Jessica okayed the Counselling Related 15-hour Workshop organized by the Social Service Training Institute & Community Addictions Management Programme.
Very often I come across gambler clients at the Maintenance Mediation Chamber where I mediate cases. My experience with gambling addict as I grew up made me view them with a degree of disrespect. My maternal grandmother gambled all her life. Nasty words were hurled at me whenever I cried or showed up at her home. I was a jinx in her eyes. I was disgusted when I was older and learnt that she had gambled away most of money inherited from great-grandparents. To me gambling was a horrible habit a person adopted as a life-style. Well, the workshop I attended did change my perception to a large extent.
The Disease Model of Addiction came as a surprise. It views addiction as a biological illness that requires medical & psycho-social intervention. According to the model, addiction involves biochemical processes in the brain. It involves the mid-brain and parts of the pre-frontal cortex. It is a medical illness, chronic, relapsing, genetic, environmental, psychological, though no `cure’ is treatable. The addicts may not be responsible for the disease but they definitely are responsible for the recovery.
Addiction is a family disease. For every person with addiction, 5 family members are affected. And gambling addiction has the highest risk of suicide.
Ms Marjorie Nixon the trainer described the different types of gamblers, i.e., professional gambler, anti-social gambler, social gambler, serious social gambler & problem gambler. The National Prevalence Survey on Problem Gambling (2004) indicated that an estimated 2.1% of Spore’s population were probable pathological gamblers (PPGs). And 1/3 to ½ of all problem gamblers are women with 89 – 95% of WPG are escapist gamblers and most often favour EGM’s (Electronic gaming machine).
I learnt that compulsive gambling may be due to the following factors: Family history of addiction; growing up in a family with extremely critical, rejecting or emotionally unavailable parents; family that emphasizes status or overvalues of money.
We went through the DSM-IV for Pathological Gambling. Some of the behaviors include restless/irritability when attempting to cut down/stop/withdraw, return another day to get even after losing money (chasing losses), relies on others to provide money to relieve desperate financial problems….
The therapist and addict need to work on treatment goals of returning the addicted individual to his/her best level of functioning and avoid damage/dysfunction to the individual and society. Also for the addict to maintain sobriety and actively work on preventing relapse.
The paradigms of Addiction Treatment include Motivating Interviewing (Tailoring interventions to stages of change); CBT; Behavior Modification; Psychodynamic Therapy; Family Systems Therapy; Pharmacotherapy; 12 Step Recovery Programme & Other Self-Help Groups & Sponsorship.
Ms Marjorie went over the 12 Steps of Gamblers Anonymous in greater depth. There seems a lot of conscientious effort required on the part of the gamblers to admit loss of control, to believe in a Power greater than them, to submit to God, to make a moral inventory of self, to humbly ask for God’s intervention, make a list of all persons harmed in the process and make amends to them all.
Basically the 12-Step is about changing ONE thing, i.e., EVERYTHING.
It is a life-long process to change from a gambler to a NON-gambler. It is difficult and it may mean forsaking a brother who is a gambler. The path to a new way of life for the addict is paved with HOPE, responsible thinking/living, self-acceptance, trust from others, improved behaviour and insight into self…
I wish someone was there to offer my grandma the help she needed to recover.
As a therapist, my task is to release that potential for change in the addict, to facilitate the natural process already inherent in the individual. (Miller & Rollnick, 1991)
The 5 basic principles of Motivational Therapy to help elicit change include expressing empathy (identify with feelings/human yearnings), develop discrepancy (to create and amplify, in the client’s mind, a discrepancy between the present behaviour and broader goals), avoid argumentation/roll with resistance (resistance is a signal for the therapist to change strategies), support self-efficacy (acknowledge progress, no matter how small).
According to Mrs Marjorie, `in the final analysis, it is our clients who ultimately choose to maintain or change their problematic behaviour. We must not only accept this reality but when working with clients who want to change, we must also respect and protect their right to freely choose the type and intensity of treatment that they believe will best meet their need.’
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