1. + Treating Gambling Disorder: Considerations for the Treatment Provider Heather A. Chapman, Ph.D, NCGCII, BACC Louis Stokes Cleveland VA Medical Center Case Western Reserve University School of Medicine

2. + THE MEDIA: 5 Ways to Overcome a Gambling Addiction: Seattle Post Intelligencer published March 1 2014 1. Admit you have a problem. 2. Join a support group. 3. Seek professional help. 4. Consider medication. 5. Implement regulatory mechanisms.

3. + Griffiths (2005) proposed that all addictions have seven distinctive characteristics: Salience: This activity has a high level of importance in a persons life. Typically it dominates their thinking. Mood modification: Change in subjective experiences that people with an addiction report. As a result of the activity they may feel a ‘high or buzz’. Tolerance: Decreased sensitivity to activity over time, leading to an increase in the amount of the activity to achieve the same buzz. … betting larger amounts over time to get same feeling. Withdrawal: Unpleasant psychological and/or physical reactions when activity is reduced such as sadness or nausea. Conflict: Clashes that arise due to addiction that may be intrapersonal (within themselves) or interpersonal (with others) conflicts. Relapse: After a period of control the recurrence of earlier patterns of behaviour occur. Impaired self control: Lack the ability to suppress urges.

4. + Griffiths (2005) proposed that all addictions have seven distinctive characteristics: Salience: This activity has a high level of importance in a persons life. Typically it dominates their thinking. Mood modification: Change in subjective experiences that people with an addiction report. As a result of the activity they may feel a ‘high or buzz’. Tolerance: Decreased sensitivity to activity over time, leading to an increase in the amount of the activity to achieve the same buzz. … betting larger amounts over time to get same feeling. Withdrawal: Unpleasant psychological and/or physical reactions when activity is reduced such as sadness or nausea. Conflict: Clashes that arise due to addiction that may be intrapersonal (within themselves) or interpersonal (with others) conflicts. Relapse: After a period of control the recurrence of earlier patterns of behaviour occur. Impaired self control: Lack the ability to suppress urges.

5. + Griffiths (2005) characteristics specific to gambling: Salience: money is particularly salient in our culture This activity has a high level of importance in a persons life. Typically it Mood modification: dissociation/ hyperstimulus/ moneyChange in subjective experiences that people with an addiction report. As a result of the Tolerance: impact of extreme debt debtDecreased sensitivity to activity over time, leading to uzz. … betting larger amounts over time to get same feeling. Withdrawal: sadness and anxiety related to debt, fixing the problem, coping with losses; suicidalitya psychological and/or physicals or nausea. Conflict: significant issues related to losses/debt/liesClashes that arise due Relapse: After a period of control the recurrence of earlier patterns of behaviour occur. Impaired self control: Lack the ability to suppress urges.

6. + What does the literature say? Treatment is aimed at the raising affective and frustration tolerance, improvement of their social and professional integration, building (or rebuilding) of adequate family and personal ties And working on patients values and goals and any discrepancies Money: Gambling as a solution to problems gambling caused in the first place Recreational and leisure skill building Purpose and direction

7. + What do people with gambling problems say? Problem gamblers aren't only a danger to themselves — the NCPG estimates that the bankruptcies, burglaries, spouse abuse, child neglect, foreclosures, and even suicide associated with gambling addiction costs the U.S. $6 billion each year.costs the U.S. $6 billion each year. The money gets attention but what about the emotional impact?