As most gambling counselors and therapists will attest, there’s no single treatment that works across the board for all clients. However, meditation and other mindfulness-based therapies, which have increased in popularity, are showing promise in helping people cope with a range of mental health conditions, including gambling addiction.
What is Mindfulness?
First, what exactly is mindfulness? While definitions vary slightly depending on the context, all center around the concept of moment-to-moment awareness without expectation. According to Jon Kabat-Zinn, founder of mindfulness-based stress reduction (MBSR), “mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally.”
Ollie Stocker, LICSW, LADC, MN-CGC, a therapist at Fairview Recovery Services who both practices meditation personally and encourages his clients to try it, feels that mindfulness and meditation work hand in hand. “I see meditation—in all its various forms, such as focusing on breath, focusing on senses, listening to guided meditations, etc.—to be the basic training, the boot camp of mindfulness. The goal is to do some daily mediation practice that you can then carry over to everyday activities. Even if one is unable to integrate mindfulness practices into everyday living, it is minimally effective to have 20-30 minutes of calming relaxation.”
The concept of “practice” is an important aspect. “I refer to mindfulness as a ‘practice’ because it takes time to develop the skills needed to maintain mindfulness and meditate for any significant amount of time,” says Susan Campion, MS, LACD, ICGC-II, problem gambling group counselor at Fairview Recovery Services. “We generally start open group with a five-minute meditation and encourage clients to grow their practice at home.”
Why Consider Meditation and Mindfulness?
“Gamblers are impulsive and lack self-regulation skills, which makes it difficult for them to manage urges and cravings,” says Ollie. Meditation quiets the “monkey mind” associated with gambling while mindfulness keeps clients in the present and less focused on past mistakes or future concerns. Thus, it can help gamblers, who tend to operate on autopilot and respond to addictive urges without awareness, according to Ollie.
Other reasons that gamblers can benefit from meditation and mindfulness is to realize the cognitive distortions and rationalizations that may take place when they gamble. Additionally, the majority of gambling patients have co-occurring disorders, such as other addictions or mental health issues, which can also benefit from mindfulness practices.
Effectiveness of Mindfulness
Both evidence-based practices and anecdotal reports have supported the notion that mindfulness can be effective. A study conducted in 2010 (“Short-Term Meditation Induces White Matter Changes In the Anterior Cingulate,” by Tang et al.) found improvements in white matter integrity after four weeks of meditation training. These improvements were evident in brain areas involved in neural communication from and to the anterior cingulate cortex, a central area of the brain known to be involved in controlling cognition and emotion.
A study of mindfulness and problem gambling treatment conducted by the Problem Gambling Institute of Ontario at the Centre for Addiction and Mental Health found that participants who completed mindfulness practices averaged a 4.40 MAAS (mindful attention awareness scale) score after treatment compared to 3.65 before. (The MAAS is a 15-item scale designed to assess a core characteristic of dispositional mindfulness, namely, open or receptive awareness of and attention to what is taking place in the present.)
Another study (“Mindfulness-Enhanced Cognitive Behavior Therapy for Problem Gambling: A Controlled Pilot Study,” International Journal of Mental Health and Addiction 12:2, 197-205.) in which one group of participants received cognitive behavioral therapy (CBT) and the other received both CBT and mindfulness training demonstrated that those receiving the mindfulness training experienced significantly reduced gambling urges and psychiatric symptoms. The study further showed that those practicing mindfulness continued to show improved outcomes at three months.
Treatment Implications and Guidance
Given the experiential nature of meditation, patients need to practice it. Ollie says it’s important to include some type of meditation practice in each session and to include daily meditation as part of a patient’s treatment plan. Patients benefit from being given meditation resources to learn about ways to meditate and how to practice it daily.
At Fairview, patients are introduced to meditation in their first group session with a five-minute meditation. Other forms of meditation, such as yoga, coloring, breathing exercises or prayer, are also recommended. “Having clients share how coloring mandalas for 10 minutes helps quiet their brain is a powerful moment for many,” says Susan.
Ideally, gambling counselors that encourage clients to practice meditation are daily meditators or mindfulness practitioners themselves. Counselors are also encouraged to make referrals to meditation or MBSR classes, as meditation is more powerful in group settings according to Ollie. They may also recommend some of the many free resources online and available apps that help patients learn meditation.
If you’d like to view Ollie Stocker’s PowerPoint presentation, including a list of books and resources, please click here.