- ISBN: 9780471484844 | 0471484849
- Cover: Paperback
- Copyright: 3/30/2007
William A. Howatt, PhD, EdD, has more than eighteen years' experience as an addiction counselor. He is an internationally certified alcohol and drug addictions specialist, gambling addictions specialist, registered professional counselor, and registered social worker who has also completed post-doctoral work in addiction studies at UCLA School of Medicine. He is a faculty member of Nova Scotia Community College where he teaches in the addiction counselor program for the School of Health and Human Services. He is author of numerous books including The Addiction Counselor's Desk Reference and is coeditor of the Wiley Series on Treating Addictions (both published by Wiley).
Acknowledgments | p. xvii |
Series Preface | p. xix |
Preface | p. xxi |
About the Authors | p. xxiv |
Conceptual Foundations of Gambling Disorders | |
Introduction to Gambling | p. 1 |
Definitions of Problem and Pathological Gambling | p. 5 |
Definitional Distinctions | p. 5 |
An Introduction to the Three Cs of Problem and Pathological Gambling | p. 7 |
Myths versus Facts about Problem and Pathological Gambling | p. 9 |
Transient versus Chronic Problems | p. 11 |
Spontaneous Remission and Maturing Out | p. 13 |
Clinical versus Nonclinical Populations: Why Some Gamblers Do Not Mature Out | p. 14 |
Risk Factors for Gambling Disorders | p. 16 |
Exposure, History, Attitudes, and Expectancies | p. 16 |
Personality Variables | p. 17 |
Blaszczynski's Types | p. 17 |
Specific Contradictory Personality Variables | p. 18 |
Comorbid Psychiatric Disorders | p. 20 |
Biology and Genetic Factors | p. 20 |
Coexisting Addictive Disorders | p. 22 |
Epidemiology of At-Risk Populations | p. 22 |
Gender Differences | p. 24 |
Gambling, the Family, and Multicultural Considerations | p. 25 |
What the Future Holds for the Treatment of This Disorder | p. 26 |
Where the Field Is Going | p. 26 |
Summing Up | p. 28 |
Key Terms | p. 29 |
Recommended Reading | p. 30 |
Recognizing Gambling Disorders: Signs and Symptoms | |
Developmental Stages in the Progression of Problem and Pathological Gambling Behavior's | p. 33 |
The Gambling Continuum | p. 34 |
Recognizing Gambling Disorders | p. 36 |
The Signs and Symptoms of Pathological Gambling | p. 38 |
Client Information | p. 39 |
Coexisting Addictive Disorder Screening | p. 42 |
Other Client Signs | p. 47 |
What Spouses or Others May Report | p. 49 |
Employers and Supervisors | p. 50 |
Traditional Psychological Assessment | p. 51 |
Complicating Diagnostic Issues | p. 56 |
Healthy versus Problematic Attitudes and Behaviors | p. 59 |
Social Settings | p. 60 |
Professional Collaboration, Accountability, and Responsibility in the Screening-Intake Process | p. 60 |
Summing Up | p. 62 |
Key Terms | p. 63 |
Recommended Reading | p. 64 |
Utilizing Optimal Professional Resources | |
Referral Benefits and Disadvantages | p. 68 |
Screening Reports, Documentation, and Responsibility | p. 71 |
How to Develop a Professional Referral Network | p. 72 |
State and National Councils on Compulsive and Pathological Gambling | p. 73 |
Gambling Hotlines | p. 74 |
Liaison with Gamblers Anonymous | p. 75 |
GamAnon | p. 78 |
Psychiatrists and Emergency Facilities | p. 78 |
Matching Clients with the Best Professional Options | p. 79 |
Referrals to Counselors under Contract in the Private Sector | p. 80 |
Referral Do's and Don'ts | p. 81 |
Motivation Strategies and Techniques for Getting a Person to Professionals | p. 83 |
Ambivalence | p. 84 |
Using Motivational Interviewing | p. 85 |
Avoiding Anger and Shame: The Rapid Demotivators | p. 87 |
Procrastination | p. 88 |
Overcoming Client Obstacles | p. 88 |
Common Practical Obstacles | p. 89 |
The "Controlled Gambling Experiment" | p. 90 |
Preventing and Dealing with Crisis Situations | p. 91 |
Family and Concerned Others Involvement | p. 93 |
Risk Management Strategies and Techniques to Protect Clients and Families | p. 94 |
Suicide and Suicidal Ideation | p. 94 |
Six Step Model | p. 96 |
Define the Problem | p. 96 |
Ensure the Person's Safety | p. 96 |
Provide Support | p. 96 |
Explore Options and Alternatives | p. 97 |
Make a Plan | p. 97 |
Get a Commitment | p. 97 |
Risk Management Strategies and Techniques to Protect Counselors | p. 101 |
Duty to Warn for Property Damage | p. 101 |
Referral Follow-Up and Cautionary Notes | p. 103 |
Summing Up | p. 103 |
Key Terms | p. 104 |
Recommended Reading | p. 104 |
Developing an Effective Treatment Plan | |
Therapeutic Benefits of Treatment | p. 108 |
Initial Attrition | p. 110 |
Telephone Contact and Crisis Intervention | p. 112 |
Client Intake | p. 113 |
The Counselor's Tasks During the Intake | p. 115 |
Questions That You Might Need to Ask Yourself | p. 117 |
Helpful Information Before the Intake | p. 117 |
Informed Consent and Limits of Confidentiality | p. 118 |
HIPAA, Intake, and Client Records | p. 123 |
Intake Do's and Don'ts | p. 124 |
Formal Assessment Processes | p. 125 |
Assessment Measures and Instruments Commonly Used and Why They Are Useful | p. 127 |
Diagnostic Processes and Determinations | p. 128 |
Treatment Planning | p. 129 |
Fees and Insurance Coverage | p. 130 |
Managed Care | p. 131 |
Filing for Insurance: The Practice of Responsible Client Billing | p. 131 |
Ethics of Insurance: Modeling Financial Responsibility for the Pathological Gambler | p. 132 |
Family and Concerned Others Involvement | p. 132 |
Recovery Contracts | p. 134 |
Action Plans | p. 135 |
Summing Up | p. 138 |
Key Terms | p. 138 |
Recommended Reading | p. 139 |
Resource for General Paperwork | p. 139 |
HIPAA | p. 139 |
Dual-Diagnoses Clients | p. 140 |
Recovery Theories, Programs, and Tools | |
An Overview: What We Know from Other Addictions | p. 143 |
Levels of Traditional Gambling Treatment | p. 145 |
Applying ASA Levels of Care To Gambling Treatment | p. 146 |
Recovery Theories and Models | p. 147 |
The Disease Model | p. 148 |
The Alternative Model | p. 149 |
Motivational Therapies | p. 155 |
Social Interventions | p. 156 |
Medical Treatments | p. 157 |
Responsible Gambling | p. 158 |
Teaching How Video Gambling Works | p. 159 |
Family Therapy | p. 160 |
Psychosocial Therapies | p. 162 |
Insight and Psychodynamic Therapies | p. 163 |
Grief Counseling | p. 164 |
Behavioral Therapies | p. 164 |
Cognitive and Cognitive-Behavioral Models | p. 164 |
Existential and Spiritual Interventions | p. 166 |
Holistic and Alternative Treatments | p. 167 |
Financial Counseling | p. 167 |
Support Groups | p. 167 |
Internet Treatment | p. 171 |
Formal Treatments | p. 172 |
Very Minimal Treatment | p. 172 |
Develop a Gambling Intervention Tool Box | p. 172 |
Workbook and Journaling Programs | p. 173 |
Cultural Pathways of Recovery | p. 175 |
Summing Up | p. 176 |
Key Terms | p. 176 |
Recommended Reading | p. 177 |
Continuing Care: When and How Should Clients Be Discharged | |
Recovery-What Are the Goals? | p. 181 |
Criteria for Exiting Clients from Supervised Treatment | p. 183 |
Discharge Criteria For Different Problem Intensities | p. 184 |
Gambling Problems and Mastery-Based Discharge: Using Cognitive Corrections | p. 185 |
Gambler Discharge or Step-Down Criteria | p. 185 |
Discharge Criteria and Concerns during Various Stages of Recovery | p. 186 |
Discharge and the Developmental Recovery Processes | p. 188 |
Continuing Care Plan Procedures and Guidelines | p. 189 |
Legal, Moral and Ethical Issues | p. 192 |
Proper and Improper Methods of Termination | p. 193 |
Abandonment | p. 194 |
Assessing Community Resources | p. 195 |
Organizing Recovery Supports Where Lacking | p. 196 |
Styles of Recovery: Methods of Disease Management | p. 197 |
Spheres of Recovery | p. 199 |
Family and Concerned Others Involvement and Spheres of Recovery | p. 200 |
Rates of Recovery and Failure | p. 201 |
Summing Up | p. 203 |
Key Terms | p. 204 |
Recommended Reading | p. 204 |
Posttreatment Recovery Management: Models and Protocols of Relapse Prevention | |
Relapse Prevention | p. 208 |
Models of Relapse Prevention | p. 208 |
Behavioral Models of Relapse Prevention | p. 209 |
Cognitive Models of Relapse Prevention | p. 210 |
Cognitive-Behavioral Models | p. 210 |
Belief that relapses are inevitable | p. 211 |
Belief that relapses are impossible | p. 211 |
Belief that God intervenes to allow chance to favor people in need | p. 211 |
Belief that all problems (finance, stress, etc.) need immediate solutions | p. 212 |
Belief that "What did not work in the past will suddenly start to work." | p. 212 |
An Integrated Model of Relapse Prevention | p. 212 |
Baumeister's Model of Self-Regulation | p. 212 |
Proactive Strategies for Preventing and Dealing with "Triggers" for Relapse | p. 213 |
Cognitive Triggers | p. 213 |
Triggers in Cognitive Behavioral Therapy | p. 215 |
Developing Relapse Prevention Plans | p. 216 |
Common Themes in Relapse Prevention | p. 219 |
Emergence of Sadness and Subclinical Depression | p. 219 |
Sleep | p. 220 |
Modification of Social Networks | p. 220 |
Reduction in Other Addictive Substances | p. 221 |
Exercise | p. 221 |
Monitoring and Negotiating Follow Up in Recovery | p. 223 |
Emergency Plans | p. 224 |
Obstacles in Relapse Prevention: Emerging Difficulties | p. 225 |
Emergence of Psychiatric Disorders | p. 225 |
Emergence of Physical Problems | p. 226 |
Emergence of Couples and Family Problems | p. 227 |
Community Linkage as Relapse Reversion Prevention | p. 228 |
Community-Based Vocational Counseling | p. 228 |
Academic Counseling | p. 228 |
Financial Counseling | p. 229 |
Pastoral Counseling | p. 230 |
Leisure Counseling | p. 230 |
Health Counseling | p. 230 |
Telephone and Internet Follow Up | p. 231 |
Family and Concerned Others Involvement during Posttreatment Recovery | p. 232 |
Preventing Chronic Relapses | p. 233 |
Mindfulness | p. 233 |
Summing Up | p. 235 |
Key Terms | p. 236 |
Recommended Reading | p. 236 |
New Beginnings: Moving Beyond the Addiction | |
Moving Beyond | p. 240 |
Recovery in Psychological and Mental Health Domains | p. 241 |
Personality Changes | p. 242 |
Psychotherapies | p. 244 |
Psychodynamic Therapy | p. 244 |
Narrative Psychotherapy | p. 245 |
Humanistic Psychotherapies | p. 246 |
Increasing Positive Emotions and Happiness | p. 248 |
Moral Development | p. 250 |
Beyond Selfhood | p. 251 |
Family Recovery | p. 253 |
Vocational Recovery | p. 255 |
Physical Health and Spirituality | p. 257 |
Summing Up | p. 258 |
Key Terms | p. 259 |
Recommended Reading | p. 259 |
References | p. 261 |
Index | p. 271 |
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