Cognitive Behavioral Therapy for Pathological Gambling

Reviewed by Eric Patterson, LPC

Pathological gambling, or gambling addiction, is more than just an occasional trip to the casino or buying lottery tickets. For those affected, it becomes a compulsive need that can negatively affect every aspect of their life. From financial struggles to strained relationships to deteriorating mental health, the consequences can be devastating.

The relentless pull of the next bet can seem overwhelming as it traps individuals in a cycle where they continue to gamble even when faced with negative outcomes. It's not just about winning money; it's a deep-rooted behavioral compulsion that requires attention and intervention.

That is where cognitive-behavioral therapy comes in. This structured, goal-oriented treatment has shown promise in helping individuals regain control, restructure their thought patterns, and rebuild their lives.   

What is Cognitive Behavioral Therapy? 

Cognitive Behavioral Therapy, or CBT, is a widely practiced therapeutic treatment that focuses on identifying and addressing the unhealthy thought patterns that can lead to maladaptive behaviors. 

For instance, someone with a fear of social situations might avoid parties (maladaptive behavior) because they believe they will embarrass themselves (unhealthy thought pattern). Or, a person might compulsively gamble (maladaptive behavior) because they believe their next bet will be their big win, despite repeated losses (unhealthy thought pattern).

CBT operates on the belief that our thoughts, feelings, and behaviors are intricately linked. By changing one aspect, like a negative thought pattern, we can bring positive change in our feelings and actions. 

CBT in Addiction Treatment

CBT in addiction treatment aims to help individuals recognize and challenge the thought patterns that lead to addictive behaviors. In cases of pathological gambling, this means identifying the cognitive distortions that make gambling seem more appealing or less risky than it actually is. 

For instance, a person might think, "I'm due for a win," even when the odds are heavily against them. By addressing these distortions, individuals can start to change their behavior.

CBT also emphasizes the development of behavioral changes and coping strategies. In addiction treatment, these can include methods to handle cravings, ways to avoid triggers, or skills to manage stress without turning to gambling. The goal is not just to stop the unwanted behavior but to provide individuals with the tools they need to maintain their progress long-term.

CBT vs. Other Therapies 

While there are many types of therapy that can be used to help individuals overcome addiction, CBT stands out in several ways. One of the primary distinctions is its highly structured nature. 

Unlike some other forms of therapy, which might be more exploratory, CBT is goal-oriented and often short-term. The emphasis is on achieving specific outcomes, which can be particularly beneficial for those seeking tangible results.

Furthermore, CBT is an evidence-based therapy. Numerous studies have documented CBT’s effectiveness in treating a wide range of conditions, from depression and anxiety to various forms of addiction, including pathological gambling.

Another difference is the active involvement required of the patient. In CBT, individuals are not passive recipients of therapy; they actively engage in the therapeutic process, often through homework assignments or practicing new strategies.

Finally, while many therapies focus on looking into the past, CBT is predominantly present-focused. Although understanding past experiences can be helpful, the emphasis in CBT is on changing current thought patterns and behaviors to create a healthier future.

How Does CBT Work? 

CBT uses various techniques to correct negative thought patterns and behaviors. Here’s a breakdown: 

1. Understanding the Problem: The first step of the process involves a thorough conversation between you and a therapist. This discussion centers around challenges the one may face, such as an overwhelming urge to gamble. 

2. Finding Distorted Thoughts: Together, you and your therapist will work to pinpoint specific thoughts that amplify the need to gamble. For example, a recurring thought could be, "Just one more game, and I'll win."

3. Challenging These Thoughts: Your therapist will help guide you in evaluating these thoughts. For instance, "one more game" might have made you lose more money in the past.

4. Learning New Thought Patterns: As you progress, you'll be introduced to healthier thought processes and actions. Rather than fixating on the elusive jackpot, the focus shifts to getting enjoyment from activities other than gambling.

CBT is about teamwork. It requires one to work diligently and actively with their therapist. This consistent effort can help foster healthier ways of thinking and behaving. 

Cognitive Behavioral Therapy Exercises 

With cognitive behavioral therapy, there are structured exercises that are designed to address and reduce the urge to gamble. Here are a few examples:

• Thought Records: Think of this as a cognitive journal. Each time you get the urge to gamble, you write down your immediate thoughts. Over time, these entries may reveal recurring thought patterns that you can then work on changing. 

• Role-playing: With your therapist, you might act out situations where you want to gamble. This serves as a rehearsal as it equips you with the skills to navigate similar real-life situations more effectively. 

• Relaxation Techniques: Stress can make some people want to gamble; however, CBT incorporates several techniques that can help you to relax. This may include deep-breathing exercises, guided visualizations, or other alternatives to resorting to gambling. 

• Problem-solving: Problem-solving exercises in CBT are designed to uncover the root causes triggering the need to compulsively gamble. For instance, if you gamble when you’re bored, you might make a list of other fun activities you could do instead. 

These exercises aren't a quick fix. They work best with consistent practice and commitment. With time and effort, they can help an individual struggling with gambling addiction to adopt healthier cognitive behaviors. 

Common Cognitive Distortions in Gambling

Gambling often comes with its own set of cognitive distortions. Essentially, cognitive distortions are ways our brain tries to trick us into believing something that might not be true. Some of the most common ones include:

• The Gambler's Fallacy: This is the belief that if something happens more frequently now, it will happen less frequently in the future, and vice versa. An example would be thinking that after a string of losses, a win must be around the corner.

• Illusion of Control: Some gamblers believe they have control over an outcome that is actually random. This could look like thinking a dice will land on a particular number because they threw it a certain way.

• Superstitions: Many gamblers have rituals, lucky charms, or specific routines they believe will increase their chances of winning.

• Chasing Losses: Chasing losses is the belief that one can recover their losses by continuing to gamble. This can often lead to even greater losses.

Recognizing these distortions is the first step to addressing and challenging them.

Benefits of CBT for Pathological Gambling

Cognitive-behavioral therapy can be an effective way to treat pathological gambling. Some of its benefits include:

• Targeted Approach: CBT zeroes in on the thought processes and behaviors specifically related to gambling. This makes it a tailored approach to address the core issues.

• Skill Development: Individuals learn practical skills to resist the urge to gamble, manage their emotions, and deal with financial problems stemming from gambling.

• Long-term Focus: While CBT is often a short-term treatment, the skills and strategies learned have long-lasting benefits. These skills can help individuals remain gamble-free in the long run.

• Enhanced Self-awareness: Through CBT, individuals gain insights into why they gamble and how they can change their patterns of thinking and behavior.

Seeking Treatment 

Pathological gambling can be a challenging issue to confront, but the first step towards recovery is recognizing the problem. This recognition sets the groundwork for intervention and healing.  

Once the addiction is acknowledged, it's recommended to consult with a mental health professional or addiction specialist. These experts are equipped to provide guidance on the most appropriate and effective treatment options that are tailored to an individual's unique circumstances. 

Cognitive-behavioral therapy is a great treatment option for those struggling with addiction. This collaborative therapeutic approach addresses the cognitive patterns that are associated with gambling and introduces strategies to develop healthier thinking and behavior.  

Beyond individual therapy, support groups offer another layer of assistance. Connecting with others facing similar challenges provides a sense of community and understanding.

References: 

What Is Maladaptive Behavior? | Verywell Mind

Coping With Stress | Centers for Disease Control and Prevention

The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses | National Library of Medicine

Stressful Life Events and Gambling: The Roles of Coping and Impulsivity Among College Students | National Library of Medicine

How to recognize and tame your cognitive distortions | Harvard Health Publishing