Overview of management of gambling concerns
Principles of care guide the management of gambling concerns. Establishing a therapeutic relationship that engages the person (and ideally those close to them) is key to the management of addictive behaviours.
Specialist advice for patients with gambling concerns or their clinicians is available, and contact is encouraged. Specialist gambling treatment services provide advice to clinicians and accept referrals in some states. Gambling support services are available across the country; they primarily advise patients directly but also welcome contact from clinicians.
Endorse the patient’s disclosure of gambling concerns and invite them to discuss next steps.
Provide a message of hope for recovering good health; acknowledge that relapses are common, but a return to good health is feasible. Shared stories of patient experiences can support this message; examples include videos from GambleAware and stories from the South Australian Statewide Gambling Therapy Service website.
Evidence to guide management of gambling concerns is limited but supports:
- brief interventions
- early referral to gambling support services
- specialist psychological therapies
- self-help tools.
No drugs have been approved by the Australian Therapeutic Goods Administration (TGA) for treatment of gambling disorder. Evidence for the use of naltrexone1 in gambling disorder is limitedKovanen, 2016Ward, 2018; it should only be used in gambling management under the guidance of a specialist treatment service as an adjunct to specialist psychological therapies.
Consider the need for management of comorbid conditions such as anxiety, mood disorders (eg major depression or bipolar disorder) and disorders of substance use, particularly alcohol use.
Long-term care is recommended to maintain the therapeutic relationship.
Considerations for specific populations may be relevant in managing gambling concerns, particularly if the patient has a concurrent disorder of substance use.