Healthcare Training Institute - Quality Education since 1979
Psychologist, Social Worker, Counselor, & MFT!!

Section 1
Track #1 - Introduction

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Welcome to the Home Study Course sponsored by the Healthcare Training Institute, homestudycredit.com.  This course is entitled, Pathological Gambling: Diagnosis and Treatment.

Our primary intent for this home study course is to provide quality education to foster your professional growth.  The Institute has provided quality education since 1979.
 
We appreciate that you have chosen us as a vehicle for you to earn your Continuing Education Credit.

The purpose of the course is to assist you in increasing your knowledge regarding how to treat patients, clients, etc. dealing with pathological gambling.  As each case study is given, if the concepts seem to be applicable to your situation, I encourage you to turn your CD player off and make a few notes regarding the application of the principle to your setting.  However, these notes are for your purposes only and are not to be sent to the Institute.  Also each track is very content dense.  So feel free to replay the track to review the content either for your own purposes, or if you feel appropriate play the track in an individual or group session for client education.  Also permission is granted to reproduce this CD.  We encourage you to duplicate and give copies of this CD to colleagues, clients, etc. as you deem appropriate. We feel the information on our CD's is valuable.  Thus, we have an interest in distributing CD's in as many ways as possible, to benefit the greatest number of people, who have a need and are receptive to this practical information.

The questions in your Answer Booklet are sequential and deal with the section of content that preceded it.  For this reason, to facilitate the answering of each question, you might read the question from the Answer Booklet prior to listening to that CD track.  By knowing what the question is ahead of time, you will then know the content to listen for that contains the answer.  So just a hint, after you write down the answer to a question in your Answer Booklet, read on to the next question in order to give you a “heads up” to listen for the content that contains the answer to the next question.

Merely write the correct letter on the corresponding blank line in your answer booklet. Each answer is only used once. Keep in mind there is nothing tricky or hard about these questions.  They are merely intended to verify the playing of this CD.

For the purpose of brevity, most generally, I will use the term “therapists” or “mental health professional.”  However, don’t let these terms deter you from applying the concepts to your situations.  When you hear the word “therapists,” if your job title is social worker, psychologist, marriage and family therapist, mental health counselor, professional counselor, resident director, program assistant, etc. merely substitute the appropriate term that is the most meaningful to you. In short, don’t let my use of the term “therapists” cognitively set you off track from hearing the content because your job title is school counselor, for example.  I will also use the term “client” for the purposes of brevity.  However, if you deal with patients, residents, students, consumers, etc., transpose “client” for the term that is the most meaningful to you in your work setting. 

On this CD set we will discuss such topics as: daily self monitoring diaries, developing a controlled treatment plan, exposure to gambling, finances and relationships, attaining and maintaining abstinence from gambling, and relapse prevention. 

So  let’s get started

On the rest of this track we will discuss pretreatment assessments.  pretreatment assessment.  Three tools for pretreatment assessment are the diagnostic interview, assessing comorbidity, and the daily self monitoring diary. 

#1  The Diagnostic Interview
First, let’s discuss the diagnostic interview.  To cover different aspects related to the history and evolution of the client’s gambling problem, you might find that a diagnostic interview structured specifically for pathological gambling to be helpful.  As you are probably aware, the American Psychiatric Association provides ten diagnostic criteria to facilitate assessment within a semistructured interview.  The ten APA criteria for pathological gambling are motives of consultation, games that lead to a partial or complete loss of control, history of gambling habits, information on the current gambling problem, consequences of the gambling problem, presence of suicidal ideation, current living conditions, other present or past addictions, presence of prior mental health problems, and personal strengths and resources available.  How might these ten criteria help you structure a diagnostic interview for your client?

#2  Assessing Comorbidity
Regarding other present or past addictions, let’s discuss assessing comorbidity.  As you know, comorbidity studies have found a strong association between pathological gambling and substance use disorders, particularly alcohol abuse and dependence.  In treatment facilities for gamblers, thirty to seventy percent of patients are reported to have an addiction to one or more substances.  Moreover, as you probably also know, there is a high prevalence of affective disorders in pathological gamblers seeking treatment.  Estimates of major depression in these samples ranges from thirty to seventy-six percent.  Suicidal ideation and suicide attempts are also found among pathological gamblers at rates from thirty-six to fifty percent and twelve to sixteen percent, respectively.  Clearly, these high percentages are not found in the general population, but rather among a specific population.  Gamblers who are consulting a professional or who are admitted to a treatment facility. 

Do you expect there to be a significant proportion of pathological gamblers with more than one problem?  And consierations of a second problem complicate the therapeutic process?  Would you agree that if gamblers show signs of severe mental problems, depression or suicidal intention that these problems should be treated as priorities?

Technique:  Initial Steps in Dealing With Suicide and Depression
If your client, like Tom, suffers from depression or has displayed suicidal tendencies, perhaps these initial steps in dealing with suicide and depression might be effective treatment tools.  Tom, age 37, had lost his wife, his job, and was in danger of not having a place to live.  Tom’s gambling had resulted in these losses.  Tom stated, “I thought I hit bottom after college, but that was nothing.  Now I really know what bottom is.  Why should I even bother living?”  First, I ensured that Tom knew whom to turn to and where to go if intense suicidal ideations (i-DEE-ae-sions) surfaced.  Think of your Tom.  What resources might your client have?  Next, I made a life contract with Tom.  Tom signed a contract with me stating that he would not, do anything to harm himself without first speaking to me.  Depending on the situation with your client, a third step in dealing with suicide and depression may be to refer the gambler to a doctor to obtain medical or pharmacological monitoring. 

#3  Daily Self Monitoring Diary
In addition to the diagnostic interview and assessing comorbidity, a third effective tool in pretreatment assessment is a daily self monitoring diary.  We’ll discuss the daily self monitoring diary in more detail on the next track.

On this track we discussed pretreatment assessment.  Three tools for pretreatment assessment are the diagnostic interview, assessing comorbidity, and the daily self monitoring diary. 

On the next track we will discuss the daily self monitoring diary in more detail. 

QUESTION 1
What are three tools you can use in your pretreatment assessment? To select and enter your answer go to Answer Booklet