On July 18th , Maxine Howe presented to our members the topic: Working with Problem Gambling – Theoretical and Practical Insights.


I appreciated Maxine’s candour in admitting that when she began working with this group, the prospect of helping and achieving a good outcome during and after therapy seemed daunting. Gambling can be a very secretive activity that may trigger much shame for those that engage with it and want to stop. I was wondering too how counselling could help as I was feeling stuck and helpless just thinking about it!


The first part of her talk focused on sharing her knowledge of this client group by introducing us to various ways of thinking about what gambling is and how it presents. It was interesting to find out that suicide attempts are higher for this group than for any other addiction. Gambling may be something that all or some of us do at different levels. Maxine presented a list of activities that are considered gambling which included playing the lottery, bingo, buying scratch cards and online

betting. So what makes someone become addicted to gambling and others not?


Maxine went on to explain neuroscience’s perspective on problem gambling. In short, every time we play and win, we feel good. Our brain releases dopamine, a neurotransmitter, into different areas of our brain. This causes us to continue wanting this feeling and therefore gambling continues.


Maxine shared with us how recovery from gambling is a social process that involves social learning (recovery by copying others), social control (we are shaped by the people that surround us) and social network (creating resources and opportunities). Adopting a Psycho-social approach in which there is a mutual dependency between an individual’s ability to make changes to their core self-concepts/belief systems and increase interaction in their social network can be a good foundation for gambling treatment.


Before the break, Maxine went on to describe the GamCare Model – toolbox. This was a very comprehensive overview. The four items in the toolbox are:

  1. Node Link Mapping – exploring the client’s situation through the use of diagrams, flow charts, etc.
  2. Motivational Interviewing – a collaborative, person-centred way of guiding to strengthen and/or elicit change from client.
  3. Building Self-esteem and self-efficacy – work with client to appreciate their own worthiness and uniqueness while empowering client to try new things.
  4. CBT, Mindfulness and relapse prevention – setting behavioural assignments to promote cognitive change, paying attention to feelings and behaviours, exploring ways to prevent relapse.


This part of the talk made me realise how within the Game Care approach many different tools are integrated to achieve an overall change/shift in a person’s outlook towards gambling. Maxine explained that ultimately it is through the client’s autonomy that change takes place.


After the break Maxine shared with us the RAT Park Video (see link below). For me, this was the most impactful part of the evening. So far, Maxine had explained the theory and models to work with problem gambling, but the question as to why some people develop an addiction and others that engage in the same kind of activities do not was still left unanswered.


The video explains the research project involving rats by Dr. Bruce Alexander in the 1970s. He concluded that human bonding and connections have a direct impact on whether a person can become an addict. I truly recommend you to watch this five minute clip. There was much discussion in the group after seeing it.


Another member shared that this video confirmed what some of her clients (with drinking problems) see as important after recovery – keeping and strengthening family connections.


Some of our roles as practitioners (as per Maxine’s slide) are:

 Explore client’s social network

 Encourage client to develop a support system

 Help client to find positive role models.


Some important issues for clients to consider were also pointed out:

 Letting go of negative influences

 Involving family, friends, peers

 Finding local support groups – for recovery and in general (debt advice, housing, etc.).


Maxine ended her talk by looking at problem gambling through the lens of Transactional Analysis. She shared with us the Karpman Drama Triangle and the Acey Choy Winner’s Triangle. Clients are invited to look at both triangles and make necessary changes to move to a healthier state. The aim in TA is to strengthen the Adult that has been contaminated by the Parent and Child.


There was a lengthy Q&A session in which many questions were asked. My question, which I am going to do some more research on, had to do with the link between trauma and gambling. Maxine answered that she believed there to be some research suggesting there is indeed a link.


I truly enjoyed this talk.  It was well-attended and thought-provoking (watch the video*!)


I thank Maxine for taking the time and sharing her expertise with us on the evening.


*Video: Rat Park You Tube link: