Many college students may be concerned about their gambling behavior but not sure that they have a problem. A good place to begin is the free and confidential BBGS e-Screener. This screen can help a student decide whether to seek help for a gambling behavior.
Another free and confidential online source is Your First Step to Change, a self-help toolkit designed to assist those who are thinking about changing their gambling behavior. The toolkit provides information about gambling disorders, helps to evaluate gambling behavior and recommends strategies for changing their behavior should they decide that is the best course.
The questions in this toolkit take approximately 20 minutes to complete, and a student’s identity will remain anonymous at all times.
It’s important for your campus health center to make it known that campus resources are available to treat students struggling with gambling problems. Campus health professionals can also direct college students to the following resources.
Confidential gambling helplines are available for students to speak to someone about a gambling problem, whether for their own support or that of someone they know. The helpline can also refer students to other resources such as treatment providers or Gamblers Anonymous meetings. Contact your state's department of public health to see if they sponsor a helpline. If not, call the National 24-Hour Problem Gambling Help Line (confidential): 1-800-GAMBLER.
The following organizations provide helpful resources for individuals and families dealing with gambling problems or for those who just want to learn more. This is not a complete list of organizations, but a selection of helplines and websites that may be useful for you or someone you know.
The following organizations provide useful links for those who would like to learn more about the gambling industry.
If students choose to seek assistance for their gambling problem off-campus, you can refer to the following resources.
Researchers are just beginning to understand what influences the transition from healthy, recreational gambling to disordered gambling. Similarly, research is starting to unravel how and why people move from disordered gambling to a healthier state. Although treatments for gambling disorder have been available for many decades, the young field of gambling research has not yet provided many scientifically tested intervention strategies.
During the past decade, the explosion of scientific research focusing on gambling and the improving quality of research design have resulted in scientifically-based clinical trials of behavioral and drug treatments, as well as a new focus on natural recovery and brief interventions. This research has important implications for how health care providers, communities, insurance companies and public health planners respond to the needs of people struggling with gambling disorders.
While one-third of people with gambling problems seem to recover on their own without formal treatment, two-thirds of those with problems need additional help. Although there is no treatment standard for gambling disorder, therapies such as cognitive-behavioral therapy, motivational interviewing and drug treatments appear to be promising. Below is information on some different options for recovery.
Self-exclusion programs provide a way for a person to voluntarily ban him or herself from a casino or an online gambling site as a way to deal with a gambling problem. These programs can be mandated by the government or voluntarily established by the gambling operator. The operator agrees to remove the self-excluded person from its direct mail lists.
Read more about self-exclusion in the ICRG’s fifth volume of Increasing the Odds: A Series Dedicated to Understanding Gambling Disorders, which is titled “Evaluating Self-Exclusion as an Intervention for Disordered Gambling.” The ICRG’s monograph series provides easy-to-understand summaries of seminal peer-reviewed research on gambling disorders, as well as implications for future research and prevention efforts.
Cognitive therapy (CT) and cognitive behavioral therapy (CBT) are two of the few approaches that have been scientifically examined, and the outcomes have been extremely promising. These strategies focus on reducing the individual’s excessive gambling by correcting erroneous perceptions about probability, skill and luck that only reinforce problematic gambling behaviors. Cognitive behavioral treatment techniques include: cognitive correction, social skills training, problem solving training and relapse prevention.
Specialists in addiction have developed motivational interviewing (MI), a widely disseminated clinical approach that uses a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence about changing the addictive behavior. William R. Miller, Ph.D., Emeritus Distinguished Professor of Psychology and Psychiatry at the University of Mexico, led the development and testing of the original concept. Multiple studies have been conducted in support of the approach.
We are just now learning about the effectiveness of MI for gambling problems. As with other addictive disorders, individuals with gambling problems struggle with the idea of changing their gambling behavior, even when facing the dire consequences of their excessive gambling. One of Dr. David Hodgins’s studies examined the language of problem gamblers in treatment with counselors using MI. He and his colleagues hypothesized that participants who expressed stronger commitment to change their gambling behavior during the MI would exhibit better gambling outcomes over 12 months than those who expressed weaker commitment or no commitment to change their gambling behavior during the MI.
The authors explained, “Client speech is the focus of the MI because verbalizing an intention to change and developing a plan to produce change lead to public and personal obligations to modify one’s behavior.” They measured outcomes by looking at participants’ change in days gambled, dollars lost to gambling, self-confidence in their ability to change their gambling behavior, and success at meeting their treatment goals.
Dr. Hodgins and co-authors reported that the results of their analysis show good support for the initial hypothesis in that the strength of commitment expressed during the MI was predictive of a participant’s gambling outcome over the next year. But what are the practical implications?
Understanding what trends in language are related to positive outcomes allows practitioners to have an accurate perception of the progress of the MI session. Evaluating a client’s likelihood of success on the basis of the MI session allows practitioners to incorporate more or less stringent therapeutic techniques to aid a client in modifying his or her behavior. It also allows the practitioner to modify the interview protocol according to each individual client’s level of resistance and motivation while conducting the MI.
In an interview for this article, Dr. Hodgins further elaborated on the importance of MI for treating gambling problems:
“Gambling problems, similar to other addictions, are essentially motivational challenges—individuals are pulled towards something that they are pushing against. There is a good side and a bad side to their gambling- motivational interviewing addresses this head on, helping the person to find the resolve to move ahead.”
Extensive continuing education opportunities now exist for clinicians interested in MI. Visit http://www.motivationalinterview.org/ for more information.
While no medications are approved by the U.S. Food and Drug Administration for the treatment of gambling disorder, there are many promising treatments to help with gambling urges and cravings.
One medication that has performed well in clinical trials is naltrexone, which has been used to blunt cravings for alcohol. Several studies suggest that naltrexone can reduce the intensity of gambling urges among adults with gambling disorder. Naltrexone is currently approved by the FDA as a treatment for alcohol dependence and has been used in small doses to treat adolescents.
Lithium, currently used to treat bipolar disorder, is another medication with potential. It has been shown to reduce thoughts and urges associated with gambling disorder in people with both bipolar spectrum disorders and gambling disorder. One attribute that makes lithium particularly appealing is that it has been used safely with adolescents to treat bipolar disorder.
Hodgins, D.C., Ching, L.E., & McEwen, J. (2009). Strength of commitment language in Motivational Interviewing and gambling outcomes. Psychology of Addictive Behaviors, 23, 122-130.
Ladouceur, R., Sylvain, C., Boutin, C., Lachance, S., Doucet, C., LeBlond, J., & Jacques, C. (2001). Cognitive treatment of pathological gambling. Journal of Nervous and Mental Disease, 189, 774-780.
Petry, N.M., Ammerman, Y., Bohl, J., Doersch, A., Gay, H., Kadden, R., Molina, C., & Steinberg,
Grant, J. E., & Potenza, M. N. (2010). Pharmacological treatment of adolescent pathological gambling. International Journal of Adolescent Medicine and Health, 22(1), 129-138.
Miller, W.R.., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd ed.). New York: Guilford Press.
Miller, W. R., & Rose, G. S. (2009). Toward a theory of motivational interviewing. American Psychologist, 64(6), 527-537.