A SHORT TERM GROUP REHABILITATION AND PSYCHOTERAPY
PROGRAM FOR PATHOLOGICAL GAMBLING
Gianluigi Conte, Francesca D’Amico, Annamaria Di Gioia, Mariapia Di
Paolo, Raffaella Franza, Anna Gerecitano, Corrado Villella, Pietro Bria
e-mail: cvillella2001@yahoo.com
Universita Cattolica del Sacro Cuore, Roma, La Promessa
ONLUS, Roma
Since November 2005 our institutions have been developing a group therapy
program for pathological gambling, providing two sessions weekly for
ten weeks.
Up to may 2007 24 patients joined the program: 23 men and one woman;
their mean age is 45,1; 12 are married, five are divorced, 2 have a
stable relationship, 4 are single.
Their education is generally low: one of them completed only primary
schools, 11 have a lower intermediate education, 11 have an upper intermediate
education, only one has a degree.
Some patients have an associated psychopathology: 8 have a depressive
disorder, 3 have a type II bipolar mood disorder, 4 have a history of
cocaine abuse, 1 has a mild cognitive impairment related to a Parkinson’s
disease.
After a psychiatric evaluation and an appropriate pharmacological therapy,
patients attend each week a psychodynamic group therapy session and
a Gamblers Anonymous-like group, lead by a counsellor , ex gambler.
This double approach provides a psychological support, useful to face
their dysfunctional behaviour and helps developing a first insight on
their relational difficulties. This short term intervention focuses
on a clear target: a shift from acting out to a possibility of thought,
in order to stop gambling and to go on with a an appropriate therapy
for each patients: individual or group psychotherapy, GA groups.
Results: 18 patients completed treatment, while 6 dropped out. During
treatment 11 patients were totally abstinent from gambling, while 7
were not.
At treatment completion 13 patients were in a complete remission, while
5 were still gambling.
Tijekom studenog 2005. u našoj instituciji je razvijen
program psihodinamičke grupne terapije za patološko kockanje, koji se
provodi kroz deset tjedana sa dvije seanse tjedno.
Do svibnja 2007. godine, 24 pacijenata su sudjelovala u programu: 23
muškarca i jedna žena. Srednja dob je bila 45,1; 12 ih je oženjeno,
pet razvedeno, dvoje imaju stabilne odnose, a četiri su samci. Njihova
je edukacija uglavnom niska: jedan ima završenu samo primarnu školu,
11 nisku srednju edukaciju, 11 ima višu srednju edukaciju, a samo jedan
je diplomirao.
Neki pacijent imaju pridruženu psihopatologiju: osam depresivni poremećaj,
tri ima tip II bipolarnog poremećaja, četiri povijest zlouporabe kokaina,
jedan srednja kognitivna oštećenja koja su u odnosu sa Parkinsonovom
bolesti.
Nakon psihijatrijske evaluacije i odgovarajuće farmakološke terapije,
pacijenti počinju svakog tjedna sa seansama psihodinamičke grupne terapije
i sudjelovanja u grupama sličnim Gamblers Anonymous, koje vodi savjetnik,
bivši kockar.
Ovakav dvostruki pristup osigurava psihološku podršku, korisnu za preokret
njihovog disfunkcionalnog ponašanaj i pomoć razvoju prvog uvida o teškoćama
koje imaju u odnosima. Ta kratka intervencija fokusirana je na ciljanu
metu: pomak od acting outa prema mogućnostima koje pruža razmišljanje,
prema prestanku kockanja i prijelazu na adekvatnu terapiju za svakog
pacijenta, individualnu ili grupnu psihoterapiju i GA podršku.
Rezultat: 18 pacijenata je u cijelosti završilo tretman, a šest ga je
prekinulo. Tijekom tretmana 11 pacijenata je potpuno apstiniralo od
kockanja, a sedam nije.
Kompletnu remisiju postiglo je 13 pacijenata, dok pet još kocka.
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