Table Of ContentA Cognitive
Behavioural
Therapy
Programme for
Problem
This book is a treatment manual providing
Gambling guidance for therapists treating clients with
gamblingaddictions.
In this book the authors use a cognitive
behavioural approach and provide a session by
session guide for overcoming problem gam-
Namrata Raylu has been bling.Essentialtopicscoveredinclude:
involved in a number of
research activities in the area of assessmentandpsychoeducation
addictive behaviours over the cognitive behavioural strategies to stabilize
last 12 years and has published gambling
in the problem gambling area. identifyingandchallengingthinkingerrors
Currently, she works as a relaxationandimaginalexposure
research collaborator at the problemsolvingandgoalsetting
Psychology Department, Uni- managingnegativeemotions
versity of Queensland and as a relapse prevention: maintaining a balanced
clinical psychologist in private lifestyleandcopingwithhigh-risksituations
practice.
A Cognitive Behavioural Therapy Programme for
Tian Po Oei has published ProblemGamblingsuppliesdetailed information
widelyintheareasofsubstance, to help the therapist and client understand
anxietyandmooddisordersand gamblingbehaviours, aswellaspracticaladvice
processes of change in psycho- ontechniquesthatcanbeusedwiththeclientto
therapy,especiallyCBTinAsian changethesebehaviours.
cultures. Currently, he holds a
personal Chair in Clinical Psy- This practical guide includes handouts and
chology at the University of exercisesthatcanbedownloadedbypurchasers
Queensland and is the Director of the print edition. It will provide helpful
of the CBT Unit at Toowong guidance for addiction counsellors and thera-
PrivateHospital. pistsworldwide.
A Cognitive
Behavioural
Therapy
Programme
for Problem
Gambling
NAMRATA RAYLU
AND TIAN PO OEI
Therapist Manual
Firstpublished2010byRoutledge
27ChurchRoad,Hove,EastSussexBN32FA
SimultaneouslypublishedintheUSAandCanada
byRoutledge
270MadisonAvenue,NewYork,NY10016
Routledgeisanimprinto ftheTaylor&FrancisGroup,anIn formabusiness
This edition published in the Taylor & Francis e-Library, 2010.
To purchase your own copy of this or any of Taylor & Francis or Routledge’s
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Copyright(cid:216)2010NamrataRayluandTianPoOei
Allrightsreserved.Nopartofthisbookmaybereprintedorreproduced
orutilisedinanyformorbyanyelectronic,mechanical,orothermeans,
nowknownorhereafterinvented,includingphotocopyingand
recording, orinanyinformationstorageorretrievalsystem,without
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Thispublicationhasbeenproducedwithpapermanufacturedtostrict
environmentalstandardsandwithpulpderivedfromsustainableforests.
BritishLibraryCataloguinginPublicationData
AcataloguerecordforthisbookisavailablefromtheBritishLibrary
LibraryofCongressCataloging-in-PublicationData
Raylu,Namrata.
Acognitivebehavioural therapyprogrammeforproblemgambling:
therapistmanual /NamrataRaylu&TianPoOei.
p.cm.
Includesbibliographicalreferences.
ISBN978-0-415-54816-8(pbk.)
1.Compulsivegambling–Treatment. 2.Compulsivegamblers–
Rehabilitation.3.Cognitivetherapy.I.Oei,TianPo.II. Title.
RC569.5.G35R392010
616.85'227–dc22
2009049336
ISBN 0-203-85042-4 Master e-book ISBN
ISBN:978-0-415-54816-8(pbkonly)
Contents
List of figures and tables xi
Preface xii
1. Overview 1
1.1 Programme content and goals 1
1.2 Structure of the programme and sessions 3
1.3 Guidelines on using the treatment programme 4
2. Review of the problem gambling treatment
literature 9
2.1 Introduction 9
2.2 Factors implicated in playing a role in the development and
maintenance of problem gambling 10
2.3 Overview of the problem gambling treatment literature 18
2.4 Summary of the problem gambling treatment literature and
rationale for the CBT programme contained in this book 34
3. Session one: Assessment 36
3.1 Discuss aim and rationale of the session 36
3.2 Conduct an assessment 37
3.3 Devise a case formulation and treatment plan 46
3.4 Provide treatment rationale and plan 51
3.5 Introduce home exercises 53
vi Contents
4. Session two: Psychoeducation and self-
management strategies to stabilize gambling 56
4.1 Discuss aim and rationale of the session 56
4.2 Provide psychoeducation 58
4.3 Discuss self-management strategies to stabilize gambling 61
4.4 Introduce home exercises 68
5. Session three: Cognitive-restructuring I –
identifying gambling specific thinking errors 71
5.1 Review home exercises 71
5.2 Discuss aim and rationale of the cognitive restructuring sessions 71
5.3 Discuss identifying gambling specific thinking errors 73
5.4 Practise identifying gambling specific thinking errors 76
5.5 Introduce home exercises 76
6. Session four: Cognitive-restructuring II –
challenging gambling specific thinking errors 80
6.1 Review home exercises 80
6.2 Discuss aim and rationale of the session 80
6.3 Discuss challenging gambling specific thinking errors 81
6.4 Practise challenging gambling specific thinking errors 83
6.5 Generate rational self-statements 83
6.6 Introduce home exercises 84
7. Session five: Cognitive-restructuring III –
identifying and challenging other/general
thinking errors 89
7.1 Review home exercises 89
7.2 Discuss aim and rationale of the session 89
Contents vii
7.3 Discuss identifying other/general thinking errors 90
7.4 Practise identifying other/general thinking errors 93
7.5 Discuss challenging other/general thinking errors 93
7.6 Practise challenging other/general thinking errors 95
7.7 Introduce home exercises 103
8. Session six: Relaxation and imaginal exposure 108
8.1 Review home exercises 108
8.2 Discuss aim and rationale of the session 108
8.3 Discuss relaxation techniques 110
8.4 Discuss imaginal exposure 111
8.5 Practise relaxation/imaginal exposure 112
8.6 Introduce home exercises 113
9. Session seven: Problem-solving and
goal-setting skills training 117
9.1 Review home exercises 117
9.2 Discuss the aim and rationale of the session 117
9.3 Discuss problem solving 118
9.4 Discuss setting goals 120
9.5 Practise problem-solving and goal-setting skills 123
9.6 Introduce home exercises 123
10. Session eight: Management of negative
emotions 127
10.1 Review home exercises 127
10.2 Discuss aim and rationale of the session 127
10.3 Discuss negative emotions that are common among problem
gamblers 128
viii Contents
10.4 Explore the client’s negative emotions 131
10.5 Discuss strategies for dealing with negative emotions 131
10.6 Introduce home exercises 135
11. Session nine: Relapse prevention and
maintenance of therapeutic gains I – balanced
lifestyle 138
11.1 Review home exercises 138
11.2 Discuss aim and rationale of the session 138
11.3 Discuss what constitutes a balanced lifestyle while assisting
the client to assess areas of his/her life that need
changing 139
11.4 Assist the client to change unbalanced areas of his/her life 143
11.5 Introduce home exercises 143
12. Session ten: Relapse prevention and
maintenance of therapeutic gains II – coping
with high-risk situations 146
12.1 Review home exercises 146
12.2 Discuss aim and rationale of the session 146
12.3 Discuss any anxieties the client may have about leaving the
programme 147
12.4 Discuss possible high-risk situations that could lead to a
lapse/relapse 148
12.5 Discuss strategies to avoid a lapse/relapse 149
12.6 Discuss strategies to deal with lapses 150
13. Elective session: Assertiveness skills training 155
13.1 Review home exercises 155
13.2 Discuss aim and rationale of the session 155
Contents ix
13.3 Discuss assertiveness 156
13.4 Discuss ways to be more assertive 157
14. Elective session: Getting out of debt 164
14.1 Review home exercises 164
14.2 Discuss aim and rationale of the session 164
14.3 Discuss steps to getting out of debt 165
15. Elective session: Teaching significant others
strategies to cope/deal with the gambler’s
behaviours 168
15.1 Discuss aim and rationale of the session 168
15.2 Assessment of the impact of the client’s and his/her
significant other’s behaviours on each other 171
15.3 Provide psychoeducation 172
15.4 Discuss stages in stopping problem behaviours 173
15.5 Discuss strategies to improve the client’s readiness to
change and assist him/her through recovery 174
15.6 Discuss effective strategies to cope with the negative
consequences of the client’s behaviours 177
15.7 Discuss self-care strategies with the significant other 179
APPENDICES
Appendix A: Guidelines for home exercises 184
Appendix B: Guidelines for role-plays/behavioural rehearsals 187
Appendix C: Assessing and managing suicidal clients 188
Appendix D: Notes on stages of change 191
Appendix E: Notes on motivational interviewing 194
