Бесплатный фрагмент - Gambling Addiction

Disclaimer

This material is provided for informational and educational purposes only. It is not intended to serve as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions regarding a medical condition.

The Psychology of Gambling Addiction: Causes, Consequences, and Treatment Approaches

Gaming addiction, also known as pathological gambling, is a mental disorder defined by an uncontrollable compulsion to participate in gambling or video games, regardless of the adverse effects on an individual’s social, financial, and emotional well-being. This addiction impacts individuals across all age groups, though it is particularly prevalent among adolescents and young adults. It is crucial to recognize that gaming addiction entails not only psychological repercussions but also physical consequences.

What constitutes gambling addiction?

Gaming addiction represents an intense compulsion for gaming, which ultimately becomes the focal point of an individual’s existence. This phenomenon can present itself in the form of both gambling (such as poker, casino games, and sports betting) and video game addiction (for instance, multiplayer online games). Crucially, the individual forfeits the capacity to regulate the duration of their gaming activities, resulting in a decline in overall quality of life.

— Indicators of gaming addiction:

— An enduring urge to engage in play, notwithstanding the inclination to regulate this impulse.

— Extending the duration of gameplay with each session.

— Gaming sessions are increasingly intense and prolonged.

— Disregarding genuine obligations such as employment, academic pursuits, and connections with cherished individuals.

— Ineffective efforts to curtail or diminish the duration of gaming activities.

— Prolonged financial or personal setbacks resulting from gaming.

Playful activities serve as a means to alleviate stress, depression, anxiety, and other adverse emotions.

2. Categories of gaming addiction

Gaming addiction can present itself in various forms, influenced by the type of game and the context in which the individual engages.

— Gambling: This encompasses all forms of gambling, including lotteries, sports betting, casinos, poker, slot machines, and more. The primary feature of this addiction is the compulsion to win, irrespective of the repercussions (financial losses, reputational harm).

— Video and computer gaming addiction: This refers to an addiction to online, mobile, or console games that may necessitate extended gaming sessions and active engagement in virtual environments. This encompasses titles such as World of Warcraft, Fortnite, League of Legends, and various other multiplayer games.

— Hybrid forms: Currently, there exists a synthesis of gambling and video games, exemplified by games that incorporate elements of betting or virtual currency (e.g., in-game purchases), which may heighten the risk of addiction.

3. Causes and Factors Contributing to the Development of Gaming Addiction

Gaming addiction has multifaceted origins, with various factors contributing to its emergence. It may arise from the interplay of biological, psychological, and social influences.

3.1. Biological determinants

— Genetic predisposition: Certain studies indicate that genetics may contribute to the onset of gambling addiction, similar to other types of addiction, such as alcohol or drug dependency.

— The neurobiology of pleasure: Gambling addiction may be associated with disruptions in neurochemical processes within the brain, particularly an overabundance of dopamine, which is linked to the sensations of pleasure and reward.

— Dysfunction of the reward system: In certain individuals, the brain’s reward system may operate differently, rendering them more sensitive to the stimulation derived from gaming.

3.2. Psychological Influences

— Diminished self-esteem and internal conflicts: Individuals with low self-esteem or emotional challenges frequently turn to gaming as a means of escaping reality and evading the resolution of personal issues.

— Stress and depression: Gaming can serve as a means to “escape” stress, depression, or loneliness. Games offer a sense of control and accomplishment, which can provide temporary respite from real-life challenges.

— Inability to manage real-life failures: Individuals who encounter frequent setbacks in various aspects of life (such as professional, academic, or personal relationships) may seek affirmation of their successes and accomplishments in the digital realm.

3.3 Societal Factors

— Family environment and upbringing: Children nurtured in high-stress families characterized by low support or violence may exhibit a greater vulnerability to gaming addiction. Additionally, unsupervised access to computers or games during childhood can significantly contribute to this issue.

— Social environment: Gaming addiction is frequently nurtured by peers. When a significant portion of an individual’s social circle consists of gamers, it can enhance their engagement. For instance, social pressure within a school or group context may compel individuals to participate in gambling or online gaming.

— Advertising and marketing: The aggressive promotion of online casinos, video games, or in-game microtransactions can significantly attract attention to games and contribute to addiction.

4. Implications of gambling addiction

Gaming addiction significantly affects various facets of an individual’s life, encompassing physical and mental health, as well as social and financial challenges. Let us examine the primary consequences.

4.1 Psychological Implications

— Stress, anxiety, and depression: Continuous engagement in a virtual environment can result in a sense of disconnection from reality, subsequently leading to depression, anxiety, and stress.

— Sleep disturbances: Extended gaming sessions may result in insomnia, jet lag, and chronic fatigue.

— Self-esteem challenges: the perception that success in gaming is the sole avenue for recognition or achievement diminishes self-esteem and fosters addictive behavior.

4.2. Societal Implications

— Loneliness and isolation: gaming addiction can result in detachment from reality, leading to withdrawal from family and friends. The individual may choose to invest their time in gaming, which hinders the development of their social skills.

— Relationship conflicts: Addictions often create strain in relationships with family, partners, or colleagues, particularly when gaming time encroaches upon responsibilities or disrupts regular communication.

4.3. Fiscal implications

— Debt and financial losses: Gambling, encompassing online casinos and sports betting, can result in substantial financial losses. Gambling addiction impacts not only the individuals involved but also their families, who may experience financial hardships.

5. Approaches to treating gambling addiction

The treatment of gambling addiction necessitates a multifaceted approach, potentially incorporating both psychotherapeutic techniques and medication when deemed necessary.

5.1. Psychotherapy

— Cognitive Behavioral Therapy (CBT): assists patients in identifying and altering detrimental thoughts and behaviors associated with gambling. CBT enables them to investigate the underlying causes of addiction and cultivate new strategies for managing their gambling habits.

— Group therapy: enables individuals grappling with gambling addiction to connect and share experiences with others encountering similar challenges. Support groups alleviate feelings of isolation and offer opportunities for assistance.

— Family therapy: Engaging family members in the treatment process fosters a supportive environment for the patient, thereby enhancing treatment outcomes.

5.2. Pharmacological intervention

The utilization of pharmacological interventions for addressing gambling addiction represents an ancillary approach that may prove beneficial in the treatment of co-occurring disorders, including depression, anxiety, or impulse control disorders.

Antidepressants or anti-anxiety medications (such as SSRIs) may be prescribed to alleviate anxiety or depression related to gambling.

Psychotherapeutic approaches for addressing gambling addiction

Gaming addiction is a disorder marked by an overwhelming compulsion to engage in gaming, resulting in significant mental health, social, and financial repercussions. Effective treatment for gaming addiction typically involves psychotherapy designed to alter the behavioral and cognitive patterns that fuel the addiction. Psychotherapy can be conducted in both individual and group formats. Let us examine the primary psychotherapeutic approaches employed in the treatment of gaming addiction.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is among the most effective interventions for gambling addiction. It seeks to alter the negative thoughts and behavioral patterns that perpetuate the addiction. CBT enables individuals to identify how their thoughts and emotions contribute to gambling and teaches them to substitute these with healthier alternatives.

The primary objectives of cognitive-behavioral therapy (CBT) are:

— Identifying and modifying distorted thoughts: Cognitive Behavioral Therapy (CBT) assists patients in recognizing automatic thoughts that contribute to the urge to gamble (e.g., “I can win big,” “Games are the sole source of joy”) and instructs them on how to substitute these with more rational and realistic alternatives.

— Gambling urge reduction: The therapist instructs the patient in self-control techniques designed to diminish the compulsion to gamble, employing self-monitoring strategies alongside the development of skills to manage anxiety and depression.

— Gradually decreasing the duration of gameplay: Rather than an immediate cessation, cognitive behavioral therapy emphasizes the gradual reduction of gameplay time to mitigate the stress associated with sudden withdrawal.

— Enhancing social engagement: Cognitive Behavioral Therapy (CBT) instructs patients on identifying alternatives to gambling behavior, such as pursuing new hobbies, participating in social activities, or exploring interests, thereby fostering healthier social relationships.

Cognitive Behavioral Therapy techniques:

— Cognitive restructuring techniques: Assist in altering detrimental thoughts that drive an individual to engage in gaming.

— Behavioral activation: Focused on substituting games with alternative positive activities that enhance the patient’s psychological well-being.

— Behavior modeling: The patient observes real-life examples to understand appropriate behaviors in situations that may provoke the urge to gamble.

2. Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy (ACT) emphasizes assisting individuals in accepting their thoughts and emotions without attempting to alter them, while also guiding them to live in accordance with their values, even in the face of challenges. In the realm of gambling addiction, ACT enables individuals to take action despite the compulsion to gamble, directing their attention toward long-term objectives rather than immediate gratifications.

The primary objectives of ACT are:

— Embracing addiction as a facet of the experience: ACT assists individuals in reconciling with the reality that gambling addiction is challenging to navigate in the short term; however, it is crucial to recognize that it does not define their identity.

— Emphasize values: The patient recognizes the aspects of life that hold the greatest significance for them (e.g., familial relationships, career, health) and starts to concentrate on these rather than on the transient gratifications of gambling.

— Cultivating mindfulness: ACT instructs individuals to be aware and attentive to their emotions and experiences, thereby assisting in the avoidance of automatic responses linked to the urge to gamble.

ACT Approaches:

— Mindfulness: The individual acquires the ability to remain in the present moment, refraining from attempting to control or evade their thoughts and emotions.

— Distancing from thoughts: The patient learns to recognize his thoughts as mere thoughts rather than absolute truths, thereby diminishing their impact.

— Value orientation: The process of recognizing life values and dedicating oneself to actions that align with these values.

3. Gestalt Therapy

Gestalt therapy prioritizes awareness of the patient’s present experiences and the reestablishment of personal integrity. In the realm of gambling addiction, it assists patients in comprehending their internal conflicts and fears that may be fueling their addiction.

The primary objectives of Gestalt therapy:

— Awareness of present experiences: The patient develops the ability to recognize and acknowledge their thoughts, emotions, and behaviors, while also understanding how these experiences may be connected to gambling addiction.

— Restoring a sense of control: Gestalt therapy assists individuals in reclaiming authority over their actions, emotions, and lives, which is crucial for overcoming addiction.

— Engaging with “non-viable” aspects of the personality: The therapist assists in identifying internal conflicts that may reflect the disparity between the desired and actual lifestyle.

Gestalt therapy techniques:

— Emphasize the “here and now”: The patient learns to engage with their experiences in the present moment, rather than evading them through distractions.

— The role of play: The therapist employs play-based techniques and activities to engage with the patient’s emotions and responses, facilitating awareness of the underlying issues related to addiction.

— Addressing unconscious conflicts: The patient acquires the ability to recognize and reconcile internal contradictions that contribute to the addiction.

4. Familial therapy

Family therapy plays a crucial role in the treatment of gambling addiction, as this condition frequently impacts not only the individual but also their family members. The emphasis of family therapy is on fostering a supportive familial environment and restoring trust within relationships.

The primary objectives of family therapy:

— Reconstructing Family Support: The family is integral to the recovery process; therefore, it is essential to foster a nurturing environment where support and understanding supplant criticism and judgment.

— Addressing familial conflicts: Gambling addiction may be associated with familial issues (e.g., ineffective communication, insufficient emotional support), and therapy facilitates the resolution of these conflicts.

— Family Education: Families are instructed on how to support the individual struggling with addiction, identify signs of relapse, and respond effectively in a crisis.

Family therapy techniques:

— Interpersonal Problem Solving: Addressing conflicts and misunderstandings that may arise from gaming addiction.

— Effective Communication Training: Enhancing the capacity of family members to communicate effectively with one another, thereby alleviating stress and tension.

— Realistic Expectations: The therapist assists the family in recognizing that recovery is a gradual process requiring time and patience.

5. Group therapy and support networks

Group therapy and involvement in support groups like Gamblers Anonymous or Players Anonymous can serve as a valuable adjunct to individual treatment for gambling addiction. Within these groups, participants exchange their experiences, provide mutual support, and acquire strategies for managing their addiction.

The primary objectives of group therapy:

— Social support: Collaborative assistance among group members alleviates feelings of isolation and shame.

— Sharing experiences: Group members can gain insights from the experiences of others and discover new strategies for addressing challenges.

— Dedication to the recovery program: Groups assist patients in maintaining motivation and commitment to the recovery journey.

Group therapy techniques:

— Discussion of personal narratives: Participants convey their experiences and insights, thereby enhancing the comprehension of the issue.

— Group support: Members of the group can provide practical advice and strategies for overcoming addiction.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) for gambling addiction, commonly associated with pathological or problematic gambling, seeks to identify and alter detrimental thought and behavior patterns linked to gambling. It also aims to cultivate self-control and skills for preventing relapse. The following discussion will explore the primary features, objectives, and techniques of CBT employed to address gambling behavior.

1. Characteristics of gambling addiction (compulsive desire for gambling)

— Compulsive desire

A person experiences an intense, uncontrollable urge to gamble, persistently seeking to play repeatedly despite the adverse consequences, such as debts and issues within the family and workplace.

— Cognitive distortions

Gambling addicts frequently cultivate erroneous beliefs regarding a “winning system,” “a sense of luck,” “a premonition,” and “near wins” (for instance, “Just a bit more and I’ll recover my losses”).

A belief in “luck” and the ability to exert “control” over random events emerges, thereby intensifying the desire to engage in play.

— Affective dysregulation

Gaming addiction is frequently linked to stress, anxiety, and depression.

A person may engage in gambling as a means to evade problems, escape reality, alleviate boredom, or experience an adrenaline surge, often referred to as a “dopamine rush.”

— Social and economic repercussions

— Deterioration of familial relationships (conflicts, erosion of trust) and at the workplace.

— Accumulating debts, liquidating assets, and securing loans for the purpose of acquiring a new game.

The primary objectives of cognitive-behavioral therapy for gambling addiction.

— Reduction or total cessation of gaming behavior

Assist the client in identifying the patterns that result in a “breakdown” during the game, and guide them in learning how to disrupt these patterns.

— Cultivate alternative methods for leisure and stress alleviation.

— Rectification of cognitive distortions

— Acknowledge fallacious thoughts (“I nearly won, so fortune is imminent,” “I will recover all my losses now”) and substitute them with realistic beliefs regarding the probabilities and outcomes of the game.

— Advancement of self-discipline and emotional regulation competencies

— Formulating innovative strategies for addressing stress, boredom, and anxiety without reliance on gaming.

— Enhancing the capacity to endure discomfort and “deferred” gratification.

— Prevention of recurrences

— Instruct the client to recognize “triggers” (situations, emotions, thoughts) that elevate the likelihood of resuming gambling.

— Develop an “action plan” to address gambling cravings and stressful situations.

3. Essential elements of cognitive-behavioral therapy for gambling addiction

3.1. Psychoeducation

— Insights into the essence of gambling

Discuss the randomness of outcomes, mathematical probability (the inherent unlikelihood of “winning”), and common misconceptions (“the illusion of control,” “the law of repetition,” “near misses”).

— The process of addiction development

Repeated reinforcement, even in the form of infrequent wins, cultivates a powerful compulsion to engage in gambling. Concurrently, emotional challenges can intensify this urge, further exacerbating the desire to gamble.

3.2. Recognition and alteration of cognitive distortions

— Journal of reflections and circumstances

The client documents instances when the urge to gamble emerges, noting the context, accompanying thoughts (“If I play now, I’ll surely get lucky”), emotions (such as anxiety or boredom), and the actions taken (either engaging in the game or abstaining).

— Examination of detrimental beliefs

A therapist assists in recognizing erroneous thoughts: “I will win today and settle all my debts,” “The system alters if I modify my bets,” “Fortune will surely favor me now.”

— Focus: confront these irrational beliefs and substitute them with facts (“Gambling relies on chance, debts are not alleviated by fortuitous winnings, and statistically, there is a significant risk of loss”).

3.3. Advancement of behavioral competencies and self-regulation

— Steering clear of hazardous circumstances

— Identify triggers: visiting casinos, online platforms, gambling advertisements, interacting with gambling acquaintances, etc.

— Formulate a strategy: “Refrain from carrying excess cash, restrict access to gambling websites, and steer clear of establishments featuring slot machines,” etc.

— Development of alternatives

— Alternatives to gaming include engaging in sports, pursuing hobbies, socializing with friends who are not gamers, acquiring relaxation techniques, maintaining a gratitude journal, and participating in support groups such as Gamblers Anonymous.

— Techniques for managing stress

— Mastering breathing techniques, progressive muscle relaxation, and brief “mindfulness moments” to assist you in managing stress or boredom without engaging in play.

3.4 Components of Motivational Interviewing

— Enhancing motivation for transformation

— Request the client to enumerate the adverse effects of gambling (financial losses, conflicts, and depletion of time and energy).

— Contrast values and aspirations (family, stability, career progression) with the realities of gambling addiction (debts, distrust, lost opportunities).

Aids an individual in making a self-aware decision regarding the significance of ceasing or diminishing gambling behavior.

3.5. Relapse Prevention

— Examination of “breakdown” scenarios

— Recognize the emotional states that present the greatest risk (for instance, following conflicts, experiencing loneliness, or during payday).

— Strategy for Engagement

“If I find myself thinking, ‘I need to go to the casino,’ I reach out to a friend or a consultant, head to the gym, or engage in household tasks.”

“I monitor triggers: I graciously decline when friends invite me to play, or I restrict access to websites on my computer.”

4. Standard progression of the CBT process for gambling addiction

— Preliminary phase

— Establishing objectives: total cessation of gambling (abstinence) or substantial reduction, enhancing control over one’s life.

— Psychoeducation regarding the nature of addiction, along with the documentation of thoughts and emotional patterns in a diary.

— Midpoint of therapy

— Engaging actively with cognitive distortions (“I will certainly win if I wager X”).

— Alternative behavior training: strategies for managing boredom and stress, while avoiding “risky” environments and associations.

— Developing the ability to identify indicators of an imminent breakdown.

— Maintenance Stage

— Consolidation of attained enhancements, oversight of “critical situations.”

— Relapse prevention: developing a comprehensive “action plan” (including contact numbers and steps to take if the urge to gamble arises unexpectedly).

— Completion

— Progress assessment: a decrease in both the frequency and intensity of gaming episodes, enhancement of financial and emotional stability, and the restoration of familial relationships.

— Formulating a strategy for autonomous continuation: participating in support groups (such as Gamblers Anonymous) and scheduling regular personal evaluations.

5. Potential outcomes of cognitive behavioral therapy for gambling addiction

— Reduction or termination of gaming activity

With effective therapy, the client either completely abstains from gambling or rigorously regulates the frequency and amount of bets, avoiding a return to compulsive behavior.

— Mitigation of cognitive distortions

A person ceases to believe in “mystical luck” and “special instincts,” recognizing that gambling is a system characterized by a high likelihood of loss.

— Advancement of alternative behavior

A novel lifestyle devoid of gambling is taking shape: engaging in hobbies, cultivating relationships, advancing in one’s career, and focusing on self-development, all without relying on “easy (yet unrealistic) winnings.”

— Enhancing emotional well-being

The client develops healthier strategies to manage boredom, stress, and anxiety through activities such as sports, creativity, and communication.

— Levels of depression diminish, self-esteem rises, and social connections are revitalized.

— Relapse prevention

The client is adept at recognizing a “risky state” (such as anger, apathy, or a salary “increase”) and is capable of swiftly responding to thoughts of a “quick win.”

If needed, he consults relatives, engages a consultant, and participates in supplementary sessions to enhance motivation.

—

Below are examples of exercises and techniques applicable within cognitive behavioral therapy (CBT) for problem gambling (pathological gambling). These exercises assist individuals affected by problem gambling in recognizing and altering detrimental thoughts, diminishing cravings, and cultivating self-control skills in real-life scenarios.

1. Stimulus and Cognitive Log

Target:

— Assist the client in recognizing “triggers” (situations, locations, emotions) that elicit a strong urge to gamble.

— Observe and adjust automatic thoughts related to “winning” or “replaying.”

How to execute:

— Furnish the client with a specialized form (or recommend maintaining a notebook) for consistent documentation.

— When the urge to gamble emerges, the client records:

— The circumstances (when, where, what transpired, who was present).

— Reflections (“It appears that fortune is on the verge of unraveling,” “I can reclaim what I have lost”).

— Emotions (anxiety, excitement, shame, boredom, etc.) and their intensity (on a scale of 0 to 10).

— Behavioral response (either exhibited an urge or exercised restraint).

— During the session, analyze the recurring patterns and identify the thoughts that most frequently lead to breakdowns.

Comment:

Maintaining a diary consistently enhances self-awareness: the client becomes adept at recognizing “critical thoughts” beforehand and cultivates alternative responses.

2. “ABC Analysis” (ABC Framework)

(A — Event/Trigger, B — Belief/Thought, C — Emotion and Behavior)

Target:

— Develop the ability to distinctly differentiate between external or internal circumstances (A) and one’s own interpretations (B), along with the ensuing emotional and behavioral reactions (C).

— To recognize that it is “B” (beliefs, thoughts) that instigates the desire to engage in play.

How to execute:

— Following an episode of gambling addiction (or a genuine “breakdown”), the client finalizes the chart:

— A: “I noticed a banner advertisement regarding betting. I received my paycheck.”

— B: “Today will be my lucky day; I haven’t played in quite some time,” “This is where the significant victories commence.”

— C: Emotions (enthusiasm, fervor), Behavior (visited the betting site, placed a wager).

In therapy, examine the distortions at point B that contributed to the urge to gamble. How might point A have been interpreted in an alternative manner?

Comment:

— Enables the client to distinguish between actual circumstances and their personal “narrative” that perpetuates gambling behavior.

3. Cognitive Restructuring

Target:

— Identify common cognitive distortions (magical thinking, illusion of control, “near misses,” etc.) and develop more realistic beliefs.

— Diminish reliance on “systems” and “instinct,” which foster unwarranted confidence that “this time I will certainly succeed.”

How to execute:

— Extract particular phrases from the client’s “Diary” or “ABC-analysis” (for instance, “I’m perpetually unlucky, but if I’ve experienced misfortune 10 times consecutively, then I am certain to succeed on the 11th”).

— With the assistance of a therapist, pose “Socratic questions”: “What leads you to believe that the likelihood of winning is influenced by past failures?”, “Do you possess objective evidence to support this?”

— Develop alternative perspectives: “The probability of winning remains consistently low; past losses do not enhance the chances of future success.”

— Consolidate: document new thoughts and review them when the next “urge” arises.

Comment:

It is essential to recognize the complete range of irrational beliefs — concerning luck and “role-playing” — and to systematically deconstruct these myths.

4. “Behavioral experimentation”

Target:

— In practice, evaluate the veracity of beliefs, such as “I can restrain myself for 5 minutes,” “I possess exceptional intuition for winning,” and so forth.

— Foster a more realistic perspective on game outcomes and personal agency.

How to execute:

— Identify the client’s explicit assertion: “If I engage with minimal stakes, my losses will be limited, and I can cease at any moment.”

— Design an “experiment”: the client engages (safely and in strict accordance with the conditions) in demo mode (or a brief segment in reality), observing whether a compelling urge to continue emerges to evaluate the hypothesis “will I be able to stop?”

— Prior to the experiment, document your prediction: “I anticipate that I will effortlessly cease at the 2nd minute.”

— Subsequently, compare it with actual experience (it often becomes evident that cessation is not as straightforward, and the excitement intensifies).

— Conclude: “My confidence was an illusion; therefore, it is preferable to abstain entirely or implement a more rigorous restriction mechanism (such as not carrying credit cards or blocking websites).”

Comment:

Experiments should be “minimally risky” and safe; it is advisable to favor demo versions or symbolic bets that do not impose a financial burden, and subsequently proceed under supervision if deemed appropriate by the therapist.

The objective is to demonstrate to the client in practice that their perception of “control” may be misguided.

5. Stimulus Regulation

Target:

— Decrease the frequency of exposure to gambling stimuli.

— Cultivate a practice of steering clear of locations, websites, and circumstances that provoke gambling impulses.

How to execute:

— A compilation of “triggers” is created: casinos, lottery kiosks, betting websites, calls from known players, bookmaker advertisements.

— Restrictive measures are currently under development:

— Uninstall applications on your phone and implement website blockers.

— Avoid walking along the street where the gaming club is situated; alter your route.

— Reach an agreement with the bank or spouse to reduce the amount of cash or credit cards available to you.

— Record in the “diary” how these measures performed, and modify the plan if it remained impossible to circumvent the “triggers.”

Comment:

Restricting access to the game, whether physically or technically, diminishes the likelihood of impulsive betting and allows for the implementation of alternative coping strategies.

6. Encourage Management

Target:

— Learn to identify the initial signs of a burgeoning desire to gamble and promptly transition to an alternative activity that upholds self-discipline.

— Refrain from “automatic” submission to attraction.

How to execute:

— Recognize physical and emotional cues: “A tingling sensation, a mental image of a machine gun,” “Thought: ‘One more time!’”

— Formulate an alternative: “Engage in 10 deep breaths, reach out to a friend, take a 10-minute walk.”

“Urge surfing”: the conscious awareness that attraction, akin to a wave, ebbs and flows if not sustained by additional thoughts.

— Document your achievements: instances when you successfully “weathered” the storm without succumbing.

Comment:

After multiple practice sessions, the client becomes convinced that the craving can subside if they resist the urge immediately. This reinforces their confidence in their capacity to manage it.

7. Functional Replacement

Target:

— To fulfill those needs (for adrenaline, social interaction, distraction from issues) that were previously addressed by gambling, but in a more secure manner.

— Mitigate the likelihood of “returning” to the game due to boredom or stress.

How to execute:

— Ascertain the benefits the client derives from the game: “Excitement, motivation, an avenue for escapism, and social interaction (in the club/online).”

— For every requirement, identify an alternative:

— Drive and exhilaration — extreme sports, dance, hiking.

— Escape from reality — meditation, literature, cinema, creativity.

— Social communication — seek out a club that shares your interests, a sports team, or a community of like-minded individuals.

— Reinforce: “When I experience boredom, I find myself attracted to the machines; I can engage in practice, socialize with friends at a non-gaming event, and so forth.”

8. “Engaging in role-play to counter social pressure”

Target:

— Learn to assert your stance when friends or acquaintances attempt to engage you in gambling (“Let’s go, it’s enjoyable!”).

— Learn to deflect pressure through composed reasoning and a self-assured “no.”

How to execute:

One of the therapy participants, or the therapist, assumes the role of a “friend” who proposes, “Let’s go betting; there’s a special offer today!”

The client navigates the responses: “No, I’ve already resigned, please refrain from attempting to persuade me,” “This is not suitable for me; I have alternative plans.”

The therapist and the group, if applicable, offer feedback on which phrases appeared persuasive and where uncertainty was evident.

Comment:

— Assists an individual in preparing for real-life scenarios when the temptation to gamble is instigated by others.

9. Relapse Prevention Strategy

Target:

— Prepare the client in advance for the possibility of challenging moments, and be equipped to respond swiftly if a surge of attraction engulfs them.

— Alleviate the sense of helplessness that accompanies sudden urges to play.

How to execute:

The therapist, in collaboration with the client, identifies the circumstances that may pose the greatest risk, such as receiving a salary, experiencing losses in other areas, or engaging in familial disputes.

— Specific steps are outlined: “Contact a friend, conceal your credit card, exit the gathering if they begin playing cards, consider the repercussions — debts, risks.”

— Maintain the plan in a readily accessible location (near the phone, on paper) so that at the first indication of a “breakdown,” the client can promptly recall and execute the necessary actions.

Comment:

— A highly effective instrument, particularly when utilized alongside a “thought journal” and the “Stimulus Control” technique.

Below is a sample cognitive behavioral therapy (CBT) script designed for the treatment of gambling addiction. Each session typically lasts between 45 and 60 minutes. The content may differ based on the therapy stage, the client’s progress, and the therapist’s approach.

1. Commencement of the session (5–10 minutes)

— Salutations and initiating communication

— Therapist (T): “Good day, Mark. How are you this fine day?”

— Mark (M): “Hello… I have ambivalent feelings: on one hand, I have begun to visit gaming sites less frequently, but on the other hand, I still experience the urge in the evenings.”

— A concise assessment and reflection on the previous week

— T: “Could you please share how your week unfolded? Were you able to maintain a ‘thought journal’ and refrain from playing the game?”

— M: “Indeed, I was completing a diary. There was a challenging moment on Saturday evening — I wished to review the sports bets.”

— Reviewing assignments

— T: “Let us review the entries you recorded in your diary. What triggers emerged? How did you respond?”

— M (shows notes): “There was an occasion on Saturday when a friend invited me to a football match, and everyone was placing bets there… I nearly participated, but I departed early.”

2. Core segment (25–30 minutes)

2.1. Examination of historical contexts and cognitive distortions

— A comprehensive analysis of the episode

— T: “Please share how the desire to play on Saturday originated.”

— M: “I observed my friends placing bets. A thought crossed my mind: ‘I suppose I will wager 500 rubles; it’s a modest amount, and perhaps it will be an easy win.’”

— Recognizing automatic thoughts

— T: “Let us document this thought: ‘I will contribute a small amount; perhaps fortune will favor me.’ How did it resonate? What emotions did you experience?”

— M: “Anticipation, anticipation. I believed it was insignificant—500 rubles.”

— Reality assessment

— T (with “Socratic Questions”): “What might occur if you proceeded? Is it feasible for you to agree upon those 500 rubles?”

— M (thinking): “Most likely not… I tend to get carried away and attempt to recover my losses…”

The therapist assists Mark in recognizing that the thought “I’ll wager a small amount — it’s innocuous” can be a distortion, as “a small amount” frequently escalates into substantial sums.

2.2 Cognitive Restructuring

— Development of a substitute perspective

— T: “How might you rephrase your original thought now?”

— M: “It is more accurate to state: ‘Even a modest wager captivates me, for if I lose, I will desire to recover my losses, and if I win, I will seek to win even more.’”

— Documenting a “new” installation

— T: “Indeed. It is important to note: ‘Any wager, regardless of size, can initiate a losing streak.’ Will this be beneficial for the next occasion?”

— M: “I believe so… I will keep in mind that there is no such thing as a ‘harmless’ wager for me.”

2.3. Behavioral Aspect: Stimulus Control and Action Plan

— Examination of prevention

— T: “What actions can you take when your friends invite you to watch the match and engage in betting once more? How can you adequately prepare beforehand?”

— M: “Perhaps I should meet them at home rather than at a bar where everyone is gambling. Alternatively, I could inform them that I have no interest in betting.”

— Tabletop role-playing game (optional)

— T: “Let’s briefly role-play how you might convey to your friends: ‘Guys, I’m not placing any bets; I have other priorities.’”

— M (testing): “I want to emphasize that it is crucial for me to refrain from gambling at this moment. I have made the decision to quit.”

— T (as a friend): “Come on, it’s merely 500 rubles; it’s not a significant amount!”

— M: “No, it is significant to me; I do not wish to take any risks. I am already aware of how this concludes.”

— T: “Excellent, how do you feel after expressing that?”

— M: “It’s somewhat uncomfortable, yet I also experience a sense of relief.”

2.4. Exercise “Impulse Regulation”

— Development of a personalized plan

— T: “Let us devise a definitive ‘Plan B’ should the desire to play resurface intensely. You experience that in the evening, correct?”

— M: “Indeed, during the evenings, when I find myself feeling bored or anxious…”

— T: “What alternatives do you have?”

— M: “I have a plan: to call my brother immediately, go for a run, or watch a television show with my wife. Most importantly, I will block gambling sites now.”

— Endorsement of the plan

— T: “Very well, let us document this: ‘At the initial consideration of placing a bet, activate the ad blocker, contact your brother, and invite your wife to enjoy a movie together.’”

— M: “Agreed. I will practice this week.”

3. Conclusion of session (5–10 minutes)

— Summary

Today, we examined the scenario from Saturday, scrutinized the notion, “I’ll wager a small amount — it’s inconsequential,” and recognized its potential to result in significant losses. You developed a more pragmatic belief and a strategy for how to react.

— M: “Indeed, I now recognize that no wager is without risk.”

— Homework

I recommend maintaining a ‘thought journal,” particularly in the evenings, and consider engaging in role-playing with friends to practice how you will decline participation. Additionally, display your urge-management plan, “Plan B,” in a visible location.

— M: “Very well. I shall make an effort.”

— Aspiration for the week

“Have a productive week. If you experience a strong impulse, employ the ‘quick switch’ technique: contact your brother immediately or go for a run. We will review the outcomes in our next session.”

— M: “Thank you, I look forward to seeing you later.”