CHAPTER 1: GAMBLING IS EVERYWHERE, (and it doesn't appear to be going away anytime soon) 11
Global Gambling Market................................................................................................... 12
Gambling Expansion and New Horizons.......................................................................... 14
Online and Internet Gambling........................................................................................... 15
Social Gaming.................................................................................................................... 17
Sports Betting..................................................................................................................... 20
Consumer Protections and Harm Minimization to Promote Safe Gambling Use......... 22
Self-Exclusion.................................................................................................................... 23
Game Features and Structural Characteristics................................................................... 24
Gambling Behavior Characteristics................................................................................... 26
Setting Limits..................................................................................................................... 27
Training Employees who Interact with Gamblers.............................................................. 28
CHAPTER 2: Understanding Gambling Disorder: Pathways towards Etiology, Prevalence, and Comorbid Determinants of Health 30
Etiological Predictors and Risk Factors for Developing Gambling Disorder................ 32
Biological/Neurological Implications................................................................................ 34
Psychological Implications................................................................................................ 37
Social-Cultural Implications.............................................................................................. 38
Spiritual Implications......................................................................................................... 41
Pathways Model of Problem Gambling............................................................................. 43
Considerations for Special Populations and Gambling.................................................... 48
Adolescents......................................................................................................................... 48
Older Adults....................................................................................................................... 49
Diverse Communities......................................................................................................... 50
Military............................................................................................................................... 51
Trauma and Survivors Issues............................................................................................. 52
Co-Occurring Disorders..................................................................................................... 53
CHAPTER 3: Models of Intervention................................................................................... 55
Transtheoretical Model....................................................................................................... 56
Treatment Approaches and Stance of Therapy................................................................ 58
Cognitive Therapy............................................................................................................. 58
Behavior Therapy.............................................................................................................. 59
Cognitive-Behavior Therapy............................................................................................. 59
Third-Wave Behavior Therapy.......................................................................................... 61
Motivational Interviewing................................................................................................. 63
Pharmacological Therapy.................................................................................................. 65
Treatment Considerations: Modality, Duration, and Targeting Relapse....................... 66
Online Modalities.............................................................................................................. 67
Brief Treatment.................................................................................................................. 68
Relapse Prevention............................................................................................................. 69
CHAPTER 4: Models of Intervention Applied..................................................................... 71
Closing the Doors................................................................................................................. 73
Addressing Gambling Symptoms....................................................................................... 77
Cognitive Distortions......................................................................................................... 77
Habituation......................................................................................................................... 78
Chasing Losses and Wins................................................................................................... 82
Session Considerations......................................................................................................... 83
Treatment Selection............................................................................................................ 83
Mindfulness in Session....................................................................................................... 84
Relapse Prevention............................................................................................................. 85
Terminating Therapeutic Relationship............................................................................... 88
CHAPTER 5: Where to Start and What to Ask in the Beginning...................................... 90
Gambling Screens, Assessments, and Diagnostic Tools.................................................... 90
Lie-Bet Questionnaire........................................................................................................ 91
Brief Biosocial Gambling Screen (BBGS)........................................................................ 91
GBIRT................................................................................................................................ 92
Gatekeeper Question.......................................................................................................... 92
Simply Asking Open-Ended Questions (Fun Assessment)............................................... 94
Diagnostic Statistical Manual-5 (DSM-5)......................................................................... 95
International Statistical Classification of Diseases and Related Health Problems (ICD-10)96
South Oaks Gambling Screen (SOGS).............................................................................. 97
Problem Gambling Severity Index (PGSI)........................................................................ 97
Gambling Pathways Questionnaire (GPQ)........................................................................ 97
Gambling Functional Assessment II (GFA-II).................................................................. 98
The Chicken or the Egg: Which Came First.................................................................... 98
Depression and Anxiety..................................................................................................... 98
Traumatic Brain Injuries (TBI).......................................................................................... 99
Drugs, Alcohol, Nicotine/Tobacco and Cannabis............................................................ 100
Suicide Risk Assessment................................................................................................. 101
Gambling Problem or Gambling Solution...................................................................... 101
Closing the Doors............................................................................................................ 102
It's a Control Thing.......................................................................................................... 103
Creating a Safe Place....................................................................................................... 103
The First Few Sessions...................................................................................................... 104
Where to Start and What to Ask...................................................................................... 104
Presence of Suicidal Ideation........................................................................................... 105
Motivation and Consequences of Gambling.................................................................... 105
Games/Gambling............................................................................................................. 106
Development of Gambling Habits................................................................................... 106
Current Gambling Problem.............................................................................................. 106
DSM-5 Diagnostic Criteria and Other Assessments...........................................................