Are there cognitive and behavioural approaches specific to the treatment of pathological gambling?
OBJECTIVE
Treatment approaches for pathological gambling have been modelled after preexisting substance addiction models. This paper reviews cognitive-behavioural models in a search for original insights that are specific to gambling treatment.


METHODS
A computerized search of major health care databases (Medline and PsycINFO) was performed.


RESULTS
New cognitive-behavioural approaches to the treatment of pathological gambling provide 3 original additions to the traditional multimodal treatment of addictions: cognitive restructuring, in vivo exposure, and imaginal desensitization. Other cognitive-behavioural techniques, such as relapse prevention, problem solving, and social skill training, are shared by gambling treatment and addictions treatment.


CONCLUSIONS
When treating pathological gamblers, clinicians must consider introducing techniques to address cognitive distortions related to gambling. Also, cue exposure--whether in vivo or imaginal--may help deal with urges prompted by such cues. The blending of these new techniques into a multimodal addiction treatment potentially balances the rational and external orientation of the cognitive-behavioural approach with interpersonal and introspective components of the traditional addiction treatment.
Tavares
Hermano
H
Addiction Centre, Foothills Medical Centre, University of Calgary, 1403-29th Street NW, Calgary, AB T2N 2JT9. hermano.tavares@calgaryhealthregion.ca
Zilberman
Monica L
ML
el-Guebaly
Nady
N
D015928:Cognitive Behavioral Therapy / Q000379:methods*; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000523:psychology* / Q000628:therapy*; D005715:Gambling / Q000523:psychology*; D006801:Humans; D011340:Problem Solving; D016896:Treatment Outcome