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Pathological Gambling: Diagnosis & Treatment
Gambling continuing education psychologist CEUs

Section 4
Gambling Behaviors

CEU Question 4 | CEU Test | Table of Contents | Gambling
Psychologist CEs, Counselor CEUs, Social Worker CEUs, MFT CEUs

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On the last track we discussed developing a controlled treatment plan.  We discussed when to use controlled treatment and two steps to developing a controlled treatment plan.  The two steps are establishing a peer group of counselors and making problem gamblers aware of peer counselors as a resource.

On this track we will discuss exposure to gambling. We’ll examine five methods of avoiding exposure to gambling. These will include self exclusion, being near a gambling establishment, being in a gambling establishment, being alone in a gambling establishment, and receiving an invitation to gamble. As you listen to this track, consider your client. What type of exposure to gambling does he or she struggle with? Could the methods of avoidance on this track benefit your client?

Five Methods of Avoiding Exposure to Gambling

Method #1 - Self Exclusion
For your client, like Tom, from tracks 1 and 2, being in a gambling establishment obviously represents an important risky situation.  For example, Tom was addicted to horse racing.  He was at the track every night.  Tom stated, "I can’t stay away."  Clearly, Tom’s continued presence at the track fostered his urge to gamble and made it difficult to resist. Given the increasing availability and accessibility of gambling, it might be unrealistic to think clients like Tom can avoid the urge to gamble.  However, it is clear that gamblers like Tom can voluntarily bar themselves from gaming establishments.  This, of course, is certainly the first action to take when gamblers wish to cease gambling. 

One client I treated, Ben, age 42, was able to successfully ban himself from his favorite casino.  However, Ben’s success was due to a self-exclusion program set up by the casino itself.  In this program, Ben met with the casino security service and signed a self-exclusion form.  Ben stated, "My photo was taken so they could identify me if I tried to come back.  Ben found the self-exclusion program to be effective.  He stated, "Out of fear of humiliation at being thrown out, I just gave up going to the casino." 

However, the horse track that Tom frequented had no such program.  Think of your Tom.  Would it benefit your client to perhaps meet with the manager of the establishment where he or she gambles to explain the problem and ask to be denied access to the location?  Clearly, however, some may refuse to comply with this request.  If self exclusion is difficult for your client, what other methods might be effective regarding controlling exposure to gambling?

Method #2 - Being Near a Gambling Establishment
Let’s next discuss steps clients can take if they often find themselves being near a gambling establishment.  Tom stated, "I usually find myself at the horse track after work.  I usually take the same route home and so I drive right by the track."  In Tom’s case, I felt it might be useful to make some suggestions to Tom.  I stated, "Change your route home from work and make sure you don’t drive by the track.  Also, systematically avoid going to places where it is possible to gamble." 

For example, if your client insists on going to bars, you might suggest he or she avoid places where there are video lottery terminals. Other gamblers may plan vacations according to the proximity of casinos or take cruises that have casinos on board.  Would your client be receptive to reconsidering changing vacation plan?

Method #3 - Being in a Gambling Establishment
In addition to self exclusion and being near a gambling establishment, let’s discuss being in a gambling establishment. Despite Tom’s efforts to avoid the track, he reported that sometimes he went in anyway. Tom stated, "The track is like a magnet. And it’s not just the gambling, although that’s a big part of it. All my friends are there."

I proposed two strategies to Tom. I stated, "If you can’t avoid the track altogether, remain as far as possible from where you place your bets. See your friends, but stay away from the bettors, if that is possible. If you stick around and see guys winning, you’ll just feel lucky and want to place a bet. Also, try to avoid talking to your friends about the races, odds, or anything related to betting. That will just make you want to bet even more." 

Think of your Tom.  How might your client cope with being in a gambling establishment?

Method #4 - Being Alone in a Gambling Establishment
Next, let’s discuss being alone in a gambling establishment.  For Tom, it appeared that going to the track wasn’t really a problem as long as his friends were there and he could socialize.  However, when Tom found himself at the track without the company of his friends, he impulsively gambled to kill time. 

Tom stated, "I’m sure the problem is not so much in being at the track as it is being at the track alone.  Even if I think about placing a bet, it doesn’t matter because I have friends there who occupy my time.  But when I’m at the track alone, I just can’t help placing bets! The betting becomes my friend!" How might you have responded to Tom?  Unfortunately, I felt limited regarding Tom’s options for going to the track alone. 

I stated, "I can only suggest that you never go to the track alone. If you’re there with friends and they leave, you need to leave as well, even if you haven’t finished your drink or your nachos.  Clearly, the urge to bet will surely tempt you as soon as you are alone." 

Method #5 - Receiving an Invitation to Gamble
Receiving an invitation to go to a gambling establishment is another risky situation that I feel deserves consideration.  Think of your gambling client. Does he or she find it difficult to refuse these invitations?  If so, you might work with your client to learn to assert themselves and develop strategies to refuse such offers.  How do you help clients develop assertiveness in your practice?  I find that traditional role playing techniques are effective. 

During these role playing exercises, the gambler learns to say ‘no’ first using the therapist as a model and then playing their own role. Once gamblers have well-integrated ways of rejecting invitations and are able to express their refusal, the therapist can encourage them to apply these skills in their daily interactions with others. Also, you might consider discussing the client’s gambling problem with friends and family to tell them that the client is in the process of dealing with the problem. 

The purpose of the discussion should be focused on informing friends and family that they should avoid inviting the gambler to bars or gambling establishments if they wish to assist the gambler in his or her process.  Would you agree that if most of the client’s friends are linked to gambling activities it is justifiable to make changes to certain relationships or to question them?

On this track we discussed exposure to gambling.  We examined five methods of avoiding exposure to gambling.  These included self exclusion, being near a gambling establishment, being in a gambling establishment, being alone in a gambling establishment, and receiving an invitation to gamble. 

On the next track we will discuss finances and relationships.  Strategies for dealing with finances and relationships in the face of a gambling problem might include transferring management and the Relationship Developing Technique."

Peer-Reviewed Journal Article References:
Canale, N., Cornil, A., Giroux, I., Bouchard, S., & Billieux, J. (2019). Probing gambling urge as a state construct: Evidence from a sample of community gamblers. Psychology of Addictive Behaviors, 33(2), 154–161.

Corbin, W. R., & Cronce, J. M. (2017). Effects of alcohol, initial gambling outcomes, impulsivity, and gambling cognitions on gambling behavior using a video poker task. Experimental and Clinical Psychopharmacology, 25(3), 175–185.

Kvam, P. D., Romeu, R. J., Turner, B. M., Vassileva, J., & Busemeyer, J. R. (2021). Testing the factor structure underlying behavior using joint cognitive models: Impulsivity in delay discounting and Cambridge gambling tasks. Psychological Methods, 26(1), 18–37.

Quinn, C. A., Archibald, K., Nykiel, L., Pocuca, N., Hides, L., Allan, J., & Moloney, G. (2019). Does self-efficacy moderate the effect of gambling advertising on problem gambling behaviors? Psychology of Addictive Behaviors, 33(5), 503–509.

Rodda, S. N., Bagot, K. L., Cheetham, A., Hodgins, D. C., Hing, N., & Lubman, D. I. (2019). "Types of change strategies for limiting or reducing gambling behaviors and their perceived helpfulness: A factor analysis." Correction to Rodda et al. (2018). Psychology of Addictive Behaviors, 33(2), 138.

Online Continuing Education QUESTION 4
What are five types of exposure to gambling? To select and enter your answer go to CEU Test.

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