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Problem Gambling

Summary: Gambling can be a fun activity, yet when excessive, it can cause all manner of problems including financial problems, relationship problems and problems functioning at school, work and home.
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What is gambling?

Gambling involves any activity in which a person takes the chance of losing money or belongings, and when winning or losing is decided mostly by chance.

 

Gambling is a common activity in our society. Common forms of gambling include buying lottery tickets, playing poker with friends, or going to a casino. When done in moderation, gambling can be a fun activity. But at its extreme, gambling can cause problems such as bankruptcy, loss of relationships, and even lead people to commit suicide.

What is problem gambling?

When gambling becomes so excessive that it starts causing problems, it is known as pathological or problem gambling.

 

The official term is ‘pathological gambling’, and is defined by the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-IV) as a “persistent and recurrent maladaptive gambling behavior” with five or more of the following:

  • A preoccupation with gambling or obtaining money with which to gamble; a need to gamble with increasing amounts of money;
  • A continuous or periodic loss of control over gambling;
  • Restlessness or irritability when attempting to stop or cut down on gambling; using gambling as an escape from problems;
  • A continuation of the behavior despite obvious consequences; lying about the extent of involvement with gambling;
  • Involvement with legal acts to finance gambling; jeopardized or lost significant relationships and/or employment due to gambling; and
  • Reliance on others for money to gamble. (APA, 2000).

Warning signs for problem gambling

  • Gambling for longer and longer periods of time
  • Needing to gamble more to win back money that has been lost
  • Neglecting responsibilities at school, work or home
  • Needing to lie to others in order to cover up from gambling
  • Neglecting friends and family in order to gamble
  • Borrowing money, selling possessions, or even stealing in order to have money for gambling

How common is it?

It is estimated that 3.2% of Canadian adults are affected by moderate to severe problem gambling (Source: ProblemGambling.ca).

Helping a friend or loved one with a gambling problem

Although you can’t simply stop someone from gambling, your support helps your loved one get support for gambling.

 

If the problem is severe, and you are worried that the other person will not be very pleased at your confronting him/her, then please speak to a professional (such as your family physician, or a counselor) for more advice.

 

General advice:

  • Find a private, quiet time to talk to the other person.
  • Tell your loved one that you care about them, and that you are worried about the gambling behavior.
  • Tell your loved one how the gambling behaviours are affecting you and/or others
  • Ask them how you can help and support them.
  • Be prepared for denial or anger from the other person.
  • If needed, consider taking measures to protect the family’s financial assets from out of control gambling for the family’s security as well as the person with gambling problems.

Treatment and help for gambling

Treatment for gambling is offered in different settings, such as:

  • Counseling/therapy at a community mental health clinic.
  • By physicians with expertise in addictions such as gambling
  • Residential (hospital and non-hospital) programs, which is a program where you temporarily go to live and stay in the program.
  • Day programs (programs where you attend during the daytime for several hours at a time) and outpatient treatment (where you see a counselor/therapist at their office) 

Types of counselling/therapy

 

Talk therapy, or counselling, is the most common way of getting help for problems with gambling, and there are different types of counselling/therapy such as:

  • Motivational enhancement therapy (MET).
  • Cognitive behaviour therapy (CBT).

Motivational enhancement therapy (MET)  

 

Motivational enhancement therapy (MET) is a type of brief therapy that helps enhance a person’s readiness to change, and has been shown widely successful in many other types of addictions and problem behaviours (Miller, 1991.)

 

For people who are not ready to change, the therapy focuses on helping the person weigh the advantages and disadvantages of their gambling behaviour, as well as set limits on their gambling. 

 

For people who are ready to change, the therapy focuses on what to do in order to overcome gambling. E.g. Avoiding situations or people that trigger one to gamble. 

 

Cognitive behaviour therapy (CBT)

 

Cognitive Behaviour therapy (CBT) is a type of therapy that helps people by looking at their thoughts, feelings and behaviours, and which has been adapted for gambling  (Ladouceur, 2007).

Elements of CBT for gambling include:

  • Correcting unhealthy beliefs about gambling (aka cognitive distortions). For example, gamblers tend to believe unrealistically that they will get lucky, often having superstitious beliefs, which are contrary to the statistic odds of winning. Many gamblers also have an illusion of control, whereby they believe that they have the skills or abilities to beat the odds, whereas in reality, skills has a tiny impact.
     
  • Problem-solving skills. Problem-solving skills help the person deal with day-to-day problems such as how to deal with gambling urges, how to limit time and money spent on gambling, dealing with family members, finding solutions to gambling debts.
     
  • Learning social and coping skills. There are many social, coping and life skills that can be helpful such as communication skills, assertiveness skills, how to say no to invitations to gamble, as well as coping skills such as managing stress, anger and anxiety. For example:

    a) Role play: With a therapist, role play involves practicing a skills such as saying no to invitations to gamble.

    b) Visualization: Imagining a situations, and visualizing a more positive way to deal with it. E.g. Thinking about a past incident where the person lost a lot of money gambling, and having the person imagine what would need to happen differently in order to have had a more positive outcome, and prevented the loss of money

    c) Goal-setting: e.g. Setting a limit on how much to gamble, which helps keep one from 'chasing' after losses.

    d) Education about gambling: E.g. learning what things to look for that would indicate problem gambling

    e) Impulse management: learning how to deal with urges to gamble

    f) Self-monitoring: learning how to keep track of money and time spent gambling

    g) Teaching how to prevent gambling problems with happening again (i.e. relapse prevention)

Self-help

Gamblers Anonymous (GA) is a self-help, mutual aid group that provides support for people with gambling problems. Like Alcoholics Anonymous, Gamblers Anonymous is based on the 12-step principle. Members are encouraged to commit to acknowledge that their gambling is a spiritual and medical disease, and are encouraged to abstain from gambling. Groups are run by members, and not by professionals, and there is no membership fee.

Summary

Gambling is a common activity in our society, and unfortunately, some individuals are vulnerable to problem gambling, which is when gambling gets out of hand and starts causing problems. The good news is that help is available, and there are many things that friends and family can do to support the person with gambling problems.

Useful websites

  • http://ProblemGambling.ca
  • http://www.ResponsibleGambling.org/

References

American Psychiatric Association. (2000). Diagnostic and Statistical Manual for Mental Health Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Association.

 

Ladouceur, R. Overcoming Pathological Gambling: Therapist Guide, 2007. New York: Oxford University Press. 

 

Miller, W. R., & Rollnick, S. (Eds.). (1991). Motivational interviewing: preparing people to change addictive behavior. New York: Guilford Press.

About this Document

Written by members of the Mental Health Information Committee at the Children's Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada, as well as Robert Polak, Addiction and Mental Health Counsellor, Mental Health and Addictions Services, Sandy Hill Community Health Centre, Ottawa.

Disclaimer

Information in this pamphlet is offered ‘as is' and is meant only to provide general information that supplements, but does not replace the information from your health provider. Always contact a qualified health professional for further information in your specific situation or circumstance. 

Creative Commons License

You are free to copy and distribute this material in its entirety as long as 1) this material is not used in any way that suggests we endorse you or your use of the material, 2) this material is not used for commercial purposes (non-commercial), 3) this material is not altered in any way (no derivative works). View full license at http://creativecommons.org/licenses/by-nc-nd/2.5/ca/

Date Posted: Feb 7, 2011
Date of Last Revision: Oct 8, 2016

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