Longitudinal Assessment of a Manualized Group Treatment Program for Gambling Disorder: The Ohio Problem Gambling Treatment Model for Adults with Co-Occurring Disorders

Individuals with gambling disorder (GD) experience a host of negative psychosocial and physical health outcomes, yet few seek treatment. Of particular concern are individuals with co-occurring mental and behavioral health disorders, a group at higher risk for GD in the state of Ohio. To better serve this population, the Ohio Department of Mental Health and Addiction Services developed a group-based GD treatment manual for adults with co-occurring disorders. Over the course of 5 years, 353 individuals engaged in at least some of the manual’s 12 weekly modules, and more than one-third (n = 122) completed the entire curriculum. Participants who completed all 12 modules completed pre-and post-tests, and after controlling for covariates, participants significantly decreased their GD symptom severity, though changes in self-esteem and gambling urges were non-significant. These findings suggest the treatment manual holds promise at reducing gambling behaviors for individuals with co-occurring disorders, but further research is warranted to explore best practices on how to intervene on the psychological antecedents to gambling in this population.

Reasons for dropping out of internet-based problem gambling treatment, and the process of recovery – a qualitative assessment

Problem gambling (PG) is a condition affecting the economy, mental health, and relationships of both the individuals with gambling problems, and concerned significant others (CSOs). While PG is treatable, few individuals with gambling problems seek treatment, and many drop out of treatment. This qualitative study aims to investigate a) the reasons for individuals with gambling problems to drop-out from Internet-based PG treatment, and b) what individuals with gambling problems and CSOs find helpful and unhelpful processes in PG recovery. A total of 16 participants (8 individuals with gambling problems and 8 CSOs) who had participated in an Internet-based PG treatment were interviewed over the telephone in a semi-structured interview. The interviews were analyzed using thematic analysis. Drop-out from treatment was one aspect of an overarching theme identified as unstable path to recovery, where alternating periods of progress and setbacks delineate several aspects of PG. Relapses, negative emotions, and changing life circumstances were identified to separately, and in combination, contribute to drop-out. Drop-outs were also explained by participants’ experiences of a reduced need for treatment. Openness and a support from CSOs and peers were identified as themes important for recovery. The results suggest that PG treatments should consider the emotional state, and comorbidities of the patients, in order to reduce drop-out and improve chances of recovery.

Wait times for publicly funded addiction and problem gambling treatment agencies in Ontario, Canada

Background This study describes the definitions of wait times and intake processes used by drug and problem gambling treatment agencies in Ontario, Canada, as well as the various strategies employed to ameliorate client backlog. Methods An online survey was developed and distributed to 203 publicly-funded, provincial substance use and problem gambling treatment agencies from June to August, 2011. All aspects of the intake process were covered in the survey. Results Based on 139 responses, six different wait time periods were identified. Additional analyses were completed by type of service offered. Suggestions for effective interventions to shorten wait times and recommendations for future research are provided. Conclusion The results of this study highlight a need for standardized definitions of wait times across substance use and problem gambling treatment services.

Wait times for publicly funded addiction and problem gambling treatment agencies in Ontario, Canada

Background This study describes the definitions of wait times and intake processes used by drug and problem gambling treatment agencies in Ontario, Canada, as well as the various strategies employed to ameliorate client backlog. Methods An online survey was developed and distributed to 203 publicly-funded, provincial substance use and problem gambling treatment agencies from June to August, 2011. All aspects of the intake process were covered in the survey. Results Based on 139 responses, six different wait time periods were identified. Additional analyses were completed by type of service offered. Suggestions for effective interventions to shorten wait times and recommendations for future research are provided. Conclusion The results of this study highlight a need for standardized definitions of wait times across substance use and problem gambling treatment services.

Prevalence of Gambling Disorder Among Prisoners: A Systematic Review

This article presents the first systematic review of studies on the prevalence of gambling disorder among prisoners across international jurisdictions. Only original studies that were published in English and employed reliable and valid screening tools are included in this analysis. The review finds that rates of problem or pathological gambling in prison populations are highly variable, ranging from 5.9% to 73% of male and female inmates surveyed. Nevertheless, recorded rates of problem and pathological gambling among inmates are consistently and significantly higher than rates of problem and pathological gambling recorded among the general population. The review indicates that the institution of problem gambling treatment programmes in carceral settings is necessary, to aid community re-entry and reduce the likelihood of re-offending. Moreover, it is suggested that the screening of inmates should become standard practice across penal institutions and other criminal justice organisations, with a view to better addressing the needs of offenders.

Treatment and early intervention services

This chapter looks at the treatment, intervention, and support services for problem gamblers and their families. Research indicates that such gambling disorder is treatable.The role played by the mutual-help organization, Gamblers Anonymous, the importance of help for family members affected by their relatives’ excessive gambling, and the existence of medications that have been used in the treatment of gambling disorder, need to be investigated more systematically. Help for gambling problems may be sparse or non-existent, and even in better resourced countries, treatment availability is patchy and engagement in treatment is low, probably in part due to the secrecy and stigma associated with gambling problems. Gambling treatment services, if properly organized and funded, could make a contribution to reducing gambling-related mental disorder, crime, and the consequent damage to family life.

Religious and Spiritual Struggles among Military Veterans in a Residential Gambling Treatment Program

Veterans of the U. S. Armed Forces are at greater risk for engaging in problem gambling and meeting diagnostic criteria for Gambling Disorder (GD) than are non-veterans. For veterans and non-veterans alike, religious/spiritual beliefs and practices support recovery from addiction and bolster mental health and well-being. Moreover, religious/spiritual ideas pervade Gamblers Anonymous (GA), which remains the predominant community-based treatment modality for GD. However, research has increasingly highlighted the negative impact of religious/spiritual struggles—i.e., conflicts, tensions, or problems associated with aspects of religious/spiritual life—on mental health and well-being. To date, no research has examined the role of religious/spiritual struggles in GD. The current study aimed to fill that gap in the literature by assessing the prevalence and impact of religious/spiritual struggles among U.S. veterans (N = 157) admitted to a residential treatment program for GD. Findings showed that a majority of veterans in the gambling treatment program endorsed each of six types of religious/spiritual struggles assessed. Moral struggles were the most prevalent, severe, and unremitting of the religious/spiritual struggles assessed. Findings highlight the need for clinicians and chaplains working with problem gamblers to address religious/spiritual struggles generally, and moral struggles most specifically, in treatment of GD.