs can be identified relatively easily. Gambling is not so easy. With a bet, it is hard to get a bad effect immediately. Families may find the influence of excessive gambling of loved ones compared to drug use and smoking. State lottery and casino ads suggest that gambling is a harmless entertainment. The Youth Program has earned money from gambling programs such as bingo and raffle, further backing on the idea that gambling is a useful activity (Wynne et al., 1996). Many states are promoting gambling acceptance using advertising and advertising campaigns. This is (1) drawing gambling as a family entertainment or social recreation, (2) emphasizing the needs of the local community to obtain tax revenue, and (3) changing the rules surrounding the acts so that it does not deviate. , (4) Gambling ads

Probably the most coordinated preventive effort is directed to youth. Gambling often starts early and can function as an entrance to excessive gambling in the future (Shaffer and Hall, 1994), so it makes sense from the perspective of public health to target youth. Masu. Only one of the empirical evaluated youth prevention program was found. GABOURY and LADOUCEUR (1993) stated that three session programs in Quebec consisted of alcoho l-prevention models. The program discussed the outline of gambling, legal issues, how to handle the gambling industry, the beliefs and myths of gambling, the development of pathological gambling and the results. He also featured a strategy to control gambling. Five high schools of 289 youth and senior students have completed the project. As a result of the evaluation, the students learned about gambling and how to deal with them, but what they learned did not significantly affect their attitude and actions six months later. Researchers proposed in the future programs to increase the participation of students and teachers and integrate prevention programs into existing drugs and alcoholic prevention programs. In fact, the reason why youth participates in gambling is similar to the reason for the gambling of youth. Probably the most coordinated preventive effort is directed to youth. Gambling often starts early and can function as an entrance to excessive gambling in the future (Shaffer and Hall, 1994), so it makes sense from the perspective of public health to target youth. Masu. Only one of the empirical evaluated youth prevention program was found. GABOURY and LADOUCEUR (1993) stated that three session programs in Quebec consisted of alcoho l-prevention models. The program discussed the outline of gambling, legal issues, how to handle the gambling industry, the beliefs and myths of gambling, the development of pathological gambling and the results. He also featured a strategy to control gambling. Five high schools of 289 youth and senior students have completed the project. As a result of the evaluation, the students learned about gambling and how to deal with them, but what they learned did not significantly affect their attitude and actions six months later. Researchers proposed in the future programs to increase the participation of students and teachers and integrate prevention programs into existing drugs and alcoholic prevention programs. In fact, the reason why youth participates in gambling is similar to the reason for the gambling of youth. Probably the most coordinated preventive effort is directed to youth. Gambling often starts early and can function as an entrance to excessive gambling in the future (Shaffer and Hall, 1994), so it makes sense from the perspective of public health to target youth. Masu. Only one of the empirical evaluated youth prevention program was found. GABOURY and LADOUCEUR (1993) stated that three session programs in Quebec consisted of alcoho l-prevention models. The program discussed the outline of gambling, legal issues, how to handle the gambling industry, the beliefs and myths of gambling, the development of pathological gambling and the results. He also featured a strategy to control gambling. Five high schools of 289 youth and senior students have completed the project. As a result of the evaluation, the students learned about gambling and how to deal with them, but what they learned did not significantly affect their attitude and actions six months later. Researchers proposed in the future programs to increase the participation of students and teachers and integrate prevention programs into existing drugs and alcoholic prevention programs. In fact, the reason why youth participates in gambling is similar to the reason for the gambling of youth.

Known for the treatment of pathological gambling is later than known about its illness and the cause. Reviewing the literature is relatively small, and most of them lack clear concept models and conversion standards, do not report the compliance and withdrawal rate, and maintain the faithfulness of actual treatments and counselors. It can be seen that the follo w-up period is insufficient, with little explanation of measures for the purpose. There is almost no concrete view that can be said at the face value, exceeding the fact that the effectiveness of the treatment approach to gambling addiction (and pathological gambling) is effective to some extent over the unknown follo w-up period (Blaszzczynski) , PERS.) The US National Drug Abuse Research Institute (NIDA) and the US National Intr there, the expense of research expenditures from the Institute for Alcoholism (NIAAA) has become possible, and the treatment and effectiveness of drug abuse treatment are possible. You can list some of the studies you support (Institute of Medicine, 1996: 192).

However, the committee believes that treatment by experts is mostly appropriate for people with pathological gambling disorders. However, it is unlikely that recovery from pathological gambling will accompany a quick and easy treatment because there is no research on the effects of treatment. Rather, in the treatment process, sufficient compliance is not obtained and it is highly likely that it will recur after treatment, and it is not unusual for recovery patterns of chronic diseases such as alcoholism, drug addiction, hypertension and diabetes, lon g-term chronic symptoms. Following the progress may be a characteristic (McClellan et al., 1998). Known about the treatment of pathological gambling is later than knowing its illness and the cause. Reviewing the literature is relatively small, and most of them lack clear concept models and conversion standards, do not report the compliance and withdrawal rate, and maintain the faithfulness of actual treatments and counselors. It can be seen that the follo w-up period is insufficient, with little explanation of measures for the purpose. There is almost no concrete view that can be said at the face value, exceeding the fact that the effectiveness of the treatment approach to gambling addiction (and pathological gambling) is effective to some extent over the unknown follo w-up period (Blaszzczynski) , PERS.) The US National Drug Abuse Research Institute (NIDA) and the US National Intr there, the expense of research expenditures from the Institute for Alcoholism (NIAAA) has become possible, and the treatment and effectiveness of drug abuse treatment are possible. You can list some of the studies you support (Institute of Medicine, 1996: 192).

However, the committee believes that treatment by experts is mostly appropriate for people with pathological gambling disorders. However, it is unlikely that recovery from pathological gambling will accompany a quick and easy treatment because there is no research on the effects of treatment. Rather, in the treatment process, sufficient compliance is not obtained and it is highly likely that it will recur after treatment, and it is not unusual for recovery patterns of chronic diseases such as alcoholism, drug addiction, hypertension and diabetes, lon g-term chronic symptoms. Following the progress may be a characteristic (McClellan et al., 1998). Known for the treatment of pathological gambling is later than known about its illness and the cause. Reviewing the literature is relatively small, and most of them lack clear concept models and conversion standards, do not report the compliance and withdrawal rate, and maintain the faithfulness of actual treatments and counselors. It can be seen that the follo w-up period is insufficient, with little explanation of measures for the purpose. There is almost no concrete view that can be said at the face value, exceeding the fact that the effectiveness of the treatment approach to gambling addiction (and pathological gambling) is effective to some extent over the unknown follo w-up period (Blaszzczynski) , PERS.) The US National Drug Abuse Research Institute (NIDA) and the US National Intr there, the expense of research expenditures from the Institute for Alcoholism (NIAAA) has become possible, and the treatment and effectiveness of drug abuse treatment are possible. You can list some of the studies you support (Institute of Medicine, 1996: 192).

Among substance abuse experts, the general consensus, supported by 20 years of well-funded research, is that some treatment is better for substance abusers than no treatment (Institute of Medicine, 1996). At this time, there does not appear to be any compelling evidence in the pathology literature on gambling to refute the idea that some treatment is better than no treatment. Of course, as the literature on the treatment of this disorder matures, a clearer picture will emerge about the incremental value of treatment.

In the short term, it is important that a comprehensive research agenda on pathological gambling includes policy research to identify alternative and optimal funding mechanisms and structures for raising the funds needed to treat pathological gambling. It would seem prudent to model funding on the system used in substance abuse, allocating funding responsibility to state and local governments, the federal government (acting on behalf of the poor, elderly, and chronically disabled), and private insurers (acting on behalf of employers and health plan recipients). Indeed, private health insurance is currently the largest source of funding for the treatment of alcohol problems (Institute of Medicine, 1990:8). Currently, the main concern raised in the field of pathological and problem gambling treatment is the rapidly rising cost of care, which effectively prevents access to available treatment. It is clear that a more detailed understanding of the effectiveness of treatments for pathological gambling and the cost-effectiveness of various treatments is needed to implement truly non-discriminatory funding policies. Research is essential to clarify the reasons why pathological gamblers do not enter treatment and to inform clinical services on the scope of pathological gambling coverage.

It is also important to study the effects of managed care contracts and health insurance policies that impose severe restrictions on services with pathological gambling disorders. It is not well recorded how much gamblin g-addicted patients have been kicked out due to the restrictions on medical access. In addition, it is not known how much the treatment of pathological gambling has been separated from other pathological gambling disorders treatment services. It is also unknown whether several states that require another license from a pathological gambling counselor will be counterproductive to clients seeking treatment. Some states have approved drug abuse and mental health services and drug abuse treatments separately from psychiatry, medical care, family, and other related services. Such a distribution effect may be against the principle of declining service provision (McClellan et al., In press) and matching the patient to the most effective treatment.

As Rosenthal (1992) states, women account for on e-third of pathological players, but therapeutic research samples are not fully included. The need to create and evaluate treatment programs specialized for women and youth is being recognized. The results of such research will enable the development of programs for these groups. Other clients that should be noted in research are the consequences to youth (so far, only one study has reported to the youth), and the members of different ethnic groups. The characteristics of the client can predict the difference in response to various treatment approaches, and such research can be associated with the evaluation of the supported system rooted in the area. It is also important to study the impact of managed care contracts and health insurance policies that impose severe restrictions on services with pathological gambling disorders. It is not well recorded how much gamblin g-addicted patients have been kicked out due to the restrictions on medical access. In addition, it is not known how much the treatment of pathological gambling has been separated from other pathological gambling disorders treatment services. It is also unknown whether several states that require another license from a pathological gambling counselor will be counterproductive to clients seeking treatment. Some states have approved drug abuse and mental health services and drug abuse treatments separately from psychiatry, medical care, family, and other related services. Such a distribution effect may be against the principle of declining service provision (McClellan et al., In press) and matching the patient to the most effective treatment.

As Rosenthal (1992) states, women account for on e-third of pathological players, but therapeutic research samples are not fully included. The need to create and evaluate treatment programs specialized for women and youth is being recognized. The results of such research will enable the development of programs for these groups. Other clients that should be noted in research are the consequences to youth (so far, only one study has reported to the youth), and the members of different ethnic groups. The characteristics of the client can predict the difference in response to various treatment approaches, and such research can be associated with the evaluation of the supported system rooted in the area. It is also important to study the effects of managed care contracts and health insurance policies that impose severe restrictions on services with pathological gambling disorders. It is not well recorded how much gamblin g-addicted patients have been kicked out due to the restrictions on medical access. In addition, it is not known how much the treatment of pathological gambling has been separated from other pathological gambling disorders treatment services. It is also unknown whether several states that require another license from a pathological gambling counselor will be counterproductive to clients seeking treatment. Some states have approved drug abuse and mental health services and drug abuse treatments separately from psychiatry, medical care, family, and other related services. Such a distribution effect may be against the principle of declining service provision (McClellan et al., In press) and matching the patient to the most effective treatment.

In the field of qualifications and gambling advice services, the committee is looking for the needs of controversy and the need for policy research to examine executable options. In this study, the range of certified counseling services, the number of counselors with various expertise levels, demand for services provided, universities, research institutions, and medical training programs, or are established or established. It is necessary to explain the structure. This kind of study could lead to an opportunity to form a consensus in the treatment world and create an action plan in order to solve the confusion and division surrounded by game treatment experts.

Future treatment results research requires more strict methodology. The research literature has only a handful of controlled outcomes, and most of them have a small sample size, so there is a limit to statistical detection power that detects reliable effects between group differences. Many studies do not provide information on treatment refusal or dropout, and even if these data is provided, the results are discouraged (eg, Sylvain et al., 1997). In gambling treatment research, it should focus on manual treatment with particularly careful coaches and procedures. Insufficient prescriptions used will hinder the reproduction of successful programs. The manual of the therapist not only leads to intervention, but also promotes specific contributions of specific treatment components. The clarification of the main outcome scales in gambling treatment research is also the same as measurement of outcomes based on valid scale. In the field of qualifications and gambling advice services, committees see the needs of controversy and the need for policy research to examine executable options. In this study, the range of certified counseling services, the number of counselors with various expertise levels, demand for services provided, universities, research institutions, and medical training programs, or are established or established. It is necessary to explain the structure. This kind of study could lead to an opportunity to form a consensus in the treatment world and create an action plan in order to solve the confusion and division surrounded by game treatment experts.

Future treatment results need more strict methodology. The research literature has only a handful of controlled outcomes, and most of them have a small sample size, so there is a limit to statistical detection power that detects reliable effects between group differences. Many studies do not provide information on treatment refusal or dropout, and even if these data is provided, the results are discouraged (eg, Sylvain et al., 1997). In gambling treatment research, it should focus on manual treatment with particularly careful coaches and procedures. Insufficient prescriptions used will hinder the reproduction of successful programs. The manual of the therapist not only leads to intervention, but also promotes specific contributions of specific treatment components. The clarification of the main outcome scales in gambling treatment research is also the same as measurement of outcomes based on valid scale. In the field of qualifications and gambling advice services, the committee is looking for the needs of controversy and the need for policy research to examine executable options. In this study, the range of certified counseling services, the number of counselors with various expertise levels, demand for services provided, universities, research institutions, and medical training programs, or are established or established. It is necessary to explain the structure. This kind of study could lead to an opportunity to form a consensus in the treatment world and create an action plan in order to solve the confusion and division surrounded by game treatment experts.

Further research is needed to identify types of gamblers who differ in their gambling involvement, outcomes, and etiology and who may benefit most from specific treatments. Some pathological and problem gamblers' behavior may be biologically based and a direct result of defects in the brain's neurotransmitter systems (Comings, 1998). Others may experience transient symptoms that meet the minimal diagnostic criteria for pathological gambling or occur in response to emotional, affective, or stress-related difficulties (Blaszczynski, 1998). Matching patients to optimal treatment approaches is an ongoing area of research in the field of substance abuse treatment. Authoritative independent studies on matching patients to treatment environments suggest that outcomes improve when patients are matched to environments that meet their specific needs (McClellan et al., 1983). Clearly, there is no systematic research on optimal and more cost-effective service configurations for different groups of problem gamblers. Matching patients requires three elements: (1) a comprehensive assessment tool to identify the patient's problems and needs, (2) placement criteria to match them to the appropriate setting (e. g., 3), and (3) the services required to match the patient (e. g., 4). Further research is needed to identify types of gamblers who differ in their gambling involvement, consequences, and etiology and for whom specific treatments may maximize therapeutic benefit. Some pathological and problem gamblers' behaviors may have a biological basis and be a direct result of defects in the brain's neurotransmitter systems (Comings, 1998). Others may experience transient symptoms that meet the minimal diagnostic criteria for pathological gambling or occur in response to emotional, affective, or stress-related difficulties (Blaszczynski, 1998). Matching patients to optimal treatment approaches is an ongoing area of research in the field of substance abuse treatment. Authoritative independent studies on matching patients to treatment settings suggest that outcomes improve when patients are matched to settings that meet their specific needs (McClellan et al., 1983). Clearly, there are no systematic studies on optimal and more cost-effective service configurations for different groups of problem gamblers. Matching patients requires three elements: (1) a comprehensive assessment tool to identify the patient's problems and needs, (2) placement criteria to match them to the appropriate setting (e. g., 3), and (3) the services required to match the patient (e. g., 4). Further research is needed to identify types of gamblers whose gambling involvement, outcomes, and etiologies differ and for whom specific treatments may maximize therapeutic benefit. The behavior of some pathological and problem gamblers may have a biological basis and be a direct result of defects in the brain's neurotransmitter system (Comings, 1998). Patients may also experience transient symptoms that meet the minimal diagnostic criteria for pathological gambling or may occur in response to emotional, affective, or stress-related difficulties (Blaszczynski, 1998). Matching patients to optimal treatment approaches is an ongoing area of research in the field of substance abuse treatment. Authoritative independent studies on matching patients to treatment settings suggest that outcomes improve when patients are matched to settings that meet their specific needs (McClellan et al., 1983). Clearly, there are no systematic studies of optimal and more cost-effective service configurations for different groups of problem gamblers. Matching patients requires three elements: (1) a comprehensive assessment tool to identify the patient's problems and needs, (2) placement criteria to match them to the appropriate setting (e. g., 3), and (3) the services required to match the patient (e. g., 4).

The approach of behavioral therapy and cognitive therapy seems to be promising as an effective treatment for pathological gambling. According to recent special issues on empirical psychological treatments, which are inappropriately supported by Journal of Consulting and Clinical Psychology, are probably the most widely researched treatments, the most in clinical trials. It is listed as a highly valued treatment (Derubeis and Crits-Christoph, 1998: 38). It has also been pointed out that cognitive therapy is a new approach to addiction treatment (Crits-Christoth et al., 1998; derubeis and crits-christoph, 1998). But this does not mean that an eclectic approach to treat pathological gamblers should be ignored. As Blaszczynski and Silove (1995) and Lesieur (1998) argue with persuasive power, it is more and more recognized that the clien t-specific problems must be taken into account. It is being done. Therefore, a client with a mood disorder should be evaluated for antidepressants. If there is an extreme couple, a couple counseling is applicable. In addition, if a habitual behavior includes alcohol or other drug abuse, drug abuse counseling will be required.

In particular, research on the roles of anonymous games in recovery and treatment results is particularly necessary. As described in the literature, it is important to investigate the cause and strategy to reduce the cause and withdrawal rate if the rate of withdrawal from Gamblers Annimus is high. The role of the therapist's characteristics in the treatment of gambling problems is an important research field that has not been studied much. Furthermore, the effects of the treatment environment are unknown. Good results have been reported from both hospitalization and outpatient programs, but the difference in effect is still unknown. Further research is also required for the treatment of a spouse with pathological gambling addiction (Lesieur, 1998). It is common for a spouse to be guided to the GAM-Anon program to deal with partner gambling. The spouse joint therapy is claimed that spouse joint therapy is a necessary element in the recovery process of the couple (Heineman, 1987; Steinberg, 1993).

It is necessary to expand drug therapy research to see if this approach plays an important role in the treatment of pathological gamblers. It is not yet known whether drugs can have a therapeutic effect by improving the desire, craving, and negative emotions of pathological gamblers.

One of the most reliable forecast factors in the treatment of drug abuse dependence is proven to be convincing (Procaska et), regardless of the treatment policy (PROCASKA et al., 1992). Therefore, in the field of pathological gambling treatment, it is necessary to pay attention to the preparation for the patient's change in general and the concrete changes as a predictive factor in the treatment performance.

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Last modified: 27.08.2024

And if the gambling problems were chronic, the problem gambler was considered a "compulsive gambler," an early term for pathological gambler. Go to. In an RCT examining lithium monotherapy for pathological gamblers with bipolar spectrum disorders, lithium was beneficial in reducing both. Data describing the extent of pathological and problem gambling are useful for many purposes, including planning public health services and medical services.

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