Identification and treatment strategies for youth with gambling problems . Jeffrey L. Derevensky, Ph.D. McGill University. International Centre for Youth Gambling Problems and High-Risk Behaviors www.youthgambling.com Delaware, 2007. Our current state of knowledge .
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Jeffrey L. Derevensky, Ph.D.
International Centre for Youth Gambling Problems and High-Risk Behaviors
Videotape with other adolescents
Profile of the adolescent problem gambler with other adolescents
Profile - continued with other adolescents
Off-kilt physiological resting state Maladaptive coping
characterized by unhealthy feelings, either due to trauma, loss, or poor upbringing.
Problem Severity Continuum
Is Youth Problem Gambling whole life and I’m tired. I’m tired of lying and stealing…for something I can’t seem to control, but don’t want to do. What has happened to me? I need help (male, age 14).
A Primary Disorder?
Continuous involvement in and preoccupation with gambling (and an inability to stop) despite resulting adverse consequences
DSM-IV-J gambling screen (Fisher, 1992)* (DSM-IV-J)
Do you often find yourself thinking about gambling activities at odd times of the day and/or planning the next time you will play? (81.6%)
Do you lie to your family or friends or hide how much you gamble? (78.9%)
After spending money on gambling activities do you play again another day to try and win your money back? (More than half the time?) (73.7%)
In the past year have you spent your school dinner money, or money for bus fares, on gambling activities? (68.4%)
In the past year have you taken money from someone you live with, without their knowing, to gamble? (57.9%)
Do you ever gamble as a way of escaping problems? (50.0%)
Do you find you need to spend more and more money on gambling activities? (36.8%)
In the past year, have you stolen money from outside the family, or shoplifted, to gamble? (28.9%)
Do you become restless, tense, fed up, or bad tempered when trying to cut down or stop gambling? (26.3%)
Treatment approaches……. serious money worry caused by participation in gambling? (21.1%)
The McGill Model
Stage 1: Precontemplation
gambling is not viewed as a problem
Stage 2: Contemplation
beginning to think about gambling as an activity to change
Stage 3: Preparation
decision to change gambling behavior
Stage 4: Action serious money worry caused by participation in gambling? (21.1%)
the gambler takes steps to stop gambling
Stage 5: Maintenance
long-term success requires continued work to sustain initial changes
Stage 6: Termination
gambling no longer represents a temptation or problem
When you treat an individual with a gambling problem, you must take into account their entire person…. Not just the fact that they gamble uncontrollably.
Gambling Problems must take into account their entire person…. Not just the fact that they gamble uncontrollably.
time they spend gambling.
Alternative approaches????? risk for relapse. In the ideal setting the individual will choose abstinence over controlled gambling.