A Cognitive-Behavioral Treatment Approach for Problem Gambling

The treatment literature on problem gambling is sparse and strongly influenced by a disease model adopted from the drug and alcohol literature. Many of the treatment programs that are described in the literature are centered on in-patient facilities and there is little in the way of guidelines for the clinician working in an out-patient setting. This paper describes a strategic treatment approach which emphasizes the importance of the client’s cognitions and beliefs in initiating and maintaining gambling behavior. It is recommended that assessment should also incorporate techniques from motivational interviewing (Miller, 1983). A number of treatment stages are suggested: stabilization, self-management, cue exposure, construction of alternative behavioral repertoires, improvement of self-esteem, and maintenance. A case study is described to demonstrate this strategic approach.