If a problem gambler or family member wants face to face counselling, then the second stage of GamCare’s “stepped -care” approach comes into play. This will involve a referral for individual or couple counselling with GamCare’s own counselling service based in London .

GamCare’s counselling service offers an integrative counselling approach, using a broad range of therapeutic interventions relevant to the needs of each individual person. Cognitive Behavioural Therapy plays a major part in the counselling process due to the important role of perceptions, beliefs and behavioural patterns in problem gambling.

During the initial sessions the focus will be on assessing the severity and

extent of problem gambling behaviour (e.g. whether gambling is acting as an

escape from the perceived pressure and demands of others or significant life

events) and formulating a programme to reduce or change gambling behaviour.

Focus will also be on the problem gambler’s thoughts and beliefs (e.g the

extent they may believe that gambling is a reliable way to make money) and

how they use coping strategies to perpetuate their gambling.

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Other therapeutic approaches are also integrated into the counselling process. Transactional Analysis, with its emphasis on life scripts (whether the gambler sees themselves as a “loser” in life or has strong investment in maintaining their identity of always being a “winner”) and on game playing is used regularly, especially when counselling couples and addressing family issues. Furthermore, incorporating more psychoanalytic concepts (e.g. the extent to which gambling may confirm a conscious or unconscious desire to lose or may be a way of dealing with guilt) has proved particularly valuable and has helped many gamblers understand their gambling behaviour more clearly.