Increased access to gambling is proving to be a great burden on the individuals who partake, their families and society in general. Despite growing evidence for the use of Cognitive-Behaviour Therapy (CBT) with problem gamblers, important questions remain unanswered regarding those individuals who do not respond to CBT. This paper compares gamblers who are considered 1) treatment completers, 2) drop-out following an initial assessment and, 3) drop-out after commencing treatment from a specialized CBT service. The results indicate a number of differences between the groups in regard to gambling severity and behaviour, demographic profile and variations in overall psychopathology.

Cognitive-Behaviour Therapy (CBT) is considered the number one non-pharmacological treatment for a number of mental and psychological disorders (Tolin, 2010; Stuhlmiller & Tolchard, 2009). While CBT with problem gamblers has shown promise, the quality of the research in this area is lacking. One area of concern is that across the many trials and reports using CBT with gamblers no single unified approach has been used and so comparison across studies is limited. Similarly, translation of the CBT research into clinical practice is almost entirely absent (Walker, 2005). This article will explore the concepts of CBT with problem gamblers and identify common elements across all reported approaches. A unified model of CBT with problem gamblers will be suggested and the direct clinical application of this model described from a state-wide gambling service in Australia (Flinders Approach) with 205 problem gamblers. The results indicate that the Flinders Approach is successful in treating gamblers considered to be at the severest end of the experience, with a 69% completion rate. Implications for future research in which this model may be tested against other therapies and pharmacological treatments will be discussed.