By skyforbes 
The DSM-5 (American Psychiatric Association, 2013) states that to meet the definition of a gambling disorder, the following applies:
Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the following in a 12-month period:
- Needs to gamble with increasing amounts of money in order to achieve the desired excitement.
- Is restless or irritable when attempting to cut down or stop gambling.
- Has made repeated unsuccessful efforts to control, cut back, or stop gambling.
- Is often preoccupied with gambling (e.g., having persistent thoughts of reliving past gambling experiences, handicapping or planning the next venture, thinking of ways to get money with which to gamble).
- Often gambles when feeling distressed (e.g., helpless, guilty, anxious, depressed).
- After losing money gambling, often returns another day to get even (“chasing” one’s losses).
- Lies to conceal the extent of involvement with gambling.
- Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.
- Relies on others to provide money to relieve desperate financial situations caused by gambling.
The DSM-5 also states that the behaviour should be viewed through the lens of a possible manic episode before applying a gambling addiction criteria.
As with many addiction type issues, treatment can come in the form of addressing many issues that focus on:
- Motivation for change
- Behavioural change to addiction cues and triggers
- Managing stress
- Interpersonal relationships
- Coping strategies
- Relapse prevention
The loss of control over gambling behaviour often leads to a significant detrimental effect on an individual’s family, work, and social circles. This multi-factorial effect can impact a number of parties who may be confronted by the individual’s behaviour of lying, theft, and financial crisis.
Gambling has a strong reward component for individuals as they often seek to strengthen wins and compensate for any losses. The individual often becomes locked in a cycle of attempting to repeat past wins and rectify past losses.
Distortions in thinking is a strong factor in the development and maintenance of gambling addiction. Individuals are prone to align with superstitions, control over outcomes, and overconfidence of skills vs chance.
Emotions also factor in gambling activities as individuals will often gamble based on the high emotions of winning and appearing rich and impressive to people. Additionally, individuals experience the emotions of feeling helpless and guilty about losing gambling outcomes.
HOW ART THERAPY CAN HELP WITH GAMBLING ADDICTION
Addictions have a strong link to anxiety and therefore art therapy can benefit clients with addictions through the same art therapy techniques used for those experiencing anxiety.
Feelings of shame are prevalent in individuals who have addictions. This shame often stems from the outcomes of dysfunctional addictive behaviour which may include loss of a job, relationships, lying, theft, and devastating financial impact.
Art therapy can assist in exploring feelings of shame, however, discussing shameful feelings can be painful for individuals, so art therapy allows the individual to explore the feelings without needing to express the shame verbally. Verbal expression of shame can often be confronting which can result in the individual avoiding any discussion surrounding these feelings.
As the client progresses through reducing gambling behaviours and subsequent recovery, art therapy techniques can provide a self-control technique by disrupting maladaptive behaviour by the individual.
MOTIVATIONAL COMPONENT
It is important to explore a client’s motivation towards recovery and whether they have accepted their behavioural patterns indicate an addiction. You can work with your client to determine your client’s baseline level of motivation for recovery from addiction.
Furthermore, it’s important to discuss goal setting with your client and explain the process of constructing goals that are realistic, and measurable. Once the goals are established, you can work with your client to develop a plan that will help achieve the agreed goals. This plan should include achievable steps with a feedback mechanism to reflect on the steps that the client undertakes.
It is useful to work with your client to ascertain what factors may motivate them to engage in gambling behaviours as well as any factors that may motivate them to abstain from gambling behaviours.
BEHAVIOURAL INTERVENTIONS
An art therapist can work with a client to determine the foundations of understanding the behavioural component of gambling addiction. This includes:
- Understanding the triggers and cues that are linked to gambling
- Identifying the situations that are considered high-risk for gambling addiction
- Developing behavioral strategies to intervene the pull towards gambling behaviours
Art therapy is a creative space that helps explore and provide clients with insight into possible cues that precede engaging in gambling behaviour. Art therapists can help clients identify these cues and understand how the knowledge of these cues may influence their behaviour.
Specific situations and other sensory cues can often trigger a fear, threat or loss that your client may attempt to cope with through addictive behaviours. In many cases, often the gambling behaviour doesn’t start as a problem behaviour but instead starts as a solution by an individual to deal with complex situations. Addictive behaviour may have multiple triggers and cues that your client may need to explore.
COPING STRATEGIES
Once your client has explored possible addiction cues they have a better understanding of the development of their addictive behaviour. This understanding can assist your client in establishing a strategy to manage stressful situations in the future. Having a strategy in place can provide your client with confidence that they can prevent engaging in addictive behaviours in the future. Art Therapy can also help diffuse your client’s emotional state when stressful situations occur.
RELAPSE
Relapse is common when working through addiction recovery. Your client’s motivation and self-belief in their ability to recover is a strong influence on recovery. This also translates to your client’s expectation of the process of recovery from addiction, including accepting external support and engaging in positive interpersonal relationships.
An understanding of relapse should be included in the set of coping skills your client has available to them. As your client will have a set of coping skills for stressful events, they should also be provided with a strategy for relapse.