PsychMed provides expert evidence-based cognitive behavioural treatment programs for disordered gambling, which complement and articulate with supportive and financial counselling services and family and relationship support. Our treatment program provides practical and useful information to individuals, partners, and families to help understand and change problematic gambling behaviours and associated issues. We specialise in complex presentations and also provide evidence-based treatment for comorbidities such as depression, anxiety, mental illness, drug and alcohol misuse and relationship difficulties. Our services are fee free and confidential.
Signs of a problem
There are many signs that gambling may be a problem or beginning to become more risky in a person’s life. A typical sign of a developing problem is your gambling becoming frequent, with no breaks or days without gambling, and gambling being thought about at all times of the day – in short, when gambling becomes much more important, a bigger focus, or more central in a person’s life that it starts to take priority over other activities and responsibilities. Another sign is a growing feeling of wanting to spend more money on gambling activities, or wanting to chase what was lost in previous gambling sessions.
If you feel that gambling is creating issues, book for an assessment, talk to someone, phone PsychMed and make an appointment.
How Problems Develop
The cause of problem gambling is complex. Research tells us that people vary a lot in their level of risk of developing a gambling problem – some people can gamble without it being an issue, whereas others are more susceptible to struggling with gambling at a safe level. Being depressed or lonely, growing up around gambling and having lots of opportunities to gamble, being a heavy drinker or other substance user, or having a particular biological predisposition to taking risks or being bored easily can all contribute to making a person more vulnerable to problem gambling. People can develop problems with gambling quickly and particularly so when a player has a big win or jackpot early in their career and there is not much else that is fulfilling or exciting in their life.
Impact on others
Problem gambling does not only affect the gambler. Problem gambling places a major strain on couples, on families, and on our society at large. Many problem gamblers have relied on someone, like a parent or partner, to help them out financially due to gambling debts at some point in their life, while also finding it hard to be completely honest about the extent of gambling losses. This can contribute to feelings of shame and guilt and a sense of stigma about gambling, which makes it hard to seek out help or other support.
Problem gambling can often present with many other risks in a person’s life. Some of these risks, like depression, suicidal thoughts, binge drinking – can become worse as gambling becomes riskier. The earlier that a gambler can seek treatment as problem gambling develops, the better the outcome will usually be and the easier it will be to tackle many of the associated problems that can occur with gambling, including relationship conflict issues, financial problems, and depression and anxiety. It is also never too late to seek help.
Stages of Change
Psychological treatment of problem gambling is about developing a strong partnership between the clinician and the client (and their support network if possible). Therefore, the success of treatment will depend on the extent to which the client feels ready and motivated to make positive changes in their life. A therapist can help to talk about some of the mixed feelings and barriers to change in addressing a gambling problem. It is often easier to work toward goals for treatment when discussing these with someone you trust first.
Gambling is increasingly available in places other than casinos and gaming rooms – it is now possible to gamble on many different activities from your living room using a computer, smartphone, or similar device. The accessibility and convenience of online gambling makes it a very attractive gambling prospect, but also a very risky one for some players. It is important to remember that the online gambling landscape can be like the Wild West – very few regulations, and many unscrupulous operators that do not have the player’s best interest in mind.
Gambling is not harmful or problematic for everyone. Many people are able to balance their gambling with other interests, or set limits and stick to them. It is important for people who want help for gambling problems to consider what type of gambling would be their goal for change. What is responsible in terms of spending money or time for one person may not be responsible for another person. It is important to remember that many gamblers who try to gamble less say it can be more difficult than giving up gambling completely.
Although gambling can be very appealing because of the excitement or fun factor, many people actually continue to gamble due to the mental aspect of gambling – having certain beliefs, attitudes and expectations about gambling in the long term. Many of these types of thinking about gambling can become distorted, biased, or based on big emotions rather than objective truth or facts. Gambling is essentially about randomness, which makes it very difficult for the human mind to understand clearly. Our brains are designed to tell us that there is an order to how things work because it is usually to our benefit to use limited information to make predictions. Therefore, many gamblers believe there are patterns in randomness, or other ways of influencing chance events (for example, like tapping the poker table for better cards), and this way of thinking can often lead to making risky decisions in gambling situations.
Help is always there if you or someone you know is showing signs of a gambling problem. It might be helpful to firstly think about whether some of the signs of problem gambling listed on this site might apply to you. Seeking help can be a big step forward and it can be important to identify people in your life who will support the decision. It is a normal human need to seek help when you feel stuck with a problem and there is no shame in reaching out.
Making changes to a gambling habit can be a big challenge for anyone but we know from research studies that people who stay committed to treatment have much better outcomes and more success in the long run. It is important to remember that nobody is perfect and slips in commitment to address problem gambling can happen and can be managed with the right strategies.
Decision to make changes
Dealing with problem gambling can be a big decision and it is completely understandable if you feel ambivalent. Our team at PsychMed is here to work with you and talk through the decision to make gambling changes. It can often be useful to write down some of the reasons that you currently gamble to help you to understand your thoughts and perspective on this part of your life. What do you like about it, and what don’t you like? When we do something very regularly it can become almost automatic and we can lose sight of what initiates and sustains our involvement in the activity. It can be helpful to first work out our motivation to stop or reduce gambling.
We often need goals in order to change. It can be very helpful to have a plan with set goals in order to overcome problem gambling. Reducing gambling means that there will be more time in the day, which can feel very empty if there is nothing planned or available at this time. It is good to be aware of the times that you would usually gamble (e.g., Friday night) and identify some other opportunities or events to fill that time and meet your goals.
One of the most powerful psychological techniques is called ‘exposure’ which refers to the experience of steadily training oneself to learn to handle the discomfort of facing something that we fear, dislike, or otherwise find difficult to do. Everyone can use exposure. Exposure for gambling involves developing the ability to face situations that involve gambling and beating the urge to gamble. The benefit of this approach is that we cannot always avoid every single gambling opportunity in our society, so being able to resist the urge and temptation is a very helpful skill to have when managing problem gambling.
Dealing with unwanted thoughts
Reducing gambling can give an initial sense of achievement but it can also often be accompanied by the danger thought that you are now completely in control and you can therefore give yourself permission to just have a small bet or go out with friends to gamble as a treat. Unfortunately, this way of thinking can be very seductive or appealing, and can be a slippery slope to having a very strong and irresistible urge to gamble. It can be helpful to record the unwanted thoughts about gambling, and check whether there is evidence that supports them.
Illusion of control
The illusion of control is a cognitive bias or incorrect way of thinking that tells the gambler that they can somehow control the outcomes of completely chance-determined events, like the lottery or the pokies. It works because everyone wants to feel at least some degree of control in their life. However, it is important to remember that gambling is not a skill-determined game, and the outcomes are designed to prevent the player from making a profit in the long term. While there may be some ways to reduce how much one loses when gambling, like betting smaller amounts or making optimal decisions in some card games, it is not possible to directly control any aspect of gambling activities to achieve a financial advantage.
The gambler’s fallacy is another common error in thinking that involves the belief that outcomes in a game of chance (e.g., red or black results in roulette) are related to each other in some way. This means that some people will assume that, because a particular sequence of outcomes has occurred (such as 20 blacks in a row), then it is far more likely that a different result will occur (such a red result). It is important to remember that chance-based events are completely random, and even within randomness there may be some uneven strings of results that appear to be related when they in fact they are not. Just because a coin has landed on Heads 5 times in a row, it is still a 50/50 chance of landing on Heads again the next time. The coin does not remember what it has landed on.
Coping with Urges
Many people trying to reduce their gambling report that it then becomes difficult to manage stress or boredom because usually gambling would provide a means to do this. It can be useful to remember that the urge to gamble is a natural consequence of reducing gambling. The brain relies on gambling as a means of feeling pleasure. The urge will feel strong initially, and especially at certain times when you are used to gambling, but this feeling will get easier to manage with time, even if it never fully goes away. It is important to reward yourself for choosing other things to do instead of gambling, and to share this achievement with others who support you. If you feel the urge to gamble, it can be helpful to have a plan in place, like somebody to call, an alternative activity to do, or having financial options limited, to avoid following through on the urge. Remember the urge will eventually pass on its own if you do nothing.