This book is a CBT treatment manual for problem gambling. The manual is designed to be used by a range of mental health professionals with some knowledge of CBT and has been logically structured with an easily digestible format, clear rationale and excellent handouts and exercises for clients. The manual begins with a comprehensive chapter detailing the prevalence of problem gambling and the associated social and physical consequences, along with a clear literature review of the underlying psychological “motivations” for gambling. This is followed by a concise review of the treatment literature to enable practitioners with less knowledge of problem gambling to use the manual with greater confidence and understanding. Included in this review are the outcome data from the trial of this particular manual, which was delivered in both individual and group formats, which showed significant improvements in problem gambling outcomes both at the end of treatment and at 6-month follow-up.

The manual is structured into 10 core sessions plus 3 elective sessions to be included where appropriate. Each encompasses excellent exercises and handouts to be undertaken between sessions. The core sessions range from cognitive restructuring through to managing negative emotions and relapse prevention. Meanwhile the elective sessions revolve around assertiveness training, managing finances and supporting significant others. Whilst the authors provide a clear “agenda” for each session with an explicit rationale and description of the material for the less confident/experienced practitioner, they encourage a flexible use of the manual in order to best meet the needs of the client. This is aided by the comprehensive assessment guidance provided at the start of the manual.

The manual encompasses material core to CBT in general, including psychoeducation, cognitive restructuring of (gambling and non-gambling) thinking errors, relaxation and management of negative emotions, goal-setting and relapse prevention. Alongside this the authors have included additional aspects integral to gambling treatment, including self-management strategies to stabilize gambling, imaginal desensitization, problem-solving skills and financial management to help clients to find more effective ways of resolving difficulties caused by gambling. In addition, the manual incorporates a session to help significant others to understand the client's gambling behaviours and to aid the recovery process. The manual also provides a fantastic set of guidelines and notes on topics such as the stages of change and motivational interviewing, integral to aiding behavioural change, and on assessing and managing suicidality, an issue with high prevalence amongst problem gamblers.

I would thoroughly recommend this comprehensive and clear CBT manual to clinicians treating problem gamblers. It is easy to follow and detailed in rationale and guidance to assist practitioners of varying levels of experience and knowledge to deliver effective treatment. I would, however, liked to have seen a larger section on recognizing and managing triggers and cravings, as well as developing alternative pleasurable activities. In my work at the National Problem Gambling Clinic in the UK these areas have proved vital in helping problem gamblers to begin to break the cycle of problem gambling and to begin to develop a more fulfilling gambling-free life. However, the flexibility of the approach encouraged by the authors would enable more experienced therapists to identify such needs in clients and put a greater focus on these areas where it is deemed necessary.