There is a paucity of treatment-outcome research for problem or pathological gambling. Single-session exposure therapy has been used successfully with a broad range of psychological disorders such as panic disorder and the phobias. This article will describe the use of single-session graded exposure to treat problem gambling with an Electronic Gaming Machine (EGM) gambler. Pretreatment to 6-month follow-up repeated measures showed a significant reduction in client-rated gambling severity, that is, showed a significant reduction in client-rated gambling severity (Gambling Severity Checklist [GSCL]), the Symptom Checklist-90-Revised (SCL-90-R) and the Beck Depression Inventory (BDI). This case demonstrates a novel intervention which is brief, convenient and accessible to the client, and which resulted in gains maintained over the medium-term. This promising single case indicates the need for further research to determine whether positive benefits are realised in larger randomised control designs.

The Problem with the Problem: Definition - • U.S. driven medical model • Addiction or Compulsion • DSM - failure to differentiate regular and problem gamblers • Pathology or Harm • Local context Victorian Gambling Screen (VGS) - • Developed using a definition of problem gambling based on harm: "'Problem' gambling refers to the situation when a person's gambling activity gives rise to harm to the individual player, and/or his or her family, and may extend into the community" [DIPG Report, p.106]

There is a need to establish reliability and the various forms of validity in all measures in order to feel confident in the use of such tools across a wide diversity of settings. The aim of this study is to describe the reliability and validity of the Victorian Gambling Screen (VGS) and in particular one of the sub-scales (Harm to Self - HS) in a specialist problem gambling treatment service in Adelaide, Australia. Sixty-seven consecutive gamblers were assessed using a previously validated clinical interview and the VGS (Ben-Tovim et al., The Victorian Gambling Screen: project report. Victorian Research Panel, Melbourne, 2001). The internal consistency of the combined VGS scales had a Cronbach's alpha of .85 with the HS scale .89. There was satisfactory evidence of convergent validity which included moderate correlations with another measure of gambling—the South Oaks Gambling Screen. There were also moderate correlations with other measures of psychopathology. Finally, how the VGS may best be used in clinical settings is discussed.