Clinical Management of Gambling Disorder

Abstract

This chapter deals with the new developments in the treatment of disordered gambling, as well as with the challenges for further research. Abstinence versus moderated gambling as therapeutic goals is an issue that raises many concerns and that needs to be addressed. Current psychological treatment for disordered gambling involves a number of different options, including inpatient treatments, individual and group cognitive-behavioral options, Gamblers Anonymous, and pharmacotherapy, as well as an intervention in relapse prevention. Most of the treatment is delivered on an outpatient basis. Cognitive-behavioral therapy and motivational enhancement therapy may have a success rate ranging from 50 % to 80 % of treated patients in a long-term follow-up. Psychopharmacological therapy may have incremental benefit when patients have comorbid depression or high impulsivity. A relevant issue relates to treatment intensity and the emergence of a plethora of so-called brief interventions. Responsible gambling may be a therapeutic option for young gamblers or people without a severe dependence. Further information is required about treatment for online gambling addictions and for dealing with specific populations (e.g., women and young people). Unanswered questions for relapse prevention and future research in this field are commented upon.