Book Review
Addictions
Counselling Problem Gamblers: A Self-Regulation Manual for Individual and Family Therapy. Joseph W Ciarrocchi. San Diego: Academic Press, 2002. 340 p. US$44.95.
Reviewer
rating*: Fair
Review by: John Telner, PhD, CPsych
Ottawa, Ontario
Unlike many of the DSM-IV disorders, pathological gambling suffers from a lack of well-controlled treatment studies, despite growth in the number of state-sponsored gambling establishments and a concomitant increase in problem gamblers. As the author of this book states in his introductory chapter, “we need to rely on clinical wisdom to understand problem gambling and how it differs from other addictions and mental disorders” (p 2). He clarifies this by quoting Robert Custer, one of the seminal clinician-researchers in the field, who stated that “while problem gambling is about 80% similar to substance abuse, understanding the 20% difference is crucial” (p 2). Dr Ciarocchi thus aptly names his first chapter “The Twenty Percent Difference” and sets the stage for a treatise on understanding and treating individuals with significant gambling problems.
The book is divided into 15 chapters. The initial chapters deal with the epidemiology and social costs of gambling, as well as with studies looking at the causes of pathological gambling and treatments for it. There is also a standard chapter on assessing and diagnosing the disorder. In this chapter, the author discusses the DSM criteria in some detail and describes 2 widely used gambling inventories. These instruments are printed in their entirety in the appendix to the chapter. The rest of the book is devoted to therapeutic strategies to help gamblers control gambling urges and behaviours.
Ciarrocchi devotes a whole chapter to the “Motivational Enhancement” approach. This chapter is replete with goal-setting worksheets and includes topics ranging from developing abstinence–recovery goals to relationships and spiritual–personal–character goals. He includes a chapter (Chapter 8) on the strategy of stimulus control and self-regulation strategies that offers a useful worksheet on gambling triggers. He discusses managing urges to gamble by acknowledging them through what he calls “acceptance”—a type of mindfulness coupled with what he calls “urge surfing.” Other chapters focus on cognitive strategies to deal with depression, anxiety, and guilt, and also on changing beliefs about gambling. The book ends with an examination of some associated gambling issues, including problem solving, financial and legal issues, and family treatment. The final chapter deals with spirituality.
This book was very difficult to read. The author has made a strong attempt to be encyclopedic, as evidenced by the broad range of material included in the text. Yet, there is no overall theme or approach. More important, I was left with the impression that many approaches and exercises in this work are not necessarily based on empirically supported studies. Given the vast literature on problem and pathological gambling, I would have welcomed a more evidenced-based approach. The author has published several articles on pathological gambling in peer-reviewed journals. Technically, this soft-covered book is acceptable in appearance and seems free from production errors. Its price is high, given the content.
*Reviewer
Rating Scale/ Échelle d’évaluation du réviseur
Excellent / Excellent
Very Good / Très bon
Good / Bon
Fair / Passable
Not recommended / Pas recommandé
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