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Emotional 3. The goal is to lift each client to a higher plane of living while learning the importance of a healthy and balanced life style. Our addiction recovery center will continue to deliver successful treatment outcomes at reasonable prices through residential, day-residential, and intensive outpatient programs. Palmetto also offers medical detox and hour nursing care. Based on the foundation that females must be empowered in order to have positive results in recovery, our facility is specifically designed to create the safe, respectful, and supportive environment needed to do so.

Our treatment program addresses the physical, mental, emotional, and spiritual components of recovery. We are a multidisciplinary team dedicated to providing the highest quality of care possible. Jefferson Oaks Behavioral Health, Inc. Everyday life can be overwhelming and there are times when we all need help. The programs at Jefferson Oaks Behavioral Health are designed to assist patients who are seeking more support than routine counseling can provide. Each of our programs provide comprehensive, short term, intensive treatment for levels of severity ranging from a discharge from an inpatient setting to those having difficulty managing ongoing stress, depression, or anxiety.

Our patients are afforded the care and attention necessary to recover through group, individual and family therapy. Our goal is to reduce the severity of symptoms and assist the patient in achieving emotional stabilization. Treatment goals are designed to help patients begin to practice the coping skills necessary to return to their lives with a sense of purpose and a feeling of overall wellness.

Our services are founded upon the principles of human dignity, respect and responsibility. Our recovery model approach focuses on eliminating barriers to sobriety and empowering and equipping individuals to live normal lives in their communities and with their families. Our addiction and counseling services do not just focus on just the addiction problem - We focus on the whole person.

We place high value on family and community engagement work, school, recreation, socialization, etc. Our goal is for clients to remain in "their own life" during treatment. Surrounded by their support, work, friends and everything else they love. The multi-planning system and holistic therapeutic treatment model we use allows us to help our clients achieve their goals. Let us Help You - Beat Addiction!!! STC Addiction Wellness Center is dedicated to implementing effective and affordable addiction wellness programs, helping our patients and their families to gently rediscover the best in themselves and their relationships and to achieve long-term recovery.

We serve:. As our residents recover from their traumas, we treat the co-occurring depression and anxiety, substance abuse, and process addictions that often occur with or because of traumatic events. Utilizing holistic and experiential methods and modalities, The Refuge encompasses a person's mind, body, and spirit, allowing them to Unravel the trauma story, Understand the addiction and mental health story, and Create the recovery story.

Our clinical team is comprised of licensed substance use disorder counselors and licensed professional counselors LCDC and LPC as well as interns. We provide a wide variety of treatment programs that fit an Individual's needs. We believe strongly in individualized treatment. Mississippi Drug and Alcohol Treatment Center is a primary substance abuse and alcohol treatment center. Treating Chronic Pain is also incorporated. With weekly massages, Yoga, Streatching and meditation, and having an square foot gym on property able for use daily.

Mississippi Drug and Alcohol Treatment Center also has a full time case manager to handle any of the clients needs regarding job search, resume building, court and legal issues, adult daily living activities, etc. Shades of Hope Treatment Center Verified. Are you preoccupied with food and your body? Do you eat in secret? Has anyone ever confronted you about your eating habits or behaviors? Shades of Hope can help. We are an established treatment center for over 30 years, world-renown and featured on Oprah's OWN channel for treating all types of eating disorders, including addiction to sugar and food.

Additionally, we treat substance addictions, process addictions, and co-occurring mental disorders. Rooted in the Step approach, you will learn how to let go of maladaptive behaviors that cause feelings of guilt and shame. Dedicated professionals will guide you through a journey of inner-exploration, unlocking the gates to living abundant and purposeful lives. See more therapy options for Louisiana. Gambling Treatment Centers A compulsive gambler or a pathological gambler is someone who is unable to resist his or her impulses to gamble.

The urge to gamble becomes so great that tension can only be relieved by more gambling. There is a very fine line between problem gambling or Louisiana gambling addiction and gambling too much. The critical sign of problem gambling is often hidden from awareness, with denial.

Many gamblers in Louisiana typically do not know they have a problem. Admitting you have a problem, or may have a problem, is the first step to recovery. Treatment options include individual and group psychotherapy, and self-help support groups such as Gamblers Anonymous a step program for gamblers. Abstinence principles that apply to other types of addiction are also relevant in the treatment of compulsive gambling behavior in Louisiana.

Recently, medications such as antidepressants, opioid antagonists, and mood stabilizers have been shown to be beneficial in combination with gambling treatment by a Louisiana gambling treatment center or gambling treatment centers in Louisiana or those experienced with gambling behaviors in Louisiana. The first step towards recovery usually requires clients to detox in Louisiana under medical supervision, and follow-up with a period of intensive therapy at the center. The multi-planning system and holistic therapeutic treatment model we use allows us to help our clients achieve their goals.

Let us Help You - Beat Addiction!!! STC Addiction Wellness Center is dedicated to implementing effective and affordable addiction wellness programs, helping our patients and their families to gently rediscover the best in themselves and their relationships and to achieve long-term recovery.

We serve:. Based on the foundation that females must be empowered in order to have positive results in recovery, our facility is specifically designed to create the safe, respectful, and supportive environment needed to do so. Our treatment program addresses the physical, mental, emotional, and spiritual components of recovery. We are a multidisciplinary team dedicated to providing the highest quality of care possible. Palmetto's Intensive Outpatient Programs allow clients to remain at home and maintain a regular work or school schedule while engaging in comprehensive treatment for substance use problems or a combination of substance abuse and co-occurring psychological disorders.

Palmetto's purpose is to provide treatment that is both effective and cost efficient, and to provide treatment people of all walks of life. Our Intensive Outpatient Program includes: assessment, individualized treatment plans, group therapy, treatment following the step model, education on the disease concept of addiction, family therapy, peer, support, and relapse prevention. The professionals at Palmetto Addiction Recovery Center have been bringing hope and healing to individuals and families since Call us today to begin your journey to recovery.

As our residents recover from their traumas, we treat the co-occurring depression and anxiety, substance abuse, and process addictions that often occur with or because of traumatic events. Utilizing holistic and experiential methods and modalities, The Refuge encompasses a person's mind, body, and spirit, allowing them to Unravel the trauma story, Understand the addiction and mental health story, and Create the recovery story.

Palmetto provides fundamental treatment that is both effective and cost-efficient. In addition, our therapy is for people of all walks of life, including a plan specifically created for professionals. Located within a beautiful acre rural setting on Lake Lafourche, Palmetto's private, tranquil setting promotes a safe and healing environment. The facility amenities include: Separate men's and women's cabins, state-of-the-art fitness center, tennis courts, basketball court, and volleyball court, and a 5, sq.

In this working environment, with the guidance of counselors, residents learn to live and solve problems together, accomplishing step-by-step goals. The carefully planned treatment makes the best use of each day, addressing topics and issues essential to recovery. We believe that recovery must occur in three areas: 1. Physical 2. Emotional 3. The goal is to lift each client to a higher plane of living while learning the importance of a healthy and balanced life style.

Our addiction recovery center will continue to deliver successful treatment outcomes at reasonable prices through residential, day-residential, and intensive outpatient programs. Palmetto also offers medical detox and hour nursing care. See more therapy options for Baton Rouge. Not enough Gambling Treatment Centers to choose from? East Baton Rouge Parish , Louisiana. Gambling Treatment Centers A compulsive gambler or a pathological gambler is someone who is unable to resist his or her impulses to gamble.

The urge to gamble becomes so great that tension can only be relieved by more gambling. There is a very fine line between problem gambling or Baton Rouge gambling addiction and gambling too much. The critical sign of problem gambling is often hidden from awareness, with denial. Many gamblers in Baton Rouge typically do not know they have a problem. Admitting you have a problem, or may have a problem, is the first step to recovery. Treatment options include individual and group psychotherapy, and self-help support groups such as Gamblers Anonymous a step program for gamblers.

Abstinence principles that apply to other types of addiction are also relevant in the treatment of compulsive gambling behavior in Baton Rouge. Recently, medications such as antidepressants, opioid antagonists, and mood stabilizers have been shown to be beneficial in combination with gambling treatment by a Baton Rouge gambling treatment center or gambling treatment centers in Baton Rouge or those experienced with gambling behaviors in Baton Rouge. The first step towards recovery usually requires clients to detox in Baton Rouge under medical supervision, and follow-up with a period of intensive therapy at the center.

Residential inpatient treatment in Baton Rouge consists of hour care at a live-in facility. Full treatment services, including medical and behavioral therapy, are provided all at one location. Outpatient treatment programs in Baton Rouge provide flexibility to those who are unable to take time away from their regular lives, work or school.

Programs typically meet at the clinic a couple of times every week for a few hours at a time. For instance, opiate abusers may find it helpful to begin their abstinence with a brief but intensive outpatient opiate drug detox in Baton Rouge.

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If gambling is causing a problem in your life we encourage you to ask questions, gather information and conduct research on the type of help that is most appropriate for your situation. This information is intended to be a starting point—it is not a complete list of information or services. Call: Text: Chat: ncpgambling. Please visit our Screening Tools page to access three problem gambling assessment tools. It is important to note that these screens are not a diagnosis and DO NOT replace a face-to-face evaluation with a trained clinical professional.

A 3-item survey designed to help people decide on their own whether to seek a formal evaluation of their gambling behavior. The American Psychiatric Association guidelines used for the medical diagnosis of addictive gambling.

This simple self test will help you to evaluate your gambling behavior. In addition to the resources listed above, there are many additional resources for problem gamblers throughout the National Council on Problem Gambling site. If you prefer corresponding via phone, leave your contact number. Sending an email using this page does not guarantee that the recipient will receive, read or respond to your email.

If this is an emergency do not use this form. Call or your nearest hospital. Back Psychology Today. Therapists Teletherapy Psychiatrists More. Treatment Centers Support Groups. Home Louisiana LA. Gambling Treatment Centers in Louisiana. Insurance Insurance. Treatment Programs Treatment Programs. Programs Treatment Programs. Intensive Outpatient Program.

Price Price. Sliding Scale. Video Intros. Show Video Intros. Palmetto's Intensive Outpatient Programs allow clients to remain at home and maintain a regular work or school schedule while engaging in comprehensive treatment for substance use problems or a combination of substance abuse and co-occurring psychological disorders. Palmetto's purpose is to provide treatment that is both effective and cost efficient, and to provide treatment people of all walks of life.

Our Intensive Outpatient Program includes: assessment, individualized treatment plans, group therapy, treatment following the step model, education on the disease concept of addiction, family therapy, peer support, and relapse prevention. The professionals at Palmetto Addiction Recovery Center have been bringing hope and healing to individuals and families since Call us today to begin your journey to recovery.

View Email. Our Intensive Outpatient Program includes: assessment, individualized treatment plans, group therapy, treatment following the step model, education on the disease concept of addiction, family therapy, peer, support, and relapse prevention.

Palmetto provides fundamental treatment that is both effective and cost-efficient. In addition, our therapy is for people of all walks of life, including a plan specifically created for professionals. Located within a beautiful acre rural setting on Lake Lafourche, Palmetto's private, tranquil setting promotes a safe and healing environment. The facility amenities include: Separate men's and women's cabins, state-of-the-art fitness center, tennis courts, basketball court, and volleyball court, and a 5, sq.

In this working environment, with the guidance of counselors, residents learn to live and solve problems together, accomplishing step-by-step goals. The carefully planned treatment makes the best use of each day, addressing topics and issues essential to recovery.

We believe that recovery must occur in three areas: 1. Physical 2. Emotional 3. The goal is to lift each client to a higher plane of living while learning the importance of a healthy and balanced life style. Our addiction recovery center will continue to deliver successful treatment outcomes at reasonable prices through residential, day-residential, and intensive outpatient programs.

Palmetto also offers medical detox and hour nursing care. Based on the foundation that females must be empowered in order to have positive results in recovery, our facility is specifically designed to create the safe, respectful, and supportive environment needed to do so. Our treatment program addresses the physical, mental, emotional, and spiritual components of recovery. We are a multidisciplinary team dedicated to providing the highest quality of care possible.

Jefferson Oaks Behavioral Health, Inc. Everyday life can be overwhelming and there are times when we all need help. The programs at Jefferson Oaks Behavioral Health are designed to assist patients who are seeking more support than routine counseling can provide. Each of our programs provide comprehensive, short term, intensive treatment for levels of severity ranging from a discharge from an inpatient setting to those having difficulty managing ongoing stress, depression, or anxiety.

Our patients are afforded the care and attention necessary to recover through group, individual and family therapy. Our goal is to reduce the severity of symptoms and assist the patient in achieving emotional stabilization. Treatment goals are designed to help patients begin to practice the coping skills necessary to return to their lives with a sense of purpose and a feeling of overall wellness.

Our services are founded upon the principles of human dignity, respect and responsibility. Our recovery model approach focuses on eliminating barriers to sobriety and empowering and equipping individuals to live normal lives in their communities and with their families. Our addiction and counseling services do not just focus on just the addiction problem - We focus on the whole person. We place high value on family and community engagement work, school, recreation, socialization, etc.

Our goal is for clients to remain in "their own life" during treatment. Surrounded by their support, work, friends and everything else they love. The multi-planning system and holistic therapeutic treatment model we use allows us to help our clients achieve their goals.

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This latter component focuses on how to avoid high-risk situations, being able to identify specific gambling triggers, and developing problem-solving skills for dealing with urges or cravings. McCormick believes that pathological gamblers are deficient in the number of coping skills they have available and in their ability to flexibly choose the skill most appropriate to the stressful, or potentially relapse-triggering, situations they face.

In a comparison with nongambling substance abusers, he found that substance abusers with a gambling problem utilize significantly more avoidance and impulsive coping styles. There are other therapeutic components commonly employed by addiction-based programs. One is autobiography Adkins et al. Patients write a history of their gambling problem incorporated into a narrative of the significant events in their life, and then read it to the therapy group.

Feedback focuses on the role gambling has played in the person's life, as well as how his or her behavior and perceptions contributed to the development of the problem. The reading of one's autobiography is often a very emotional experience, and many view it both as a rite of passage in the treatment program and as a turning point in their recovery Adkins et al. Joint or family therapy is another therapeutic component of addiction-based treatment.

This element is important when dealing with pathological gamblers, because families are often loath to forgive the gambler. Clinical wisdom suggests that it is not until after the individual has stopped gambling that the anger of family members begins to surface. This may be so because gambling can be easy to hide and the financial and interpersonal damage can be swift; those close to the gambler remain distrustful and hold on to their anger to protect themselves. Franklin and Thomas note that the return of the gambler into the family is often met with resentment and resistance.

The spouse and children often are depressed and have problems of their own that are in need of therapy. Alternatively, because the gambling offers intermittent rewards Heineman, , family members may be angry that the patient has stopped gambling.

Another key aspect of the addiction-based approach is after-care planning. This may include identification of a support system, continuing involvement in Gamblers Anonymous, relapse prevention strategies, a budget and plan for financial restitution, a plan for addressing legal issues, ongoing individual or group therapy, family therapy, and medication.

The literature contains several outcome studies of addiction-based treatments. For studies that reported six-month and one-year outcome data, abstinence rates for those contacted were roughly 50 percent Russo et al. All studies found that those who abstained from gambling reported greater improvement in interpersonal and intrapersonal functioning than those who returned to some level of gambling; some studies found decreased substance use as well at follow-up Lesieur and Bloom, ; Taber et al.

Whereas most of the studies involved small samples, a Minnesota study of six state-funded multimodal programs described the outcomes of several hundred clients Stinchfield and Winters, This investigation found abstinence rates of 43 percent at 6 months and 42 percent at 12 months , and rates of gambling at less than once a month for 29 percent at 6 months and 24 percent at 12 months of the contacted subjects. Interestingly, gamblers who started treatment but did not complete it, or who received only an intake evaluation, also reported improvement in virtually all variables related to gambling and psychosocial functioning, even though the extent of change was less dramatic than for those who completed treatment Rhodes et al.

Some of the multimodal approaches have been evaluated for long-term effectiveness. Hudac and colleagues assessed 26 male gamblers four years after they were treated. Of the 26, 8 were abstinent and the others showed less gambling compared with the period prior to treatment. However, the gamblers contacted at the four-year follow-up represented only about one-third of the original treatment sample of 99 pathological gamblers. Schwartz and Linder found that, after two years following inpatient treatment with a client-centered approach, 13 of 25 assessed clients remained abstinent 33 original subjects were not contacted.

Gamblers Anonymous GA is believed to be the most commonly used of all approaches to deal with pathological gambling, and it is routinely included in multimodal strategies Lesieur, The data suggest that relapse rates tend to be quite high for participants. Stewart and Brown found that total abstinence was reported by only 8 percent of members surveyed one year after their first attendance and by 7 percent at two years.

When those who continued to gamble were compared with those who dropped out of Gamblers Anonymous, Brown found that dropouts were more likely to perceive that they had less of a gambling problem, found themselves in personality clashes with the members who did attend, and reported that Gamblers Anonymous was too rigid in its abstinence-only policy.

Other researchers have examined the role of Gamblers Anonymous in maintaining abstinence. Taber and colleagues found that 74 percent of abstinent gamblers in their sample attended at least three meetings in the prior month, compared with only 42 percent of those who continued to gamble. The therapeutic effectiveness of Gamblers Anonymous has also been explored with respect to participation by the gambler's spouse.

Johnson and Nora found that there was a trend for higher abstinence rates for gamblers whose spouses were present at meetings compared with gamblers whose spouses did not attend. Although not statistically significant, the results revealed that 20 out of 44 gamblers whose spouses were present at meetings stopped gambling for at least four years, compared with 13 out of 46 gamblers whose spouses did not participate.

In sum, Gamblers Anonymous may be increasing in popularity Lopez Viets and Miller, , but whether participating in meetings makes a significant and lasting impact is still not known Brown, ; Rosecrance, Related to the Gamblers Anonymous approach is the use of self-help and psychoeducational literature for pathological gamblers.

Dickerson et al. The manual focused on the definition and underlying causes of problem gambling and how the individual could monitor the problem behaviors and replace them with incompatible but healthier behaviors. The group that received the manual plus interview experienced more rapid improvement during the first three-month follow-up, but progress was not sustained at the six-month follow-up. One interesting aspect of this study was that most clients chose abstinence as their goal rather than a reduction of gambling.

Recovery from pathological gambling need not require formal treatment. Understanding how natural recovery occurs is important. First, the factors associated with such natural recovery can be integrated into treatment services. Second, policymakers need to know how many gamblers will recover naturally if they are to estimate the social costs associated with gambling disorders.

Natural recovery rates and processes provide the baseline against which social costs and treatment effects and effectiveness can be judged. Thus, estimates of social effects Prochaska, and treatment cost-effectiveness cannot be computed until the rates of natural recovery from pathological gambling become calculable.

Some economists, for example, compute social cost estimates as if there is no recovery without treatment Institute of Medicine, If we assume some rate of natural recovery among pathological gamblers, the social costs of gambling will be lower than estimates that assume no possibility of natural recovery. Since Winick first described the process of ''maturing out" of narcotics use, the idea of natural recovery has caught the imagination of many clinical investigators.

Indeed, natural recovery has become increasingly recognized as a common phenomenon Institute of Medicine, ; McCartney, Studies about natural recovery have been reported for alcohol problems e. Some investigators have speculated that prevalence studies provide indirect evidence of natural recovery from gambling problems.

Volberg has observed that the difference between higher rates of youth gambling disorders and lower rates of adult gambling disorders suggest the presence of natural recovery, although prospective longitudinal studies would be needed to confirm this conclusion. Wynne's survey of a Canadian community revealed that 36 percent of respondents who reported a prior gambling problem reported no problems in the past year.

In a more direct investigation of natural recovery, Hodgins and el-Guebaly used publicity to recruit problem gamblers who had resolved their gambling problems either with or without the help of treatment. Among the subjects in their sample, about half reported that they recovered without treatment. The sole variable that significantly discriminated those who sought treatment from those who did not was the number of DSM-IV pathological gambling symptoms.

Those who sought treatment reported about two more symptoms compared with the nonseekers about eight versus six symptoms. Nevertheless, although research during the past decade has advanced knowledge to some degree about natural recovery from psychoactive substances, natural recovery from gambling has not been examined. Although the effectiveness of various treatment approaches is not well substantiated in the literature, it is the committee's view that treatment for most, but perhaps not all, pathological gamblers is warranted.

This position is based on three assumptions: First, pathological gambling is a serious disorder associated with several negative consequences. Second, the evidence is that self-help groups alone are not very effective Brown, Third, pathological gambling can be a chronically relapsing disorder, often persisting indefinitely even after periods of remission. Yet these assumptions are in need of substantial and rigorous research testing.

At this point, we do not know which treatments work best and why they work, and we do not know the extent to which gamblers can recover naturally. Whereas substance abuse has the attention of policymakers, the need to provide treatment for pathological gambling has not been widely recognized.

It is difficult to know the extent to which insurance coverage exists for this illness, because consistent reporting by treatment providers and by jurisdictions on how much they spend treating pathological gamblers is not available. For example, Svendsen , in a survey conducted for the committee, contacted the 20 largest insurance companies in the United States to determine how much they spent on gambling treatment.

The companies reportedly would not release the information, arguing that information about reimbursement for any specific disorder would be provided only to participating members or their physicians. Nevertheless, in the same survey, all 34 state affiliates of the National Council on Problem Gambling confirmed their understanding that most health insurers and managed care providers do not reimburse individuals receiving treatment for pathological gambling Svendsen, This exclusion from reimbursement occurs despite the fact that pathological gambling has been recognized by the American Psychiatric Association as a mental health disorder since American Psychiatric Association, Such practices not only keep many from seeking treatment, but also require many of those who do seek treatment either to pay out of their own pocket—unlikely for a debt-ridden gambler—or to obtain coverage under the guise of another diagnosis often associated with pathological gambling, such as depression or substance abuse Letson, Current treatment for pathological gambling in the United States, in many ways, may parallel the treatment of substance use disorders Blume, Many approaches have been employed in the service of pathological gamblers, although most of the treatment is probably delivered on an outpatient basis.

Inpatient care is generally limited to patients with severe acute crises, treatment failures, and severe comorbid disorders, particularly depression Lesieur, ; Blume, Although there is a growing tendency for treatment programs to focus on pathological gambling, many still operate as specialized tracks within existing substance abuse programs Lesieur, Furthermore, despite the growing trend in the United States toward harm reduction strategies and controlled behavior approaches for addiction problems Marlatt and Tapert, , most gambling treatment programs, like those that treat substance abuse, favor abstinence.

Some programs, however, particularly those dealing with problem gamblers in their early stages, do aim at reducing and controlling rather than stopping gambling Lesieur, It is important to consider that treatment for gambling is most likely to be provided by a combination of specialized and nonspecialized providers—that is, by a combination of those who treat gambling problems as the focus of their work and those who provide general counseling but occasionally work with gamblers.

It may be that nonspecialized providers deliver the majority of addiction treatment services. As an adjunct or alternative to primary treatment, treatment providers often refer gamblers to Gamblers Anonymous and Gam-Anon Lesieur, ; Stinchfield and Winters, In fact, Gamblers Anonymous appears to be the most readily available form of help for the problem gambler and its out-of-pocket costs are virtually nil.

Based on a review of its international services, its Internet web site, and archival records Svendsen, , Gamblers Anonymous has meetings in all 50 states, with the average number of meetings annually per state being 26 and the median 14, an increase of 36 percent from to see Appendix E. As already noted, it is the consensus of state affiliates of the National Council on Problem Gambling that the majority of health insurers in the United States do not reimburse those receiving treatment for pathological gambling Svendsen, There is nevertheless some funding for gambling treatment, although it is small.

Many of the 34 state affiliates, as well as the national organization itself, receive some funding from state or gambling industry organizations Letson, ; Svendsen, Approximately half of them report public funding specifically to support treatment for problem gambling Svendsen, ; the revenues generated by gambling in the state are used to pay for these services. Not surprisingly, the affiliate councils see this level of funding as insufficient Letson, Even in states that spend a good deal on pathological gambling, the amounts are small in comparison to what they take in from legalized gambling revenues.

For example, the amount appropriated by the state of New York to its Council on Problem Gambling represents a mere one-tenth of 1 percent of the state's income from legalized gambling Letson, For Minnesota, in , it represents about one-half of 1 percent of the state's income from legalized gambling Svendsen, Moreover, the majority of state affiliates to the National Council on Problem Gambling probably do not receive this level of funding Letson, and, although 47 states have some form of legalized gambling and all 50 states have gambling venues legal and illegal , only 34 have a council.

Without a good estimate of the number of pathological gamblers in the United States and the actual number of patients in treatment for this disorder, it is nearly impossible to reliably estimate the gap between the need for and use of treatment services. There are five reasons to expect that a significant gap exists between use of treatment and need for treatment in the area of pathological gambling Letson, : 1 an unwillingness by many gamblers to seek treatment; 2 a lack of recognition by the public that pathological gambling and problem gambling have significant health consequences; 3 failure of health insurers to recognize lay persons and treatment professionals who are certified by a recognized national or state organization as qualified providers of pathological gambling treatment; 4 lack of funding for treating pathological gambling; and 5 a perception that treatment is or may be ineffective.

A survey designed and conducted for the committee to provide information on problem gambling help lines in the United States reported that gambling help lines now operate in 35 of the 47 states that have some form of legalized gambling Wallisch, It is estimated that about 60 to 70 percent of calls to help lines are made by gamblers seeking help for themselves, the rest being made by spouses, family members, friends, therapists, employers, etc.

Typical services provided by help lines include offering telephone counseling, usually by experienced master's-degree-level counselors although several help lines lack a professional staff and are concerned about liability issues , information e. Some programs perform other activities, such as gambling education and public awareness, prevention activities, and professional training. About 60 percent of help lines receive most or all of their funding from the state in which they operate.

Funds to operate gambling help lines are also provided by the gambling industry, corporations, and miscellaneous other sources such as memberships, individual contributions, and in-kind donations. Help lines advertise their call-in number in different ways, including running banners on video lottery terminals when not in play South Dakota ; slot machine stickers, posters, and pens Delaware ; billboards Delaware and Louisiana ; bus tails Delaware ; telephone recordings at the Department of Social Services while the caller is on hold Delaware ; targeted mailings to professionals, clergy, and corrections personnel Minnesota ; back of grocery store receipts Minnesota ; the New York Yankees' official billboard outside the stadium New York ; part of collateral materials provided by other agencies Texas ; church newsletters Texas ; postings at Alcoholics Anonymous meeting sites Texas ; listing in Card Player magazine California ; and posters conspicuously located inside casinos.

Most help lines cover the entire state, without restriction as to area or population served, and some take calls from nearby states, particularly when a neighboring state does not have its own help line. Because the national number will attempt to find help for any individual in the United States, in theory, no state is entirely without coverage.

This diversity of ways of reaching a help line does not mean that all callers will receive equally effective services, however, and confusion can arise. For example, a problem gambler in Rhode Island may call the Rhode Island problem gambling help line and speak with a counselor at Travelers' Aid, or a counselor at the Connecticut Council because the Connecticut problem gambling help line is advertised as covering Rhode Island , or a counselor with the Texas Council which picks up Connecticut calls after hours.

Depending on how frequently these entities share and update information, they may each have a different set of referrals or use different counseling techniques. This may well be an embarrassment of riches for the caller, but it could also be a potential source of confusion. Help lines that report data on the number of calls received distinguish between legitimate calls by or about problem gamblers and inappropriate ones that ask for information on how to gamble or for the winning lottery number.

These data were provided to the committee either from responses to our mini-survey or were calculated on a weekly basis from data already reported in summary form in help-line reports or datasheets. It is important to keep in mind that a limitation of the data is that some states reported only the number of calls that generated demographic statistics, which may not represent all help-related calls.

With these caveats in mind, weekly call volume ranged from about 10 to several hundred. Some states, such as New Jersey, whose GAMBLER number is publicized nationally and receives calls from all over the country, and Texas, which contracts to cover calls from a large number of states, reported several hundred calls per week. New England and Maryland reported or more calls per week, and 6 other states Florida, Minnesota, New York, Iowa, Pennsylvania, and Wisconsin reported between 50 and calls weekly.

Some help lines have developed information systems about calls and clients. The variability between them is considerable; they ask different questions, do not necessarily ask all questions of all callers, and report data using different summary categories.

Some programs make detailed information regularly available, in the form of mailouts, annual reports, or postings to their Internet web site; others report information only as required to do so. Given this heterogeneity of formats and content of data, it is difficult to draw reliable conclusions. However, three systematic investigations of help-line data are worthy of our attention.

First, a study by Wallisch and Cox compared the demographic distribution of callers to the Texas help line with the demographics of problem gamblers in the general population of Texas. The authors found that certain groups of problem gamblers were underrepresented among help-line callers.

Notably, gamblers who were younger, female, and Hispanic were less likely to call than would be expected from their numbers in the population of problem gamblers. Given the increasing numbers of statewide prevalence surveys being conducted, extending this type of comparison study between help-line data and prevalence data on the general population would be useful as a way to further inform help-line services about population groups that they underserve.

Second, Stinchfield reported on South Oaks Gambling Screen data from a sample of consecutive callers to the Minnesota help line. The mean score was about 8, which is considerably higher than the standard cutoff score of 5 for defining probable pathological gamblers Lesieur and Blume, , although it is lower then the mean score obtained from a Minnesota sample of treatment seekers Stinchfield and Winters, This finding is interesting, in that it indicates that, at least for the Minnesota sample, help-line callers appear to be a seriously disordered group.

Third, Minnesota's Problem Gambling Division commissioned an outcome report of its state help-line callers. A random sample of consecutive callers was called after one month and evaluated on changes in their gambling and their satisfaction with help-line services Winters et al. At follow-up, 97 percent of the sample expressed satisfaction with the services received, and 71 percent reported reduction at follow-up in gambling frequency and gambling-related problems compared with baseline measures.

While encouraging, the results can only be considered suggestive, primarily because of the absence of a control group in the study. Apparent improvement over time would be expected because the help line was called at a moment of crisis, whereas the follow-up time was chosen by the investigator. The general purpose of certification of health care providers is to provide a form of recognition based on the contributions that they have made to a profession or based on the special expertise that they possess within a practice.

Although this form of credentialing does not confer any legal status on those being recognized, it is a means for professional, legislative, and regulatory bodies, private industry, third-party payers, and the public to identify individuals who have demonstrated a particular expertise.

Currently, three national organizations have developed a certification process for clinicians who specialize in the treatment of pathological gambling: 1 the American Academy of Health Care Providers in the Addictive Disorders, formed in , offers the Certified Addiction Specialist credential in the areas of alcoholism, drug addiction, eating disorders, compulsive gambling, and sex addiction; 2 the National Council on Problem Gambling, an association formed in to provide information on problem gambling, began certifying gambling counselors in ; and 3 the American Compulsive Gambling Counselor Certification Board, affiliated with the Council on Compulsive Gambling of New Jersey, Inc.

In addition, several states have formed certification boards requiring only a minimal level of experience and education for certification. An examination of the various organizations involved with the development of national standards reveals that there is no consistency in experiential and educational levels that these boards recognize. The current debate surrounding the difference between certification and licensure is an arena that deserves attention.

There is a trend toward the licensing of health care professionals who treat alcohol and drug addiction. Unlike certification, licensure confers a legal status on those receiving it. Such a process implies that the treatment of substance abuse is a profession in its own right, not an expertise within another discipline. Many of the associations declare that such a license is too narrow and would unnecessarily restrict or bar other qualified professionals, who may have a background in mental health, marriage, and family counseling, social work or psychology, for example, from practicing addiction counseling.

Individuals from any of these disciplines may possess expertise in the treatment of addictive disorders and may therefore wish to acquire a specialty certification in recognition of excellence and proficiency. There are several examples of prevention efforts in the field of pathological gambling, among them teaching gamblers about the odds of the games they play, providing help-line services, and developing public and youth awareness campaigns about the potential risks associated with gambling American Gaming Association, However, nothing is known yet about the effectiveness of these efforts.

A clear challenge for developing effective ways to prevent problem gambling is the lack of awareness of the dangers of excessive gambling. In one sense, programs to prevent substance abuse have it easy; the dangers of illicit drug use are relatively easy to identify. With gambling, it's not so easy. Placing a bet does not readily produce immediate adverse effects.

Family members may find it harder to detect the effects of excessive gambling by a loved one compared with drug use or smoking. Moreover, advertising for state lotteries and casinos suggest that gambling is a harmless form of recreation. Youth programs receive funding from gambling, such as bingo and raffles, thus further lending support to the notion that gambling is a beneficial activity Wynne et al.

Many states use advertising and promotional campaigns to foster the acceptance of gambling. They do this by 1 portraying gambling as family entertainment or social recreation, 2 emphasizing community needs for the tax revenues generated, 3 altering the norms surrounding the behavior, so as not to make it deviant, and 4 centering gambling advertisements around successful gamblers Preston et al.

Perhaps the most concerted prevention efforts have been directed toward adolescents. Targeting young people makes sense from a public health perspective because gambling often begins early, and thus may act as a gateway to future excessive gambling Shaffer and Hall, We found only one youth prevention program that has been empirically evaluated. Gaboury and Ladouceur describe a three-session program in Quebec organized around an alcohol prevention model.

It covered an overview of gambling, discussions of legal issues, how the gambling industry manipulates the chances of winning, beliefs and myths about gambling, and the development of pathological gambling and its consequences. It also covered strategies for controlling gambling. A sample of juniors and seniors from 5 high schools completed the program.

Whereas the evaluation showed that the students did learn about gambling and coping skills, what they had learned did not significantly influence their gambling attitudes or behavior six months later. The researchers suggested that future programs should increase involvement of both students and teachers and integrate the prevention program into existing drug and alcoholism prevention programs.

Indeed, the reasons attributed to young people's involvement in gambling are similar to those linked to drinking or smoking, including vicarious modeling by parents, perceived pressure from peers, and a susceptibility to illusions of control Derevensky et al. What is known about the treatment of pathological gambling lags behind even what is known about its prevalence and etiology.

A review of the literature indicates that relatively few outcome studies exist, and most of them lack a clear conceptual model and specification of outcome criteria, fail to report compliance and attrition rates, offer little description of actual treatment involved or measures to maintain treatment fidelity by the counselors, and provide inadequate length of follow-up.

This lack of rigorous research is aggravated by the fact that adequate research funding for pathological gambling treatment has not been made available in substantial amounts by the federal government. In contrast, the substance abuse field, which has benefited from treatment research made possible by expansion of research funding by the National Institute on Drug Abuse NIDA and the National Institute on Alcohol Abuse and Alcoholism NIAAA , can point to numerous investigations supporting the effectiveness and costeffectiveness of drug abuse treatment Institute of Medicine, Nevertheless, the committee views professional treatment as an appropriate response in most cases for individuals with a pathological gambling disorder.

However, and especially in the absence of research on treatment effectiveness, it is unlikely that recovery from pathological gambling will involve quick and easy treatment. Rather, the treatment process can be characterized by less than complete compliance, a significant probability of relapse after treatment, and a long-term chronic course of symptoms not uncommon to the recovery patterns of alcoholism, drug addiction, and other chronic medical illnesses, such as hypertension and diabetes McClellan et al.

The prevailing sentiment among experts in the substance abuse field, backed by two decades of well-funded research, is that for substance abusers, some treatment is better than no treatment Institute of Medicine, At this juncture, there appears to be no compelling evidence in the pathological gambling literature to reject the notion that some treatment is better than none.

Naturally, as the treatment literature matures for this disorder, a clearer picture of the incremental value of treatment will come into view. In the near term, it is essential that a comprehensive research agenda on pathological gambling include policy research to identify alternative and optimal funding mechanisms and structures for financing treatment for pathological gambling. It seems wise to model the funding on the system used in substance abuse, in which financing responsibilities are distributed across state and local governments, the federal government acting on behalf of selected poor, elderly, and chronically disabled individuals , and private insurers acting on behalf of employers and individuals who purchase health insurance.

Indeed, private health insurance is now the largest single source of funding for the treatment of alcohol problems Institute of Medicine, The major concern now being raised in the field of pathological and problem gambling treatment is over rapidly rising health care costs that have virtually blocked access to reimbursable treatment. Clearly, a more detailed understanding of the effectiveness of treatment for pathological gambling, as well as the cost-effectiveness of varying treatments, is required if a truly nondiscriminatory financing policy is to be realized.

Research that identifies what keeps pathological gamblers from undertaking treatment and that informs clinical services about how best to locate, attract, and retain patients through treatment is also important. It is also important to study the effects of managed care contracts and health insurance policies that place severe limits on services for those with a pathological gambling disorder. The extent to which gamblers are shortchanged because of limited access to health care has not been well documented.

Furthermore, it is not known to what extent treatment for pathological gambling has been carved out from treatment services for other disorders associated with pathological gambling. It is also not clear if the trend by some states to require separate licensing for pathological gambling counselors will have counterproductive results for clients seeking treatment. Some states offer separate licensing for drug abuse and mental health services and the administration of drug abuse treatment independent of psychiatric, medical, family, and other related services.

The results of partitioning these practices may result in less service delivery McClellan et al. As noted by Rosenthal , women constitute one-third of the population of pathological gamblers but are underrepresented in treatment study samples. And there is increasing recognition of the need to set up and evaluate treatment programs designed specifically for women and adolescents. Results from such studies will enable the development of programs targeted at these groups.

Other client characteristics that require research attention include outcomes for adolescents only one study to date has reported outcomes for them , as well as outcomes for members of different ethnic groups. Client characteristics may predict differential responsiveness to various treatment approaches, and this line of investigation could be linked to evaluation of community-based response systems. In the area of gambling counseling certification and services, the committee sees a need for policy research examining controversial issues and viable options.

Such research should describe the extent of certified counseling services, the number of counselors with varying levels of expertise, the demand for services provided, and alternative training and certification structures that are or could be established at colleges, universities, institutes, and health care training programs.

Research of this type could lead to opportunities in the treatment community to form consensus and create a blueprint for action that will resolve the confusion and fragmentation currently surrounding the credentialing of gambling treatment professionals.

Future treatment outcome studies need greater methodological rigor. The research literature contains only a handful of controlled outcome studies, and most of them suffer from having small sample sizes, which limits their statistical power to detect reliable effects of group differences.

Many studies do not provide information about refusals or dropouts, and, when these data are provided, the results can be discouraging e. Gambling treatment studies should focus particularly on treatments that have manual-guided treatments with careful supervision and documentation of procedures. Poor specification of the therapeutic methods used hinders the replication of successful programs.

Not only do therapist's manuals guide interventions, but they also facilitate the clarification of the specific contribution of particular treatment components. Clarifying key outcome measures of gambling treatment research is also a priority, as is measuring such outcomes on the basis of valid instruments. More research needs to be carried out to identify types of gamblers who may differ in terms of gambling involvement, consequences, and etiology and for whom special treatments may maximize treatment response.

The behavior of some pathological and problem gamblers may be biologically based, the direct result of deficits in the brain's neurotransmitter system Comings, Patients may also display transient symptoms that minimally meet diagnostic criteria for pathological gambling or emerge as a reaction to emotional, affective, or anxiety-related difficulties Blaszczynski, Matching patients to optimal treatment approaches is an ongoing area of research in the substance abuse treatment field.

Limited independent research on matching patients to treatment settings suggests that outcomes are improved when patients were matched to settings that address their particular needs McClellan et al. Clearly, there is no systematic research on the optimal, most cost-effective configuration of services for different groups of problem gamblers.

To even conduct patient matching, three elements are needed: 1 comprehensive assessment tools to identify patient problems and needs, 2 placement criteria to ensure placement in the appropriate setting e. Because the gambling treatment field does not contain an adequate knowledge base pertaining to these three elements, matching patients to treatments cannot be adequately studied until the basic research regarding assessment and placement criteria has first been conducted.

Behavioral and cognitive treatment approaches appear to offer promise as effective treatments for pathological gambling. In a recent special issue of the Journal of Consulting and Clinical Psychology on empirically supported psychological treatments, cognitive-based treatments were cited as perhaps the treatment most widely studied and most highly regarded by proponents of clinical trial methodologies DeRubeis and Crits-Christoph, It has also been observed that cognitive treatments are an emerging approach for the treatment of addictions Crits-Christoph et al.

Nevertheless, this is not to say that eclectic approaches to treating pathological gamblers should be ignored. As Blaszczynski and Silove and Lesieur cogently argue, there is growing recognition that multiple treatment components should be considered given the client's specific configuration of problems.

Thus, clients with dysphoria should be evaluated for antidepressant medication; marital counseling may be indicated in the presence of extreme family estrangement; and substance abuse counseling may be necessary for those whose addictive behavior also includes alcohol or other drug abuse.

There is a particular need for studies of the role of Gamblers Anonymous in recovery and treatment outcomes. If there is a high dropout rate from Gamblers Anonymous, as the literature suggests, then it is important to investigate its causes and strategies for reducing it. Another important understudied research area is the role of therapist characteristics in the treatment of problem gambling behaviors.

In addition, the effect of treatment settings is unclear. Although favorable outcomes have been reported from both inpatient and outpatient programs, their differential effects are still unknown. More research on treating spouses of pathological gamblers is also called for Lesieur, It is typical for spouses to be directed to Gam-Anon programs to help deal with their partner's gambling. Given the view that a spouse may be involved in the gambling addiction, it has been argued that the treatment of husband and wife together is a necessary component to the rehabilitation process for married couples Heineman, ; Steinberg, Pharmacotherapy research needs to be expanded to determine if this approach has an important role in the treatment of pathological gamblers.

We still do not know if medications provide therapeutic effect by ameliorating the pathological gambler's cravings, ruminations, or negative feelings. Research persuasively demonstrates that one of the most reliable predictors of treatment outcome for substance abuse addiction is the patient's readiness to change, regardless of treatment strategy Prochaska et al.

Consequently, the pathological gambling treatment field should direct research attention to studying the patients' overall readiness to change and the specific stage of change as predictors of treatment outcome. The committee thanks Randy Stinchfield for his written summary and presentation of the literature in this section. The committee thanks Roger Svendsen and his team for their investigation of the extent of treatment services.

The committee acknowledges Lynn Wallisch for her written report and contribution to this section. The committee thanks Janet Mann and Marcus Patterson for their written contribution to this section. Turn recording back on. National Center for Biotechnology Information , U. Search term. Defining Treatment and Challenges to Treatment In the committee's view, the definition of treatment needs to be a broad one. Functionality of Addictive Behaviors All addictions, by their nature, pose special problems to treatment providers.

Preventing Relapse A challenge in the treatment of pathological gambling is preventing relapse. Characteristics of Treatment Seekers 1 Understanding the characteristics of those who seek help for a given disorder can assist in developing effective treatments.

Demographics Treatment seekers tend to be white middle-aged men Blackman et al. Gambling Severity Most clinical studies indicate that, before pathological gamblers come in for treatment, they gamble either every day or every week Moore, ; Stinchfield and Winters, Legal and Financial Consequences Although clients may be reluctant to fully disclose their legal entanglements, most clinical studies indicate that a sizable percentage reports having criminal charges pending as a result of engaging in illegal activity to fund their gambling or pay off their debts Yaffee et al.

Other Characteristics Additional personal and social consequences reported by those seeking treatment include work absenteeism and lost productivity on the job, presumably because they either skip work in order to gamble or are involved in gambling-related activities while at work; and marital discord and family estrangement, due to the deception, lying, and stealing associated with their gambling Ciarrocchi and Richardson, ; Ladouceur et al.

Comorbidity As discussed in Chapter 4 , a number of studies have found significant rates of cooccurring mental disorders and psychiatric symptoms among pathological gamblers. Treatment Approaches and Effectiveness Methods for treating pathological gambling include approaches that are psychoanalytic, psychodynamic, behavioral, cognitive, pharmacological, addiction-based and multimodal, and self-help.

Behavioral Behavioral treatment methods actively seek to modify pathological gambling behavior on the basis of principles of classical conditioning or operant theory. Cognitive and Cognitive-Behavioral Several clinicians and researchers have convincingly argued see Blaszczynski and Silove, ; Walker, ; Gaboury and Ladouceur, that pathological and problem gamblers share irrational core beliefs about gambling risks, an illusion of control, biased evaluations of gambling outcomes, and a belief that gambling is a solution to their financial problems Ladouceur et al.

Pharmacological Pharmacotherapy is a relatively new approach to the treatment of pathological gambling. Addiction-based and Multimodal This category of treatments, which has a relatively long tradition, includes a broad range of techniques used by inpatient and outpatient programs. Self-Help Gambler's Anonymous Gamblers Anonymous GA is believed to be the most commonly used of all approaches to deal with pathological gambling, and it is routinely included in multimodal strategies Lesieur, Other Self-Help Related to the Gamblers Anonymous approach is the use of self-help and psychoeducational literature for pathological gamblers.

Natural Recovery Recovery from pathological gambling need not require formal treatment. Health Care Services and Prevention Although the effectiveness of various treatment approaches is not well substantiated in the literature, it is the committee's view that treatment for most, but perhaps not all, pathological gamblers is warranted. Availability and Access of Treatment Services 2 Whereas substance abuse has the attention of policymakers, the need to provide treatment for pathological gambling has not been widely recognized.

Help-Line Services 3 A survey designed and conducted for the committee to provide information on problem gambling help lines in the United States reported that gambling help lines now operate in 35 of the 47 states that have some form of legalized gambling Wallisch, Gambling Counseling Certification and Services 4 The general purpose of certification of health care providers is to provide a form of recognition based on the contributions that they have made to a profession or based on the special expertise that they possess within a practice.

Prevention There are several examples of prevention efforts in the field of pathological gambling, among them teaching gamblers about the odds of the games they play, providing help-line services, and developing public and youth awareness campaigns about the potential risks associated with gambling American Gaming Association, Conclusions What is known about the treatment of pathological gambling lags behind even what is known about its prevalence and etiology.

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American Journal of Drug and Alcohol Abuse 8 3 Haller, R. Hinterhuber Treatment of pathological gambling with carbamazepine. Pharmacopsychiatry Hand, I. Pathological gambling: A negative state model and its implications for behavioral treatments. Harkavy, E. The psychoanalysis of a gambler. International Journal of Psychoanalysis Harris, H. Gambling addiction in an adolescent male. Psychoanalytic Quarterly Heineman, M. A comparison: The treatment of wives of alcoholics with the treatment of wives of pathological gamblers.

Compulsive gambling: Structured family intervention. Journal of Gambling Studies 10 1 Hodgins, D. Unpublished manuscript. Hollander, E. Begaz, and M. DeCaria Pharmacologic approaches in the treatment of pathological gambling. Frenkel, C. Decaria, S. Trungold, and D. Stein Treatment of pathological gambling with clomipramine. Hudak, C. Varghese, and R. Politzer Family, marital, and occupational satisfaction for recovering pathological gamblers.

Humphreys, K. Moos, and J. Finney Two pathways out of drinking problems without professional treatment. Addictive Behaviors Institute of Medicine Broadening the Base of Treatment for Alcohol Problems. Jacobs, D. A general theory of addictions: Rationale for and evidence supporting a new approach for understanding and treating addictive behaviors.

Stein, editor; , and T. Cummings, editor. Lexington, MA: D. Heath and Company. Johnson, E. Nora Does spousal participation in Gamblers Anonymous benefit compulsive gamblers? Psychological Reports In addition to the resources listed above, there are many additional resources for problem gamblers throughout the National Council on Problem Gambling site.

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