Problem gambling
Mental
Health: have you been affected by the recession? We
would welcome your views.
About this leaflet
This leaflet is for:
- anyone who is worried about their
gambling
- the family, partner and friends of
anyone whose gambling has become a problem.
In this leaflet you can find out about:
- Is problem gambling common?
- Is my gambling a problem?
- How can someone lose control of their
gambling?
- Potential harms of problem gambling
- Steps to reduce gambling - helping yourself
- What help can I get?
- How to get help
- Living with a problem gambler - advice for family, partners and
friends
- Further reading.
What is problem gambling?
This is defined as gambling that disrupts or damages personal,
family or recreational pursuits.
How common is problem gambling?
Many of us like to place the odd bet or play
the lottery - but it’s only a problem for about 9 people in
every 1000. However, a further 70 people out of every 1000 gamble
at risky levels that can become a problem in the future.
Who is most likely to get this problem?
Across the world it seems to be common:
- In men – but this might just be
because women gamble less than men.
- In teenagers and young adults -
but problems of this sort can start at any age. Children as young
as 7 may find it difficult to control the amount of time they spend
on computer games. Older people may have too much time on their
hands.
- If someone else in your
family - particularly one of your parents - is a problem
gambler. This may be partly due to genes but can be learnt – by
seeing a parent gamble or being taught to gamble by them.
- In people who work in casinos,
betting shops or amusement arcades.
- In certain types of gambling:
- Internet gambling
- Video poker
- Dice games
- Playing sports
for money
- High-risk stocks
- Roulette
- If you drink heavily or use
illegal drugs.
- If you have depression, anxiety or
bipolar disorder (manic
depression).
Is it a problem for me?
Answer 'yes' or
'no' to each of these 10 questions:
- Do I spend a lot of time thinking about
gambling?
- Am I spending larger amounts of money on my
gambling?
- Have I tried to cut down or stop gambling -
but not been able to?
- Do I get restless or irritable
if I try to cut down my gambling?
- Do I gamble to escape from
life’s difficulties or to cheer myself up?
- Do I carry on playing after losing money - to
try and win it back?
- Have I lied to other people about how much
time or money I spend gambling ?
- Have I ever stolen money to fund my
gambling?
- Has my gambling affected my relationships or
my job?
- Do I get other people to lend me money when I
have lost?
If you have answered 'yes'
- Just once - May be a problem
- this one thing may be enough of a problem to need help.
- Three times - Problem
gambling - your gambling probably feels out of control - think
about getting help.
- Five or more times -
Pathological gambling - your gambling is probably affecting every
part of your life - get help.
How do you lose control of your gambling?
You may gamble:
- to forget about responsibilities
- to feel better when you feel depressed or
sad
- to fill your time when bored (especially if
not working)
- when you drink or use drugs
- when you get angry with others - or
yourself.
Or, you may have:
- started gambling early – some people
start as young as 7 or 8
- never been able to control your gambling
- one or both parents who are problem
gamblers.
Potential harms associated with problem gambling
Problem gamblers are more likely than other people to experience
the following harms:
- Financial harms: overdue utility bills;
borrowing from family friends and loan sharks; debts; pawning or
selling possessions; eviction or repossession; defaults; committing
illegal acts like fraud, theft, embezzlement to finance gambling;
bankruptcy; etc...
- Family harms: preoccupied with gambling so
normal family life becomes difficult; increased arguments over
money and debts; emotional and physical abuse, neglect and violence
towards spouse/partner and/or children; relationship problems and
separation/divorce.
- Health harms: low self-esteem; stress-related
disorders; anxious, worried or mood swings; poor sleep and
appetite; substance misuse; depression, suicidal ideas and
attempts; etc...
- School/college/work harms: poor school, college or work
performance; increased absenteeism; expulsion or dismissal.
Should I stop gambling or try to control
it?
The first thing is to decide to get help
- you can then work out whether you are ready to stop or just
want to control your gambling better. Many people just want to
control their gambling, but then decide to stop completely.
Steps to reduce gambling - helping yourself
Although there is no substitute for professional help, here are
some simple and practical measures to reduce gambling:
1. Limit the amount of money you spend
gambling
- Set a limit from the start on how much you are willing to spend
on gambling in a session or in a week. Stick to it!
- Leave credit/cash cards at home when you go out to gamble.
- If you use a betting account, ask them to place a limit on it -
say £50 - this works for online casinos too!
- On pay day, aim to pay all your priority debts first (mortgage,
rent, council tax, food, etc...)
2. Reduce the amount of time and days that you
gamble
- Set yourself a limit on how many times a week you will gamble
(e.g. twice a week) - be specific and name the days.
- Avoid those "I'll just have a quick go" scenarios.
- You can set your alarm on your watch or phone to remind you -
even your PC will have a calendar reminder alert you can use.
3. Don't view gambling as a way of making
money
- Always remember that you are buying entertainment.
- Always be prepared to lose - if you win, know that it will
happen by chance.
- Never spend your savings or investments on gambling.
- Ask friend and family not to lend you money if you ask
them.
4. Spend time doing other activities
- Spend more time with family or friends.
- Take up a new hobby or interest or revisit one that you enjoyed
before gambling took over.
- Join a social group or organise events with friends who don't
gamble.
- Talk to other about your worries or concerns rather than
'bottling' them up.
Where can I get help?
All of the following provide free support
to help you cut down or stop gambling:
- NHS: The CNWL
National Problem Gambling Clinic in London has
doctors, nurses, therapists, psychologists, debt counsellors and
family therapists with special experience in helping problem
gamblers.
- Gamcare - runs
the national HelpLine and its online equivalent, the NetLine, to
offer help and support for people with a gambling problem, their
family and friends. GamCare also provides face-to-face online
counselling in many parts of the UK.
- The Gordon
Moody Association - a charity which
provides treatment and housing for problem gamblers.
- The 12 step meetings of Gamblers
Anonymous.
- Gamanon: groups for
relatives of problem gamblers.
What sort of help is there?
Cognitive Behavioural Therapy (CBT)
Research has shown that CBT can:
- reduce the number of days a person gambles
- reduce the amount of money they lose
- help a gambler to stay away from gambling once they have
stopped.
How does CBT work?
If you are a problem gambler, you will think differently from other
people about your betting. You will tend to believe that:
- you are more likely to win than you would expect by chance
- in a game with random numbers, like roulette, certain numbers
are more likely to come up than others
- winning twice in a row means that you are on a 'winning streak'
– so you bet larger and larger sums
- you are more likely to win at a game of chance if you are
familiar with it
- certain rituals can bring you luck
- having lost, you can somehow win back your losses by gambling
more.
CBT is given in around 10 one-hour
sessions. The sessions focus on these ways of thinking, but
also on how you feel and behave when you want to bet or when you
are gambling. CBT helps you to work out more helpful ways of
thinking and behaving. A diary helps you to keep track of your
improvement. In the months following treatment, follow-up CBT
sessions in a group seem to help people stay away from gambling
longer.
How does CBT compare with other
treatments? We don’t know yet - there have not been
enough large studies to be clear about this.
12 Step Programmes
This is an approach which assumes that a
dependence on drink or gambling is a disease, and that the best
people to support you are those who have had similar experiences.
Regular meetings are held in which people can share the problems
they have had and the ways in which they have overcome them. They
also have a 'buddy' system, where each member has another member
whom they can contact if they feel that they are about to drink or
gamble again. The 12 Step fellowship, Gamblers Anonymous, offers
meetings throughout the UK and many problem gamblers find these
meetings helpful. You may also need practical help:
- managing your debts
- dealing with family problems
- treat other psychological/psychiatric problems, e.g.
depression.
Medication
No medication is licensed for
the treatment of problem gambling in the UK, but antidepressants can be
prescribed to help with low mood.
What if I don’t get help?
About a third of problem gamblers
will recover on their own, without treatment, and about 2 in 3
will continue to have problems, which tend to get worse.
How to get help and when
Don’t wait until life does not seem worth
living. If you get help, you will feel better and avoid many
problems with your life and health.
You can refer yourself by calling or emailing
the contacts below:
Living with a problem gambler
- Being married to or a partner of a problem
gambler – or being their parent or child - is hard and can be
distressing.
- Your loved one will probably have tried to hide the size of the
problem from you, while they have at the same time borrowed or
stolen to pay off debts.
- If, with the help of the 10 questions above, you can see that
gambling is a problem for someone in your family, it's best to be
honest with him or her about it. They need to know about the pain
and trouble they are causing other people and that help is there
for them.
- If your gambling relative doesn't take any notice, you can get
support for yourself from one of the services listed at the end of
the leaflet. There are groups and individual sessions to support
family members.
References
- American Psychiatric
Association (2000). Diagnostic and Statistical Manual of Mental
Disorders (4th ed, text rev) Washington, DC.
- Black D et al (2003) Quality
of life and family history in pathological gambling. Journal of
Nervous and Mental Disease, 191, 124-126.
- Blaszczynsky AP et al (1991)
A comparison of relapsed and non-relapsed abstinent pathological
gamblers following behavioural treatment. British Journal of
Addiction, 86, 1485-1489.
- Griffiths MD (1990) The
acquisition, development, and maintenance of fruit machine gambling
in adolescents. Journal of Gambling Studies, 6, 193-204.
- Ladouceur R et al (2002)
Understanding and treating pathological gambling. New York,
Wiley.
- Lesieur HR, Rosenthal MD (1991) Pathological gambling: A review
of the literature (prepared by the American Psychiatric Association
Task Force on DSM-IV Committee on disorders of impulse control not
elsewhere classified). J Gambling Studies 7:5-40.
- Petry N (2005) Pathological
Gambling. American Psychological Association.
- Shaffer HJ, Bilt JV and Hall
MN (1999) Gambling, drinking, smoking and other health risk
activities among casino employees. American Journal of
Industrial Medicine, 36, 365-378.
- Wohl MJA et al (2002) The
effects of near wins and near losses on self-perceived personal
luck and subsequent gambling behaviour. Journal of Experimental
Social Psychology, 39, 184-191.
- Wardle H, Moody A, Spence S,
Orford J, Volberg R, Jotangia D, et al (2010) British Gambling
Prevalence Survey. National Centre for Social Research. London: The
Stationery Office.
Further reading
- Orford J (2010). An unsafe bet?: The dangerous rise of gambling
and the debate we should be having. Wiley-Blackwell, UK.
- Orford J (2003). Gambling and problem gambling in Britain.
Brunner – Routledge
- Bowden-Jones H, Clark L (2011). Pathological
gambling: A neurobiological and clinical update. British Journal of
Psychiatry, 199: 87-89.
- George S, Copello A (2011). Treatment
provision for Britain’s problem gamblers: present gaps and future
opportunities. Advances in Psychiatric Treatment, 17:318-322
This
leaflet was produced by the RCPsych Public Education Editorial
Board.
Series Editor: Dr Philip Timms
Original Authors:
- Dr Henrietta Bowden – Jones, National Problem
Gambling Clinic & Imperial College, London
- Dr Sanju George, Birmingham and Solihull
Mental Health NHS Foundation Trust
Expert review: Faculty of Addictions' Users
and Carers Group
Illustration by Lo Cole: www.locole.co.uk
This leaflet reflects the best available evidence available at
the time of writing.
© September 2011. Due for review: September 2013.
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