The selective adaptation of the alcoholics anonymous program by Gamblers Anonymous

This paper is largely based on a year long observation study of Gamblers Anonymous and Alcoholics Anonymous meetings in northern California. The paper argues, contrary to popular assumption, that Gamblers Anonymous is significantly different from Alcoholics Anonymous. Differences, in members' consciousness for example, are discussed. The paper contends that although there is some12 step consciousness in G.A., the dominant consciousness ispage 17 consciousness. The significant differences are attributed to the selective adaptation of the Alcoholics Anonymous program. Several consequences of these differences, such as the central role of a language of the self in A.A. and not in G.A., are highlighted.This research was supported by NIAAA post-doctoral grant, 2 T32 AA07240-11, at the Alcohol Research Group, Berkeley, California. I would like to thank everyone at ARG for the wonderfully supportive and intellectually stimulating atmosphere at ARG. I would like to thank especially Mary Phillips, Ron Roizen, Kim Bloomfield, Robin Room, Mike Hilton, Laura Schmidt, John Rumbarger and David Newmark for listening patiently to the unfolding story. I would also like to thank Rachel Volberg and Richard Rosenthal, M.D. for comments on an earlier draft. Comments from the anonymous reviewers and the editor ofJournal of Gambling Studies were also quite useful. Most of all, though, I would like to thank the anonymous members of A.A. and G.A. I, however, take responsibility for the arguments advanced in the paper. This paper is a revision of one presented at theEighth International Conference on Risk and Gambling in London, England, August, 1990.     

Delabeling and relabeling in Gamblers Anonymous: Problems with transferring the Alcoholics Anonymous paradigm

Exploratory data from both structured and unstructured interviews with members of Alcoholics Anonymous and Gamblers Anonymous, as well as additional data from previous observations, suggest that the recovery rate of A.A. is higher than that of G.A.. Since the programs are virtually the same an examination of the social context of the labeling process reveals that the more readily available use of the medical model for both the alcoholic and the significant others of the alcoholic are likely significant differences between the compulsive gambler and the compulsive drinker.An embryonic version of this paper was presented at the Second Annual Conference on Gambling, Lake Tahoe, August 1975. The authors thank Henry Lesieur, Robert Custer, and the anonymous reviewers ofThe Journal of Gambling Behavior for their comments and suggestions. We give special thanks to Dan, Howie, Jeanne, Berdell, Barbara, John, Swede, Happy Jack, Nancy, Skip, and many other anonymous members of G.A. and A.A. for their help and cooperation in this study.     

Pathological gamblers and their spouses: Problems in interaction

Two parallel self-administered surveys were distributed at three conferences of Gamblers Anonymous. One survey was for members of Gamblers Anonymous and the other was for members of GamAnon. Of the approximately 450 respondents, 302 were completed by the compulsive gambler and the spouse (N=151 couples). This article is a report on these 151 couples. The survey focused on two time periods — the gambler's time of torment, a phase spent in plumbing the depths of dread and despair, and the period of recovery following abstinence from gambling. Specific areas covered focus on the gambler's gambling activities, the spouse's awareness of problems, psychosomatic and emotional difficulties of the couple, sexual relationships, children's attitudes, and financial management. The respondents also indicated their need for specific therapy and workshops which could be provided by professional mental health counselors or at Gamblers Anonymous conferences.Based on a paper presented at the Seventh International Conference on Gambling and Risk Taking, Reno, August 22–26, 1987.     

Pathological Gambling: Psychosomatic,emotional and marital difficulties as reported by the Gambler

Two parallel self-administered surveys were distributed at three conferences of Gamblers Anonymous. One survey was for members of Gamblers Anonymous and the other was for members of GamAnon. Approximately 500 respondents completed the surveys. This article is a report of some of the data from the gamblers' survey. This survey focused on two time periods of the compulsive gambler's life—during the desperation phase of the illness (Custer, 1982) and the phase following a period of abstinence from gambling. Specific areas covered in this preliminary report focus on the psychosomatic problems encountered by the gambler, emotional difficulties, sexual estrangement, and the need for mental health services. It is anticipated that some of these needs can be met through training or therapy sessions in professional gambling treatment centers and at Gamblers Anonymous conferences.This article is a revised version of a paper presented at the Sixth National Conference on Gambling and Risk Taking, Atlantic City, New Jersey, December 1984.Robert Yaffee computer scientist, was assisted by senior research assistants: Nancy Frankel, Danny Frankel, Deborah Becker, Douglas Rosen, Leslav Giermanski, Jaime Beauchamp, and Thomas Reingold. Other research assistants included Joseph Lautner, Trudy Myers, Arvind Chawla, and John Morales. To all of these individuals, the National Foundation for Study & Treatment of Pathological Gambling acknowledges its gratitude for their contribution to this project.     

Who Are the Anonymous? Involvement and Predictors of Gamblers Anonymous Attendance Among Disordered Gamblers Presenting for Treatment

Gamblers Anonymous is the most widely available form of support for disordered gambling. Although chapters exist worldwide, knowledge of how attendees interact with the program is limited. The present study aimed to investigate involvement in Gamblers Anonymous among attendees, motives for attendance, and overall satisfaction with the program. Furthermore, potential gambling-related predictors of attendance versus deciding not to attend Gamblers Anonymous were investigated. A treatment-seeking sample of disordered gamblers (N?=?512) from São Paulo, Brazil completed a series of self-report measures including an author-compiled Gamblers Anonymous survey. From the sample, 141 gamblers reported attending Gamblers Anonymous over the previous 30 days. An examination of involvement, satisfaction, and motives for attending Gamblers Anonymous was conducted, followed by regression analyses to assess predictors of attendance and satisfaction with the program. The majority of attendees (80%) reported some satisfaction with the program. The most common motive for attending Gamblers Anonymous was related to relapse prevention. Regression analyses revealed that greater gambling severity and number of days gambled were associated with not attending Gamblers Anonymous while giving testimonials was strongly related (OR?=?6.18) to satisfaction with the program. The findings of this study contribute to the literature on Gamblers Anonymous. In particular, that members derive great satisfaction from the program and see it as a way to strengthen their abstinence goals. However, despite high satisfaction, the results also suggest that most members were passively involved in the program. More research that assesses the effectiveness of Gamblers Anonymous as either a stand-alone or adjunct treatment is needed.     

The Four Es of Problem Gambling: A Psychological Measure of Risk

A focus group of Reno area Gamblers Anonymous members identified four psychological traits contributing to risk for problem gambling, including: Escape, Esteem, Excess and Excitement. A panel of four experts authored 240 Likert-type items to measure these traits. By design, none of the items explicitly referred to gambling activities. Study 1 narrowed the field of useful items by employing a quasi-experimental design which compared the answers of Reno area Gamblers Anonymous members (N = 39) to a control sample (N = 34). Study 2 submitted successful items, plus new items authored with the knowledge gained from Study 1, to validation in a random sample telephone survey across Queensland, Australia (N=2577). The final 40 item Four Es scale (4Es) was reliable (α=.90); predicted gambling problems as measured by the Canadian Problem Gambling Index of Severity (PGSI, Ferris & Wynne (2001). The Canadian Problem Gambling Index: Final Report: Canadian Centre on Substance Abuse); and distinguished problem gamblers from persons with alcohol abuse problems. The new scale can provide a basis for further study in harm minimization, treatment, and theory development.     

Parents of young gamblers

A study of gambling among juveniles in the United Kingdom reveals that their favorite form of gambling, both in terms of percent participating and amounts spent, is playing Amusement with Prizes (i.e., slot) machines. These machines are widely, freely, and legally available to persons of all ages at amusement arcades, youth clubs, cafes, sports centers, bus and railroad stations, and other public settings. Before 1980, machine gamblers were rare at Gamblers Anonymous meetings. However, since that time, their numbers have increased rapidly, currently representing about half of all new members. Of these, 50% are described as children with the remainder in their late teens or early 20s.The balance of the paper describes the difficulties faced by the parents of these youth and the recent development and objectives of a unique self-help group called Parents of Young Gamblers.Editor's Note: Since this writing, P.O.Y.G. has channeled their energies into lobbying the Home Office to take action that would recognize slot machines as gambling devices, remove them from their present easy access to children, and restrict their availability to licensed Game Clubs where only registered adult members may play. The Home Office recently has agreed to place this matter under consideration.The Reverend Gordon E. Moody, M.B.E., was Secretary of the late (British) Churches' Council on Gambling. In the United Kingdom he is Honorary Founder-Patron of Gamblers Anonymous and Chairman of the Gamblers Anonymous General Services Board. He is Founder of Gordon House (a hostel for single, homeless compulsive gamblers) and Honorary Life Member of the Society for the Study of Gambling.     

Dropouts and continuers in Gamblers Anonymous: Part four. Evaluation and summary

In this fourth part of a study of dropouts from Gamblers Anonymous, the design, aims and rationale of which are outlined in part 1 (Brown, 1985b) experiences of GA by a sample of dropouts who had attended more than one meeting are analyzed and compared with similarly obtained responses from a group of continuing attenders who had not gambled for at least one year. The overall pattern of findings from the three prior parts of the study is interpreted as suggesting that

1. Gamblers anonymous may be better at coping with those whose gambling has been severely excessive and had led to many problems. However GA's approach is not so easily accepted and therefore not so effective with those who seek help at an earlier stage in the development of their problems.
2. Gamblers Anonymous may work better with those who have few relapses or best with those who have none at all. Although it may be very helpful in avoiding relapses, it may be less helpful in dealing with them when they do occur.

problems of the representativeness of the sample, of generalizing to Gamblers Anonymous as a whole, and of arguing from associations to causes are discussed. A general picture of the organization as a whole is presented.     

Group psychotherapy with pathological gamblers

This paper reviews some of the group therapy techniques utilized in the authors' work with pathological gamblers. These conceptual tools ranged from rational-emotive psychotherapy to Zen philosophy which provided a background and foundation for working with pathological gamblers. Many therapeutic and antitherapeutic beliefs and behaviors of gamblers are discussed including narcissism, manipulative behavior, and rejection of Gamblers Anonymous. Each technique, behavior or belief discussed is explained in terms of how each affects the group process and how each is managed in group therapy.This paper represents a discourse on the group treatment of pathological gamblers primarily from the experiences of Julian Ingersoll Taber, Ph.D. who was the coordinator of the Gambling Treatment Program at the Cleveland Veterans Administration Medical Center for seven years. Dr. Taber is currently Chief of the Addictive Disorders Treatment Program at the Veterans Administration Medical Center in Reno, Nevada. Martin Paul Chaplin, Ph.D., who is specializing in the treatment of addiction, assisted in the theoretical and editorial aspects of this article. He worked under the aegis of Dr. Taber as an intern at the Gambling Treatment Program and currently has a position at Community Mental Health Services of Medina in Ohio.     

Going on tilt: Frequent poker players and control

This paper is based on three years of participant observation in California's legal commercial card parlors and one year observation at an open meeting of Gamblers Anonymous (G.A.). The grounded concept, tilt, is advanced to describe the process of losing control in the gambling situation. Although some problem gamblers and most compulsive gamblers (members of G.A.) did not use this term, they, nonetheless, described the same process. Tilt is defined and broken down into its various components. Paths to, or ways of going on tilt and the means used to avoid tilt are spelt out. Hochschild's concept, emotion work, is used to describe how successful professionals stay off tilt. The major contention of the paper is that all gamblers experience tilt, and their reactions to tilt and to tilt-inducing situations partly determine whether or not gambling becomes a major problem. The implications of tilt are also discussed.I would like to thank Bob Yamashita, Ernie Fong, and Professor Troy Duster for comments on an earlier draft of this paper. I, however, am responsible for the final product. This is a revision of a paper presented at theSeventh International Conference on Gambling and Risk Taking in Reno, Nevada, August 1987. Requests for reprints should be sent to the author at the Institute for the Study of Social Change, University of California, 2420 Bowditch Street, Berkeley, CA 94720.     

Criminal offenses in gamblers anonymous and hospital treated pathological gamblers

The purpose of this study was to compare the nature and prevalence of gambling and non-gambling related offenses in samples of pathological gamblers seeking behavioural treatment from a hospital-based program and those attending Gamblers Anonymous. A semi-structured interview schedule obtaining demographic data and details of the nature, frequency, and consequent legal action of criminal offenses committed was administered to 152 consecutive hospital treated pathological gamblers, and 154 Gamblers Anonymous attendees who volunteered to participate in the study. Of the total sample, 59% admitted a gambling-related offense, and 23% to a conviction. There was no difference in the proportion of hospital treated and Gamblers Anonymous subjects who offended. The most common gambling-related offenses were larceny, embezzlement and misappropriation. Gamblers committed a median of ten offenses over an average ten year period of pathological gambling with a median value of $ A 300¹ per offense. The median value for each non-gambling-related offense was $ A 130. Except for the significantly older mean age of Gamblers Anonymous subjects, hospital treated gamblers did not differ from Gamblers Anonymous attenders on relevant demographic features or parameters of gambling behaviour. Findings were interpreted to suggest a possible causal link between pathological gambling and the commission of non-violent property offenses.This study was supported by a grant from the Criminology Research Council. The views expressed are the responsibility of the authors and are not necessarily those of the Council. The contribution of Anna Frankova, Research Assistant, is gratefully acknowledged.     

Altering the DSM-III criteria for pathological gambling

Following a critique and revision of the diagnostic criteria for pathological gambling in DSM-III, a field trial of the revised criteria was conducted. Four groups of individuals (762 in all) were surveyed: Gamblers Anonymous members, college students, hospital employees, and outpatients in treatment for pathological gambling. The revised criteria were found to discriminate effectively between pathological gamblers and others. In order to refine the cutoff point, the results on the DSM-III revision were compared to the South Oaks Gambling Screen, a valid, reliable instrument for screening pathological gamblers (Lesieur & Blume, 1987). A cutoff point of four or more items was found to be optimal in diagnosing pathological gamblers.This research was funded by the South Oaks Foundation, Amityville, New York. Special thanks are given Sheila Blume, M.D., Julian I. Taber, Ph.D. and Robert L. Custer, M.D. for their comments on earlier drafts of this paper.     

Insurance problems and pathological gambling

A survey of 241 members of Gamblers Anonymous was conducted in order to find out the impact of pathological gambling on the insurance industry and whether Gamblers Anonymous reverses that impact. Fifty-two percent of the respondents cashed in, surrendered, lapsed or had policies revoked for non-payment. Forty-six percent borrowed on or used the cash value of their life insurance policies while gambling. Forty-seven percent admitted to some form of insurance related fraud, embezzlement or arson in connection with their gambling. The cost to the insurance industry was estimated at 66 billion dollars in surrendered policies and 33 billion dollars in fraud. Attendance at Gamblers Anonymous reversed much of this loss as members picked up new policies and engaged in programs of restitution after attendance. A discussion is made of the insurance related activities in terms of the usage of options up to and including suicide. Possible insurance industry responses are presented.     

Delinquency among pathological gamblers: A causal approach

In a comprehensive research project on gamblers in self-help groups in West Germany one object of investigation was the question of whether or not pathological gambling has a criminogenic effect. 54.5% of the 437 members of Gamblers Anonymous interviewed stated that they had committed illegal actions in order to obtain money for gambling. Comparisons of this sub-group with those interviewees who did not admit having committed criminal offences show distinct differences: Those who admitted illegal action were more excessive in their gambling behavior and experienced a higher degree of subjective satisfaction through gambling. They also showed a more pronounced problem behavior and more psychosocial problems because of gambling. A multiple regression within the framework of path analysis was computed in order to explore causal links between pathological gambling and delinquency. The results support the hypothesis that pathological gambling can lead to delinquent behavior. Forensic implications are discussed.This article is a revised version of a paper presented at the Eighth International Conference on Risk and Gambling in London, U.K., August 15–17, 1990.The content and presentation of this article has benefited from the comments of Agnes Roemer, Department of Psychology, University of Bremen.     

Pathological gambling and associated patterns of crime: Comparisons with alcohol and other drug addictions

The pattern of convictions for various categories of crime in the population of the United Kingdom was compared with the corresponding pattern in a sample of addictive gamblers drawn from Gamblers Anonymous in the U.K. A distinctive pattern of income-generating crime was found to be statistically associated with pathological gambling. This pattern was compared with other distinctive patterns associated with the intake of alcohol and with various other drugs and it was found to resemble most closely that of addiction to narcotic drugs.The possible role of gambling as a contributory cause of crime is discussed in the light of what is known of the issues surrounding other addictions as causes of their distinctive patterns of crime.The content and presentation of this paper benefited from the comments of J. Gillies and A.J. Weir, both of the Department of Psychology, University of Glasgow. The collection of the data would have been impossible without the active encouragement and assistance of the General Services Board of Gamblers Anonymous, U.K., its chairman G. Moody and the National Committee of Gamblers Anonymous, U.K.     

Dropouts and continuers in Gamblers Anonymous: Part 3: Some possible specific reasons for dropout

This is the third part of a study of dropouts from Gamblers Anonymous, the overall design, aims and rationale of which are outlined in part one. Dropouts who had attended more than one meeting were asked about many specific aspects of their experience in Gamblers Anonymous. These reports are compared with similarly obtained reports from a group of continuing attendees who had not gambled for more than one year in an attempt to explore the viability of many specific hypotheses as to the possible factors in dropout.     

Pathological gambling: Psychosomatic,emotional and marital difficulties as reported by the spouse

Two parallel self-administered surveys were distributed at three conferences of Gamblers Anonymous. One survey was for members of Gamblers Anonymous and the other was for members of GamAnon. Approximately 500 respondents completed the surveys, with 215 having completed the questionnaire for the spouse. This article is a report of some of the data from the spouse's survey. This survey focused on two time periods of the spouse's life — during the desperation phase of the gambler's illness (Custer, 1982) and the phase following a period of abstinence from gambling. Specific areas covered in this report focus on the psychosomatic problems and emotional difficulties encountered by the spouse, marital and familial estrangement, financial management, and the need for mental health services. It is anticipated that some of these needs can be met through training or therapy sessions in professional gambling treatment centers and at Gamblers Anonymous conferences.The work on this spouse survey represents a collective effort to enhance the understanding of the relationship between the pathological gambler and the spouse during the desperation phase of the illness and during recovery. Dr. Lorenz developed and implemented the survey. Yaffee organized the data processing, statistical programming, and analysis of the survey. For dedicated and outstanding assistance, special thanks must be given to our senior research assistants, who prepared the codebook and program for this spouse survey: Maria Ycasiano, Leslav Giermanski, Roger Meier, Raisa Rot and Steven Rubenstein. Thanks must also be given to Norberto Colon, Paula Diamond, Edwin Castro, Abdul Beydoun, and Fallan Rhim for their valuable assistance in entering, checking, and cleaning the data prior to analysis. Appreciation for the program written by Joseph Lautner, to check for misalignments in the data file, and the assistance provided by Deborah Becker on this project, is also gratefully acknowledged. To Dr. Thomas Wesselkamper, Chairman of the Hunter College Science Department, for permission to run this project, and all of the aforementioned research assistants, the authors express their sincere gratitude.     

Recovery,reinstatement, serenity: The personal account of a compulsive gambler

A lawyer, investment banker, and certified public accountant who committed crimes to support his gambling addiction describes the process of reinstatement after suspension, the feelings of frustration and despair, and the support he received from Gamblers Anonymous.Editor's Note: Adherence to the principles of the Gamblers Anonymous program made it incumbent upon the author to maintain his anonymity for this article.     

The Medicalization of Deviance as an Interactive Achievement: The Construction of Compulsive Gambling

This article joins two lines of research from distinct areas in sociology to illuminate the mechanisms through which the meaning of “compulsive gambling” and what it means to be “a compulsive gambler” are cooperatively constructed in interaction at meetings of the fellowship group Gamblers Anonymous (GA). Combining Conrad's work on the medicalization of deviance with a social psychological focus on support group interaction, I demonstrate how individuals' experiences and identities come to be imbued with a medical vocabulary through the homogenization of the initial diversity among members. This analysis contributes to conceptualizations of the medicalization of deviance as well as to interactionist interests in the social construction of reality.     

Gamblers Anonymous and Cognitive-Behavioral Therapies for Pathological Gamblers

Numerous types of treatments for pathological gambling have been described, but two of the most common are Gamblers Anonymous (GA) and cognitive-behavioral therapy. This paper describes some outcome data associated with the two approaches. It also reviews evidence suggesting that a combined intervention may enhance therapy engagement and reduce relapse rates.