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Are there cognitive and behavioural approaches specific to the treatment of pathological gambling?
Hermano Tavares1, Monica L Zilberman, Nady el-Guebaly
1Addiction Centre, Foothills Medical Centre, University of Calgary, 1403-29th Street NW, Calgary, AB T2N 2JT9. hermano.tavares@calgaryhealthregion.ca
Objective:
Treatment approaches for pathological gambling have been modelled after preexisting substance addiction models. This paper reviews cognitive-behavioural models in a search for original insights that are specific to gambling treatment.
Method:
A computerized search of major health care databases (Medline and PsycINFO) was performed.
Results:
New cognitive-behavioural approaches to the treatment of pathological gambling provide 3 original additions to the traditional multimodal treatment of addictions: cognitive restructuring, in vivo exposure, and imaginal desensitization. Other cognitive-behavioural techniques, such as relapse prevention, problem solving, and social skill training, are shared by gambling treatment and addictions treatment.
Conclusions:
When treating pathological gamblers, clinicians must consider introducing techniques to address cognitive distortions related to gambling. Also, cue exposure--whether in vivo or imaginal--may help deal with urges prompted by such cues. The blending of these new techniques into a multimodal addiction treatment potentially balances the rational and external orientation of the cognitive-behavioural approach with interpersonal and introspective components of the traditional addiction treatment.