Acceptance and Commitment Therapy for Gambling Addiction

Acceptance and Commitment Therapy for Gambling Addiction

Acceptance and Commitment Therapy for Gambling Addiction

Published:

May 29, 2024

Published:

May 29, 2024

Published:

May 29, 2024

Overcoming gambling addiction requires a comprehensive therapeutic approach that addresses the underlying psychological patterns driving the behavior. Acceptance and Commitment Therapy has emerged as an effective treatment for gambling addiction, offering a combination of mindfulness, self-acceptance, and committed action. By helping individuals accept their thoughts and feelings without judgment and commit to values-driven actions, ACT empowers them to break free from the cycle of addiction and reclaim control over their lives. 

What is Acceptance and Commitment Therapy?

Acceptance and Commitment Therapy (ACT) is a form of psychotherapy that encourages individuals to accept their thoughts and feelings rather than fighting or feeling guilty for them. Rooted in mindfulness and behavioral change strategies, ACT aims to help individuals live and behave in ways consistent with their personal values while developing psychological flexibility.

Gambling addiction often stems from an attempt to escape uncomfortable emotions or thoughts. ACT helps individuals confront and accept these internal experiences without resorting to gambling as a coping mechanism. In fact, a recent study reported ACT-based therapeutic education can help reduce the symptoms of Internet gambling disorder and lessen the severity of dependence. 

The Four A’s of ACT

The Four A’s of ACT—Acknowledge, Allow, Accommodate, Appreciate—serve as guiding principles for individuals undergoing acceptance and commitment therapy:

  • Acknowledge: The first step in ACT is acknowledging your thoughts and feelings without judgment. For someone with a gambling addiction, this means recognizing the urges and triggers that lead to gambling without trying to suppress or ignore them. Acknowledgment is about being honest with oneself and facing reality.

  • Allow: Allowing involves permitting yourself to experience thoughts and emotions as they are, without trying to change or escape them. In the context of gambling addiction, this could mean allowing yourself to feel the anxiety or stress that might trigger gambling, understanding that these feelings are a normal part of the human experience.

  • Accommodate: Accommodate refers to adjusting your behavior in response to your acknowledged and allowed thoughts and feelings. Instead of turning to gambling, you might find healthier ways to cope, such as engaging in physical activity, talking to a supportive friend, or practicing mindfulness techniques.

  • Appreciate: The final step is to appreciate the present moment and the progress you are making. Appreciation involves being grateful for your efforts and recognizing the small victories in your journey towards recovery. This positive reinforcement can strengthen your commitment to change and help you stay motivated. 

The Six Processes of ACT

ACT is built around six core processes that work together to help individuals overcome challenges and lead a fulfilling life: 

  • Acceptance: Acceptance is about embracing your thoughts and feelings without trying to alter them. For those with gambling addiction, acceptance means understanding that urges and cravings are natural but not necessarily a command to act on them.

  • Cognitive Defusion: Cognitive defusion involves changing the way you interact with your thoughts, helping you see them as just words or pictures rather than truths. This can help reduce the power of gambling-related thoughts and decrease their influence on your behavior.

  • Mindfulness: Mindfulness is the practice of being present in the moment without judgment. By focusing on the here and now, individuals can become more aware of their thoughts and feelings and less likely to act impulsively on gambling urges.

  • Self Observation: Self-observation, or self-as-context, means recognizing that you are more than your thoughts and feelings. This perspective helps individuals see themselves as separate from their addictive behaviors, making it easier to change these behaviors.

  • Values: Values are the core principles that give your life meaning and direction. In ACT, individuals identify their values and use them as a guide for making positive changes. For someone with a gambling addiction, this might mean valuing family relationships and working to repair and strengthen them.

  • Committed Action: Committed action involves setting goals and taking concrete steps towards achieving them, based on your values. This could include seeking therapy, joining a support group, or developing new hobbies to replace gambling.

Acceptance and Commitment Therapy vs. Cognitive-Behavioral Therapy

Acceptance and Commitment Therapy (ACT) and Cognitive-Behavioral Therapy (CBT) are both effective therapeutic approaches used to treat a variety of psychological issues, including gambling addiction. While they share some similarities, they also have distinct differences that make each approach unique. Understanding these differences can help individuals choose the best therapy for their specific needs.

Key Differences Between ACT and CBT

Acceptance and Commitment Therapy (ACT)

Philosophy: Focuses on accepting thoughts and feelings without trying to change them. Emphasizes living in accordance with personal values.

Approach to Thoughts: Encourages acceptance of thoughts and feelings as they are. Teaches cognitive defusion techniques to reduce the impact of negative thoughts.

Mindfulness: Core component, promoting present-moment awareness and non-judgmental acceptance of experiences.

Behavioral Focus: Encourages committed action based on personal values. Focuses on aligning behaviors with values to create a meaningful life.

Goals: Aims to increase psychological flexibility and resilience. Helps individuals accept and commit to their values.

Who It’s For: Might be more suitable for individuals who struggle with accepting their thoughts and emotions and who benefit from a values-driven approach to behavior change.

Cognitive Behavioral Therapy

Philosophy: Focuses on identifying and changing negative thought patterns and behaviors. Emphasizes problem-solving and skill development.

Approach to Thoughts: Aims to identify, challenge, and reframe distorted or negative thoughts. Seeks to replace negative thoughts with more positive, realistic ones.

Mindfulness: Used as a technique but not a central focus. Can include mindfulness practices to help manage stress and increase awareness.

Behavioral Focus: Emphasizes changing maladaptive behaviors through behavioral experiments and skill-building. Focuses on achieving specific, measurable goals.

Goals: Aims to reduce symptoms of distress by changing thought patterns and behaviors. Helps individuals develop coping strategies and problem-solving skills.

Who It’s For: Might be a better fit for individuals who prefer a structured, goal-oriented therapy that focuses on changing negative thought patterns and behaviors.

How ACT Works for Gambling Addiction

Acceptance and Commitment Therapy (ACT) helps individuals overcome gambling addiction through several practices:

  • Mindfulness Exercises: ACT incorporates mindfulness exercises to help individuals stay present and aware of their thoughts and feelings without judgment. Mindfulness can reduce impulsive gambling behaviors by fostering a non-reactive awareness of cravings and triggers.

  • Learning About Yourself: Through self-reflection and exploration, ACT encourages individuals to understand the underlying motivations and emotions driving their gambling addiction. 

  • Developing Coping Skills: ACT teaches practical coping skills to manage stress and emotional discomfort. By learning new strategies to handle difficult emotions, individuals can reduce their reliance on gambling as a coping mechanism. Additionally, these coping skills can help alleviate depression that often arises from financial losses, relationship issues, and other consequences of gambling addiction.

  • Practicing Self-Acceptance: Individuals are encouraged to accept their thoughts and feelings as they are, without trying to change or escape them. This self-acceptance reduces the power of negative thoughts and feelings, making it easier to resist gambling urges.

Benefits of ACT for Gambling Addiction

ACT offers a wide range of benefits for individuals struggling with gambling addiction. While it requires dedication and effort, ACT can lead to significant and lasting improvements. Benefits of Acceptance and Commitment Therapy for gambling include:  

  • Increased psychological flexibility

  • Improved emotional regulation

  • Enhanced self-awareness

  • Development of healthier coping mechanisms

  • Alignment of behaviors with personal values

  • Reduced reliance on gambling as a coping strategy 

Take the First Step Towards Recovery With ACT

Embarking on the journey to overcome gambling addiction can be overwhelming, but Acceptance and Commitment Therapy offers a powerful and effective approach to recovery. ACT helps individuals accept their thoughts and emotions without judgment, develop resilience, and align their actions with their personal values. This process fosters long-lasting change and empowers individuals to regain control over their lives.

If you're ready to take the first step towards recovery and reclaim your life from gambling addiction, consider exploring ACT as a treatment option. With the right support and guidance, ACT can help you achieve lasting change and a brighter future. 

Sources: 

The effects of cognitive defusion and thought distraction on emotional discomfort and believability of negative self-referential thoughts - Journal of Behavior Therapy and Experimental Psychiatry 

Effectiveness of Acceptance and Commitment Therapy on Sleep Quality, Academic Hope Anxiety Students' with Online Gambling Disorder with/ without Comorbidity of ADHD Disorder - Razi Journal of Medical Sciences 

Acceptance and Commitment Therapy (ACT) to reduce depression: A systematic review and meta-analysis - Journal of Affective Disorders 

The path to self-acceptance, paved through daily practice - BetterUp 

Mindfulness-Based Relapse Prevention for the Treatment of Gambling Disorder among U.S. Military Veterans: Case Series and Feasibility - Clinical Case Studies 

Overcoming gambling addiction requires a comprehensive therapeutic approach that addresses the underlying psychological patterns driving the behavior. Acceptance and Commitment Therapy has emerged as an effective treatment for gambling addiction, offering a combination of mindfulness, self-acceptance, and committed action. By helping individuals accept their thoughts and feelings without judgment and commit to values-driven actions, ACT empowers them to break free from the cycle of addiction and reclaim control over their lives. 

What is Acceptance and Commitment Therapy?

Acceptance and Commitment Therapy (ACT) is a form of psychotherapy that encourages individuals to accept their thoughts and feelings rather than fighting or feeling guilty for them. Rooted in mindfulness and behavioral change strategies, ACT aims to help individuals live and behave in ways consistent with their personal values while developing psychological flexibility.

Gambling addiction often stems from an attempt to escape uncomfortable emotions or thoughts. ACT helps individuals confront and accept these internal experiences without resorting to gambling as a coping mechanism. In fact, a recent study reported ACT-based therapeutic education can help reduce the symptoms of Internet gambling disorder and lessen the severity of dependence. 

The Four A’s of ACT

The Four A’s of ACT—Acknowledge, Allow, Accommodate, Appreciate—serve as guiding principles for individuals undergoing acceptance and commitment therapy:

  • Acknowledge: The first step in ACT is acknowledging your thoughts and feelings without judgment. For someone with a gambling addiction, this means recognizing the urges and triggers that lead to gambling without trying to suppress or ignore them. Acknowledgment is about being honest with oneself and facing reality.

  • Allow: Allowing involves permitting yourself to experience thoughts and emotions as they are, without trying to change or escape them. In the context of gambling addiction, this could mean allowing yourself to feel the anxiety or stress that might trigger gambling, understanding that these feelings are a normal part of the human experience.

  • Accommodate: Accommodate refers to adjusting your behavior in response to your acknowledged and allowed thoughts and feelings. Instead of turning to gambling, you might find healthier ways to cope, such as engaging in physical activity, talking to a supportive friend, or practicing mindfulness techniques.

  • Appreciate: The final step is to appreciate the present moment and the progress you are making. Appreciation involves being grateful for your efforts and recognizing the small victories in your journey towards recovery. This positive reinforcement can strengthen your commitment to change and help you stay motivated. 

The Six Processes of ACT

ACT is built around six core processes that work together to help individuals overcome challenges and lead a fulfilling life: 

  • Acceptance: Acceptance is about embracing your thoughts and feelings without trying to alter them. For those with gambling addiction, acceptance means understanding that urges and cravings are natural but not necessarily a command to act on them.

  • Cognitive Defusion: Cognitive defusion involves changing the way you interact with your thoughts, helping you see them as just words or pictures rather than truths. This can help reduce the power of gambling-related thoughts and decrease their influence on your behavior.

  • Mindfulness: Mindfulness is the practice of being present in the moment without judgment. By focusing on the here and now, individuals can become more aware of their thoughts and feelings and less likely to act impulsively on gambling urges.

  • Self Observation: Self-observation, or self-as-context, means recognizing that you are more than your thoughts and feelings. This perspective helps individuals see themselves as separate from their addictive behaviors, making it easier to change these behaviors.

  • Values: Values are the core principles that give your life meaning and direction. In ACT, individuals identify their values and use them as a guide for making positive changes. For someone with a gambling addiction, this might mean valuing family relationships and working to repair and strengthen them.

  • Committed Action: Committed action involves setting goals and taking concrete steps towards achieving them, based on your values. This could include seeking therapy, joining a support group, or developing new hobbies to replace gambling.

Acceptance and Commitment Therapy vs. Cognitive-Behavioral Therapy

Acceptance and Commitment Therapy (ACT) and Cognitive-Behavioral Therapy (CBT) are both effective therapeutic approaches used to treat a variety of psychological issues, including gambling addiction. While they share some similarities, they also have distinct differences that make each approach unique. Understanding these differences can help individuals choose the best therapy for their specific needs.

Key Differences Between ACT and CBT

Acceptance and Commitment Therapy (ACT)

Philosophy: Focuses on accepting thoughts and feelings without trying to change them. Emphasizes living in accordance with personal values.

Approach to Thoughts: Encourages acceptance of thoughts and feelings as they are. Teaches cognitive defusion techniques to reduce the impact of negative thoughts.

Mindfulness: Core component, promoting present-moment awareness and non-judgmental acceptance of experiences.

Behavioral Focus: Encourages committed action based on personal values. Focuses on aligning behaviors with values to create a meaningful life.

Goals: Aims to increase psychological flexibility and resilience. Helps individuals accept and commit to their values.

Who It’s For: Might be more suitable for individuals who struggle with accepting their thoughts and emotions and who benefit from a values-driven approach to behavior change.

Cognitive Behavioral Therapy

Philosophy: Focuses on identifying and changing negative thought patterns and behaviors. Emphasizes problem-solving and skill development.

Approach to Thoughts: Aims to identify, challenge, and reframe distorted or negative thoughts. Seeks to replace negative thoughts with more positive, realistic ones.

Mindfulness: Used as a technique but not a central focus. Can include mindfulness practices to help manage stress and increase awareness.

Behavioral Focus: Emphasizes changing maladaptive behaviors through behavioral experiments and skill-building. Focuses on achieving specific, measurable goals.

Goals: Aims to reduce symptoms of distress by changing thought patterns and behaviors. Helps individuals develop coping strategies and problem-solving skills.

Who It’s For: Might be a better fit for individuals who prefer a structured, goal-oriented therapy that focuses on changing negative thought patterns and behaviors.

How ACT Works for Gambling Addiction

Acceptance and Commitment Therapy (ACT) helps individuals overcome gambling addiction through several practices:

  • Mindfulness Exercises: ACT incorporates mindfulness exercises to help individuals stay present and aware of their thoughts and feelings without judgment. Mindfulness can reduce impulsive gambling behaviors by fostering a non-reactive awareness of cravings and triggers.

  • Learning About Yourself: Through self-reflection and exploration, ACT encourages individuals to understand the underlying motivations and emotions driving their gambling addiction. 

  • Developing Coping Skills: ACT teaches practical coping skills to manage stress and emotional discomfort. By learning new strategies to handle difficult emotions, individuals can reduce their reliance on gambling as a coping mechanism. Additionally, these coping skills can help alleviate depression that often arises from financial losses, relationship issues, and other consequences of gambling addiction.

  • Practicing Self-Acceptance: Individuals are encouraged to accept their thoughts and feelings as they are, without trying to change or escape them. This self-acceptance reduces the power of negative thoughts and feelings, making it easier to resist gambling urges.

Benefits of ACT for Gambling Addiction

ACT offers a wide range of benefits for individuals struggling with gambling addiction. While it requires dedication and effort, ACT can lead to significant and lasting improvements. Benefits of Acceptance and Commitment Therapy for gambling include:  

  • Increased psychological flexibility

  • Improved emotional regulation

  • Enhanced self-awareness

  • Development of healthier coping mechanisms

  • Alignment of behaviors with personal values

  • Reduced reliance on gambling as a coping strategy 

Take the First Step Towards Recovery With ACT

Embarking on the journey to overcome gambling addiction can be overwhelming, but Acceptance and Commitment Therapy offers a powerful and effective approach to recovery. ACT helps individuals accept their thoughts and emotions without judgment, develop resilience, and align their actions with their personal values. This process fosters long-lasting change and empowers individuals to regain control over their lives.

If you're ready to take the first step towards recovery and reclaim your life from gambling addiction, consider exploring ACT as a treatment option. With the right support and guidance, ACT can help you achieve lasting change and a brighter future. 

Sources: 

The effects of cognitive defusion and thought distraction on emotional discomfort and believability of negative self-referential thoughts - Journal of Behavior Therapy and Experimental Psychiatry 

Effectiveness of Acceptance and Commitment Therapy on Sleep Quality, Academic Hope Anxiety Students' with Online Gambling Disorder with/ without Comorbidity of ADHD Disorder - Razi Journal of Medical Sciences 

Acceptance and Commitment Therapy (ACT) to reduce depression: A systematic review and meta-analysis - Journal of Affective Disorders 

The path to self-acceptance, paved through daily practice - BetterUp 

Mindfulness-Based Relapse Prevention for the Treatment of Gambling Disorder among U.S. Military Veterans: Case Series and Feasibility - Clinical Case Studies 

Overcoming gambling addiction requires a comprehensive therapeutic approach that addresses the underlying psychological patterns driving the behavior. Acceptance and Commitment Therapy has emerged as an effective treatment for gambling addiction, offering a combination of mindfulness, self-acceptance, and committed action. By helping individuals accept their thoughts and feelings without judgment and commit to values-driven actions, ACT empowers them to break free from the cycle of addiction and reclaim control over their lives. 

What is Acceptance and Commitment Therapy?

Acceptance and Commitment Therapy (ACT) is a form of psychotherapy that encourages individuals to accept their thoughts and feelings rather than fighting or feeling guilty for them. Rooted in mindfulness and behavioral change strategies, ACT aims to help individuals live and behave in ways consistent with their personal values while developing psychological flexibility.

Gambling addiction often stems from an attempt to escape uncomfortable emotions or thoughts. ACT helps individuals confront and accept these internal experiences without resorting to gambling as a coping mechanism. In fact, a recent study reported ACT-based therapeutic education can help reduce the symptoms of Internet gambling disorder and lessen the severity of dependence. 

The Four A’s of ACT

The Four A’s of ACT—Acknowledge, Allow, Accommodate, Appreciate—serve as guiding principles for individuals undergoing acceptance and commitment therapy:

  • Acknowledge: The first step in ACT is acknowledging your thoughts and feelings without judgment. For someone with a gambling addiction, this means recognizing the urges and triggers that lead to gambling without trying to suppress or ignore them. Acknowledgment is about being honest with oneself and facing reality.

  • Allow: Allowing involves permitting yourself to experience thoughts and emotions as they are, without trying to change or escape them. In the context of gambling addiction, this could mean allowing yourself to feel the anxiety or stress that might trigger gambling, understanding that these feelings are a normal part of the human experience.

  • Accommodate: Accommodate refers to adjusting your behavior in response to your acknowledged and allowed thoughts and feelings. Instead of turning to gambling, you might find healthier ways to cope, such as engaging in physical activity, talking to a supportive friend, or practicing mindfulness techniques.

  • Appreciate: The final step is to appreciate the present moment and the progress you are making. Appreciation involves being grateful for your efforts and recognizing the small victories in your journey towards recovery. This positive reinforcement can strengthen your commitment to change and help you stay motivated. 

The Six Processes of ACT

ACT is built around six core processes that work together to help individuals overcome challenges and lead a fulfilling life: 

  • Acceptance: Acceptance is about embracing your thoughts and feelings without trying to alter them. For those with gambling addiction, acceptance means understanding that urges and cravings are natural but not necessarily a command to act on them.

  • Cognitive Defusion: Cognitive defusion involves changing the way you interact with your thoughts, helping you see them as just words or pictures rather than truths. This can help reduce the power of gambling-related thoughts and decrease their influence on your behavior.

  • Mindfulness: Mindfulness is the practice of being present in the moment without judgment. By focusing on the here and now, individuals can become more aware of their thoughts and feelings and less likely to act impulsively on gambling urges.

  • Self Observation: Self-observation, or self-as-context, means recognizing that you are more than your thoughts and feelings. This perspective helps individuals see themselves as separate from their addictive behaviors, making it easier to change these behaviors.

  • Values: Values are the core principles that give your life meaning and direction. In ACT, individuals identify their values and use them as a guide for making positive changes. For someone with a gambling addiction, this might mean valuing family relationships and working to repair and strengthen them.

  • Committed Action: Committed action involves setting goals and taking concrete steps towards achieving them, based on your values. This could include seeking therapy, joining a support group, or developing new hobbies to replace gambling.

Acceptance and Commitment Therapy vs. Cognitive-Behavioral Therapy

Acceptance and Commitment Therapy (ACT) and Cognitive-Behavioral Therapy (CBT) are both effective therapeutic approaches used to treat a variety of psychological issues, including gambling addiction. While they share some similarities, they also have distinct differences that make each approach unique. Understanding these differences can help individuals choose the best therapy for their specific needs.

Key Differences Between ACT and CBT

Acceptance and Commitment Therapy (ACT)

Philosophy: Focuses on accepting thoughts and feelings without trying to change them. Emphasizes living in accordance with personal values.

Approach to Thoughts: Encourages acceptance of thoughts and feelings as they are. Teaches cognitive defusion techniques to reduce the impact of negative thoughts.

Mindfulness: Core component, promoting present-moment awareness and non-judgmental acceptance of experiences.

Behavioral Focus: Encourages committed action based on personal values. Focuses on aligning behaviors with values to create a meaningful life.

Goals: Aims to increase psychological flexibility and resilience. Helps individuals accept and commit to their values.

Who It’s For: Might be more suitable for individuals who struggle with accepting their thoughts and emotions and who benefit from a values-driven approach to behavior change.

Cognitive Behavioral Therapy

Philosophy: Focuses on identifying and changing negative thought patterns and behaviors. Emphasizes problem-solving and skill development.

Approach to Thoughts: Aims to identify, challenge, and reframe distorted or negative thoughts. Seeks to replace negative thoughts with more positive, realistic ones.

Mindfulness: Used as a technique but not a central focus. Can include mindfulness practices to help manage stress and increase awareness.

Behavioral Focus: Emphasizes changing maladaptive behaviors through behavioral experiments and skill-building. Focuses on achieving specific, measurable goals.

Goals: Aims to reduce symptoms of distress by changing thought patterns and behaviors. Helps individuals develop coping strategies and problem-solving skills.

Who It’s For: Might be a better fit for individuals who prefer a structured, goal-oriented therapy that focuses on changing negative thought patterns and behaviors.

How ACT Works for Gambling Addiction

Acceptance and Commitment Therapy (ACT) helps individuals overcome gambling addiction through several practices:

  • Mindfulness Exercises: ACT incorporates mindfulness exercises to help individuals stay present and aware of their thoughts and feelings without judgment. Mindfulness can reduce impulsive gambling behaviors by fostering a non-reactive awareness of cravings and triggers.

  • Learning About Yourself: Through self-reflection and exploration, ACT encourages individuals to understand the underlying motivations and emotions driving their gambling addiction. 

  • Developing Coping Skills: ACT teaches practical coping skills to manage stress and emotional discomfort. By learning new strategies to handle difficult emotions, individuals can reduce their reliance on gambling as a coping mechanism. Additionally, these coping skills can help alleviate depression that often arises from financial losses, relationship issues, and other consequences of gambling addiction.

  • Practicing Self-Acceptance: Individuals are encouraged to accept their thoughts and feelings as they are, without trying to change or escape them. This self-acceptance reduces the power of negative thoughts and feelings, making it easier to resist gambling urges.

Benefits of ACT for Gambling Addiction

ACT offers a wide range of benefits for individuals struggling with gambling addiction. While it requires dedication and effort, ACT can lead to significant and lasting improvements. Benefits of Acceptance and Commitment Therapy for gambling include:  

  • Increased psychological flexibility

  • Improved emotional regulation

  • Enhanced self-awareness

  • Development of healthier coping mechanisms

  • Alignment of behaviors with personal values

  • Reduced reliance on gambling as a coping strategy 

Take the First Step Towards Recovery With ACT

Embarking on the journey to overcome gambling addiction can be overwhelming, but Acceptance and Commitment Therapy offers a powerful and effective approach to recovery. ACT helps individuals accept their thoughts and emotions without judgment, develop resilience, and align their actions with their personal values. This process fosters long-lasting change and empowers individuals to regain control over their lives.

If you're ready to take the first step towards recovery and reclaim your life from gambling addiction, consider exploring ACT as a treatment option. With the right support and guidance, ACT can help you achieve lasting change and a brighter future. 

Sources: 

The effects of cognitive defusion and thought distraction on emotional discomfort and believability of negative self-referential thoughts - Journal of Behavior Therapy and Experimental Psychiatry 

Effectiveness of Acceptance and Commitment Therapy on Sleep Quality, Academic Hope Anxiety Students' with Online Gambling Disorder with/ without Comorbidity of ADHD Disorder - Razi Journal of Medical Sciences 

Acceptance and Commitment Therapy (ACT) to reduce depression: A systematic review and meta-analysis - Journal of Affective Disorders 

The path to self-acceptance, paved through daily practice - BetterUp 

Mindfulness-Based Relapse Prevention for the Treatment of Gambling Disorder among U.S. Military Veterans: Case Series and Feasibility - Clinical Case Studies