Transference and countertransference reactions in the psychotherapy of pathological gamblers

Traditionally, in psychodynamic forms of treatment, the patient's relationship with the therapist is central to eliciting and exploring the patient's characteristic ways of thinking, feeling and behaving. Research has increasingly demonstrated the significance of the therapeutic relationship to the treatment outcome. Since little has been written about the therapist-patient relationship in the treatment of pathological gambling, we shall describe what we have found to be some of the common and problematic transference and countertransference reactions and interactions. Both positive and negative transferences and countertransferences will be discussed not only as obstacles to successful therapy, but as tools for understanding patients' conflicts, defenses and reasons for gambling.     

The Effects of Modeling and Experience on Young Children's Persistence at a Gambling Game

Gambling is common among children and adolescents, but Hide is known about factors initiating or maintaining this behavior. Fifty-one male and 51 female kindergarten and first grade children were invited to play a game involving repeated opportunities to select colored chips from a cup while blindfolded. Children playing for tangible incentives elected to play longer than those who were not (p < .001). Seeing a videotaped model win or fail to win a large prize had no effect on persistence with the game. Playing again one week later, children playing for incentives exhibited a more successful strategy, quitting sooner (p < .04) and with more winnings (p < .03). The parameters of experiential versus observational learning are discussed, with implications for educating children about risk-taking.     

Initial thoughts on viewing pathological gambling from a physiological and intrapsychic structural perspective

This paper is an effort to integrate the contributions of various theoretical orientations in psychology, psychiatry, and neuropsychology into a framework that facilitates the understanding and treatment of pathological gambling. It is the belief of the author that pathological gamblers in particular and perhaps addicted individuals in general lack elements in basic internal structures. Such deficits may involve a biological vulnerability as well as learned dysfunction that result in gaps in identity and ego constructs along with inadequate cognitive and emotional frameworks. Such structures make it difficult for individuals to manage many aspects of life, particularly negative affect, interpersonal relationships, intimacy, and behavioral consistency. The role of treatment begins with evaluation of existing internal structures in order to determine which are dysfunctional. Therapeutic interventions subsequently would be designed to assist patients in constructing more solid structural foundations on which they can build realistic and effective coping patterns and integrated identities. The relevance of a twelve step program in accomplishing therapeutic goals is also discussed.     

Current Inmate Expected Post-Release Needs and Perceived Barriers to Future Voluntary After-Care Program Attendance

When attendance in after-care programs that may help ex-offenders successfully reenter society is not a mandated condition of prison release, getting individuals to voluntarily attend these programs is challenging. In order to help social service agencies better encourage ex-offenders to participate in these programs, it is important to understand ex-offenders’ anticipated needs (thereby increasing possible motivation for attendance) and perceived barriers to program attendance prior to their actual release. Consequently, 256 individuals incarcerated in a county prison in northeastern Pennsylvania were surveyed to address these issues. Findings suggest that women, Hispanics, and parents of children under age 18 anticipate the greatest number of needs upon their future prison release. The most commonly anticipated post-release needs were obtaining food, clothing, education, and child care, although there are group differences. Regarding anticipated programing issues, all inmates foresee transportation barriers to post-release program attendance, and bus passes were the most preferred form of assistance. Scheduling and child care issues were also anticipated programing obstacles and were most pronounced for parents of young children, who report the greatest amount of anticipated needs but also the most barriers to voluntary post-release program attendance. Other group variations and programing implications for voluntary after care are discussed.     

Coping with chronic community violence: the variety and implications of women's efforts

To date, most researchers concerned with chronic community violence have studied children, and focused on the types, extent, and effects of their violence experiences. In contrast, using a series of in-depth repeated interviews, the current study explored African American women's methods for coping with chronic community violence. This article describes the variety of ways these women developed to avoid, minimize, or manage their own and their children's encounters with community violence. It argues for the importance of using these data to inform professional intervention and suggests specific implications for practice, program development, and policy.     

Impact of a Casino Opening on Gambling Behaviors of People Engaged in Methadone Maintenance

This study examined gambling behavior in the context of a newly opening casino, comparing disordered gamblers to non-disordered gamblers, in a population of individuals involved in methadone maintenance treatment. Disordered gamblers (N = 50) and non-disordered gamblers (N = 50) were surveyed before and after the opening of a new casino on gambling behaviors, substance use, and psychological symptoms. No statistically significant changes in gambling behaviors were observed for disordered gamblers or non-disordered gamblers across time points; however, non-disordered gamblers demonstrated non-significant increases in horse and dog race betting, electronic games, and casino table games. As expected, disordered gamblers were found to spend significantly more money on electronic games and casino table games (p < 0.05) and demonstrated higher rates of drug use and impulsivity than non-disordered gamblers. The introduction of a new casino did not appear to have a major impact on gambling behaviors of individuals attending methadone maintenance treatment, though the non-significant increases in gambling among non-disordered gamblers may indicate that this population is preferentially impacted by the opening of a new casino. Future investigation into the longer term effects of opening a new casino on this population may be warranted.     

Motherhood and Family Health Advocacy in Nutrition and Exercise: “Doing the Tradition”

Studies tend to subsume women’s routine family healthcare responsibilities under the larger heading of “household labor.” This study argues that, women’s—and particularly mothers’—family healthcare work in the area of diet and physical activity represents a distinctive area for critical family communication research with potentially serious psychological, emotional, and physical consequences for women and their families. Interviews (N = 30) with young adult-family member dyads supported this assertion. Interview data illustrated that mothers struggled to fulfill incongruous health goals for themselves and their family members, and did so at the expense of their familial relationships (particularly with children) and their own health. Moreover, dyadic data analysis highlighted how young adults ascertained and carried on the “tradition” of the established mother-as-healthcare-provider role. Implications for theory and future research directions conclude this study.