Treatment of pathological gambling - integrative systemic model. 2015

Ivica Mladenović, and Goran Lažetić, and Dušica Lečić-Toševski, and Ivan Dimitrijević
Clinic for Addiction Disorders, Institute of Mental Health, Palmotićeva 37, 11000 Belgrade, Serbia, dr.im@verat.net.

Pathological gambling was classified under impulse control disorders within the International Classification of Diseases (ICD-10) (WHO 1992), but the most recent Diagnostic and Statistical Manual, 5th edition (DSM-V), (APA 2013), has recognized pathological gambling as a first disorder within a new diagnostic category of behavioral addictions - Gambling disorder. Pathological gambling is a disorder in progression, and we hope that our experience in the treatment of pathological gambling in the Daily Hospital for Addictions at The Institute of Mental Health, through the original "Integrative - systemic model" would be of use to colleagues, dealing with this pathology. This model of treatment of pathological gambling is based on multi-systemic approach and it primarily represents an integration of family and cognitive-behavioral therapy, with traces of psychodynamic, existential and pharmacotherapy. The model is based on the book "Pathological gambling - with self-help manual" by Dr Mladenovic and Dr Lazetic, and has been designed in the form of a program that lasts 10 weeks in the intensive phase, and then continues for two years in the form of "extended treatment" ("After care"). The intensive phase is divided into three segments: educational, insight with initial changes and analysis of the achieved changes with the definition of plans and areas that need to be addressed in the extended treatment. "Extended treatment" lasts for two years in the form of group therapy, during which there is a second order change of the identified patient, but also of other family members. Pathological gambling has been treated in the form of systemic-family therapy for more than 10 years at the Institute of Mental Health (IMH), in Belgrade. For second year in a row the treatment is carried out by the modern "Integrative-systemic model". If abstinence from gambling witihin the period of one year after completion of the intensive phase of treatment is taken as the main criterion of the effectiveness of our model, at this time it exceeds 90%. Given the relatively short period of application, it is necessary to continue to monitor and evaluate the model after 5 years.

UI MeSH Term Description Entries
D005196 Family Therapy A form of group psychotherapy. It involves treatment of more than one member of the family simultaneously in the same session. Therapy, Family,Family Therapies,Therapies, Family
D005715 Gambling An activity distinguished primarily by an element of risk in trying to obtain a desired goal, e.g., playing a game of chance for money. Pathological Gambling,Gambling, Pathologic,Gambling, Pathological,Gamblings,Gamblings, Pathological,Pathological Gamblings
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015928 Cognitive Behavioral Therapy A directive form of psychotherapy based on the interpretation of situations (cognitive structure of experiences) that determine how an individual feels and behaves. It is based on the premise that cognition, the process of acquiring knowledge and forming beliefs, is a primary determinant of mood and behavior. The therapy uses behavioral and verbal techniques to identify and correct negative thinking that is at the root of the aberrant behavior. Behavior Therapy, Cognitive,Cognitive Behaviour Therapy,Cognitive Therapy,Psychotherapy, Cognitive,Cognition Therapy,Cognitive Behavior Therapy,Cognitive Psychotherapy,Therapy, Cognition,Therapy, Cognitive,Therapy, Cognitive Behavior,Behavior Therapies, Cognitive,Behavioral Therapies, Cognitive,Behavioral Therapy, Cognitive,Behaviour Therapies, Cognitive,Behaviour Therapy, Cognitive,Cognition Therapies,Cognitive Behavior Therapies,Cognitive Behavioral Therapies,Cognitive Behaviour Therapies,Cognitive Psychotherapies,Cognitive Therapies,Psychotherapies, Cognitive,Therapies, Cognition,Therapies, Cognitive,Therapies, Cognitive Behavior,Therapies, Cognitive Behavioral,Therapies, Cognitive Behaviour,Therapy, Cognitive Behavioral,Therapy, Cognitive Behaviour
D016739 Behavior, Addictive The observable, measurable, and often pathological activity of an organism that portrays its inability to overcome a habit resulting in an insatiable craving for a substance or for performing certain acts. The addictive behavior includes the emotional and physical overdependence on the object of habit in increasing amount or frequency. Addictive Behavior,Addictive Behaviors,Behaviors, Addictive
D038801 International Classification of Diseases A system of categories to which morbid entries are assigned according to established criteria. Included is the entire range of conditions in a manageable number of categories, grouped to facilitate mortality reporting. It is produced by the World Health Organization (From ICD-10, p1). The Clinical Modifications, produced by the UNITED STATES DEPT. OF HEALTH AND HUMAN SERVICES, are larger extensions used for morbidity and general epidemiological purposes, primarily in the U.S. ICD Code,ICD Codes,ICD-10,ICD-9,International Classification of Disease,ICD-10 Procedure Coding System,ICD-10-CM,ICD-10-PCS,ICD-11,ICD-9-CM,International Classification of Disease Codes,International Statistical Classification of Diseases and Related Health Problems,Code, ICD,Codes, ICD,Disease International Classification,Disease International Classifications,ICD 10 Procedure Coding System
D039721 Diagnostic and Statistical Manual of Mental Disorders Categorical classification of MENTAL DISORDERS based on criteria sets with defining features. It is produced by the American Psychiatric Association. (DSM-IV, page xxii) DSM-IV,DSM-II,DSM-III,DSM-V

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