Case example:

• What is another way of thinking?

172 Cognitive Behavioral Therapy and Clinical Applications

you spend;

behaviors.

Identifying irrational beliefs ↓

↓

↓ Positive influence on emotions ↓ Behavioral modification

Testing the validity of irrational beliefs

Replacing irrational beliefs with rational thoughts

**Table 1.** The cognitive restructuring process.

• What must I do to change this belief?

as this is pre-determined by a computer system;

human being if you lose when you gamble.

• Future wins will never be influenced by previous wins or losses;

• The machines are set up to continue playing, despite losses;

Following the disputation process, we will help the subject replace his irrational beliefs with a

• We do not have the power to influence if or how much we win by gambling slot machines,

• Slot machines are set up in such a way that what you win will always be less than what

• You are not more valuable as a human being if you win and you are not less valuable as a

The following is an example of an irrational belief: "on a certain extent, I can predict my next win". As a result of the disputation process, the compulsive gambler's irrational beliefs will be replaced by rational beliefs, which will reflect reality and will help him manage his gambling

After the cognitive restructuring process, we will suggest to the gambler that he creates a list of alternative activities to replace his gambling behavior and as well as a schedule of daily activities which should leave him no spare time to gamble or identify the triggers for his gambling behavior. Studies have shown that involving compulsive gamblers in a large number of

activities to fill up their spare time significantly reduces the risk of a relapse.

different set of beliefs, which will be rational and will reflect reality, such as [47]:

• Winning happens because of sheer chance and not because of the gambler's abilities;

*John's decisional balance sheet includes the possibility of winning a lot of money, satisfying a momentary urge and forgetting about his troubles at home among the advantages of continuing to gamble. Among the disadvantages he includes losing large sums of money, addiction, wasting his time, neglecting his responsibilities, negative emotional states, heavy smoking while gambling, a permanent state of restlessness.*

Depending on each gambler's specific circumstances, we will continue the process of cognitive restructuring with the goal of treating any potential depression and anxiety disorders, given that the negative emotionality underlying depression and anxiety play an important role in triggering as well as maintaining the gambling addiction [61–64]. The key irrational cognitions that generate negative emotional states are the following:


During the process of cognitive restructuring, these cognitions will be replaced by rational alternatives:


Raylu and Oei [6] suggest using the following cognitive techniques when fighting the urge to gamble:

• Create (or develop) several social interests: understand that the people around you have their own wishes and goals in life, and they cannot always offer you their unconditional support, you must also think of how you can support them and be there for them when

Cognitive-Behavioral Therapy for Gambling Addiction http://dx.doi.org/10.5772/intechopen.72671 175

• Learn how to take control of your life; do not let your addictive behavior control your life; • Develop a heightened tolerance to frustration so that you can achieve the goals you set for

• Learn to accept uncertainty, because we live in a world of probabilities, in which nothing

• Think logically, establish short- and long-term goals, and think about the possible conse-

• Learn to accept yourself unconditionally, without making global evaluations about who

• Take on only limited risks in order to increase your chances of achieving the goals you have

• Embrace a philosophy of long-term hedonism, striking a balance between immediate grati-

• Assume the responsibility of your own negative emotions, without blaming them on ex-

• Embrace a healthy lifestyle, with a healthy proportion of work, rest, sport and leisure

• Develop a sense of humor so as to maintain a good disposition even in the face of hardships.

The following emotional signs or behaviors may indicate that a relapse is forthcoming: exhaustion, tiredness; the tendency to hide/distort certain facts; impatience, restlessness, agitation; grumpy disposition, the tendency to be argumentative; depressive symptoms, passivity; decreased tolerance to frustration; self-victimization; reckless risk taking; heightened expectations with regard to other people; and expressing the belief in self-omnipotence.

For all gamblers who have tried to change their gambling behavior, Fong and Rosenthal [68]

• You have taken a major step on the path towards healing by completing the suggested

• Be flexible so that you can cope with the next challenges in your life;

• Develop your creativity so that you can find new ways of spending your time;

they need you;

is absolutely certain;

quences of your actions;

fication and long-term gratification;

offer the following closing advice:

• Do not forget that it takes time to make a change in yourself;

• Make sure you reward yourself after each achievement;

you are as a person;

set for yourself;

ternal causes;

activities;

exercises;

yourself;


Specialists in the field of gambling disorder recommend regularly practicing guided imagery in a state of relaxation as a way of dealing with the urge to gamble [6, 10, 65]. The rationale for using relaxation techniques has to do with the fact that gambling disorders are caused or exacerbated by feelings of stress and anxiety, given that stress plays an important role in the development and maintenance of this pathology [37, 66].

At the end of the therapeutic process, we will support the gambler in his efforts to adopt a well-balanced life style, by establishing the following intervention objectives:


#### Case example:

*John has established the following objectives for himself:*


Dryden and Matweychuk believe that the maintenance of benefits that result from treatment requires developing coping skills with regard to risk situations and future temptations, insofar as addictive behavior relapse is concerned; the authors provide the following recommendations [67]:

• Develop several healthy convictions, such as give up the habit of pleasing others and put yourself first and the others second;


Raylu and Oei [6] suggest using the following cognitive techniques when fighting the urge

• Redirect your focus from the urge to gamble to other external events, by using the STOP technique: as soon as you feel the urge to gamble, clearly tell yourself STOP in a silent

• Identify your irrational beliefs about gambling, dispute them, and then replace them with

Specialists in the field of gambling disorder recommend regularly practicing guided imagery in a state of relaxation as a way of dealing with the urge to gamble [6, 10, 65]. The rationale for using relaxation techniques has to do with the fact that gambling disorders are caused or exacerbated by feelings of stress and anxiety, given that stress plays an important role in the

At the end of the therapeutic process, we will support the gambler in his efforts to adopt a

• *Take concrete actions to change for the better, without waiting for God to work a miracle in my life;*

Dryden and Matweychuk believe that the maintenance of benefits that result from treatment requires developing coping skills with regard to risk situations and future temptations, insofar as addictive behavior relapse is concerned; the authors provide the following recommendations [67]:

• Develop several healthy convictions, such as give up the habit of pleasing others and put

• *Put more effort into managing my company so that it yields a reasonable profit;*

well-balanced life style, by establishing the following intervention objectives:

• Applying the aforementioned coping strategies in a wider context;

• Picture the negative consequences of the gambling;

174 Cognitive Behavioral Therapy and Clinical Applications

development and maintenance of this pathology [37, 66].

• Overall improvement of coping strategies;

*John has established the following objectives for himself:*

• Improving stress management.

• *Make a change in myself;*

Case example:

• *Learn English;* • *Lose weight;*

• *Quit smoking;*

• *Be a different John.*

yourself first and the others second;

voice, without saying it out loud, and focus on something else;

to gamble:

rational beliefs.


The following emotional signs or behaviors may indicate that a relapse is forthcoming: exhaustion, tiredness; the tendency to hide/distort certain facts; impatience, restlessness, agitation; grumpy disposition, the tendency to be argumentative; depressive symptoms, passivity; decreased tolerance to frustration; self-victimization; reckless risk taking; heightened expectations with regard to other people; and expressing the belief in self-omnipotence.

For all gamblers who have tried to change their gambling behavior, Fong and Rosenthal [68] offer the following closing advice:

