Gambling Addiction - Suffering In Silence
Deborah Smith has recently been quoted on ESPN.com and Forbes.com.
According to the National Council On Problem Gambling, a gambling disorder is behavior that causes disruptions in any major life area – social, psychological, physical or vocational. The essential features include: increasing preoccupation with gambling, the need to bet more money frequently, restlessness or irritability when attempting to stop gambling, “chasing losses”, loss of control which results in continuing gambling behavior despite serious negative consequences. In most extreme cases it can result in financial ruin, mounting legal problems, loss of family, career, incarceration and even suicide. It becomes quite obvious that similar to other addictive disorders a person with a gambling disorder is not just going to stop unless they get help.
It is often not identified because people seek help for other co-occurring disorders and are not screened for the gambling disorder. There is a simple 2 question screening: Have you ever lied about how much you gamble and Have you ever felt the need to bet more and more money? A yes answer to either question indicates the need for further screening usually being the SOGS (South Oaks Gambling Screen) which will then provide the some of the qualifiers for a gambling disorder as stated in the DSM V.
Once a gambling disorder is identified it is also important to screen for other co-occurring disorders. It is estimated up to 70% of people with a gambling disorder may also have another psychiatric problem such as affective disorders, ADHD disorders, anxiety disorders, depressive disorders and also substance use disorders. Identifying any personality traits or disorders can also be beneficial in the treatment planning process.
It is important to be trained in gambling disorders to understand the similarities with substance use disorders but more important to understand the differences. One important difference is that you cannot overdose with gambling because there is no saturation point, no point of passing out, no limit as there is with consumption of substances. It may produce negative behaviors as substances do but the gambler cannot blame the behavior on being intoxicated or under the influence and not knowing what they are doing. There is often magical thinking, superstitions, dreams of big wins and success. There are also worse feelings of guilt and shame which add to the increase in suicides.
The co-occurring disorders are most effectively treated concurrently but with each issue addressed on a treatment plan. Using motivational interviewing allows the therapist to build rapport with the patient with expressions of empathy and support of the patient’s ability to change. Cognitive behavioral therapy helps the patient stop the gambling behaviors as they then begin to address the cognitive distortions about the gambling behaviors. The patient begins to identify the internal and external triggers and then acquires new skills to make lifestyle changes including choosing positive non-gambling activities.
Family involvement is also an important component when treating the gambler. As with all addictive disorders it is a family disease. Addressing family issues during treatment promotes opportunities for open communication with the patient, spouse and other family members in a safe setting. The therapist can assist the families in boundary setting, self-care and support. Family support enables the patient to accept treatment and face the life changes ahead with help.
Developing a support network of recovering people is also an important component while in treatment and even more important after treatment. It is again important that all co-occurring disorders are addressed concurrently but with individual components including self- help groups. AA and NA for the substance disorder help the patient feel understood. GA does the same for the gambler. They are similar yet different in their approach and equally important to the patient. It is best practice not to substitute one group for another but to include AA, NA and GA. Family member are also encouraged to attend their own groups such as Al-Anon, Gam-Anon and CoDa.
Sunspire Health Recovery Road provides treatment based on Sunspire Health’s proven, effective, evidenced based protocol. Any patient that enters Recovery Road with a possible co-occurring gambling disorder is assigned to a therapist trained and certified in gambling disorder treatment. All of the treatment components discussed above are included in the treatment planning for the patient. Their plan is tailored to their specific needs to allow them to participate in a program to address their issues and empower them to recover.
It doesn’t end there. Completing treatment is the beginning of a lifetime of freedom and Recovery Road hopes to be on that journey with our alumni program. Every former patient is invited to attend an alumni meeting every Wednesday evening and connect with other alumni to share their stories of success. A larger event takes place each quarter when staff gather with the alumni to provide strength, hope, and encouragement to each other. Once you enter the doors at Recovery Road you are welcomed as a family member and families don’t give up.