What is Gamblers Anonymous?

Gamblers Anonymous (GA) describes itself as ‘a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from a gambling problem’ (Gamblers Anonymous 1984). It is important to note that GA states that ‘any betting or wagering, for self or others, whether for money or not, no matter how slight or insignificant, where the outcome is uncertain or depends upon chance or “skill” constitutes gambling’.

Origins of Gamblers Anonymous

The fellowship of GA was founded by Jim W in 1957 in Los Angeles, USA. He was a drinker and a gambler. He joined Alcoholics Anonymous (AA) in 1946 and, seeing its benefits, applied similar principles to help himself with his gambling addiction. A few years later, with three fellow drinkers/gamblers, Jim set up the forerunner of GA – the Algamus Society. This survived just two meetings and Jim too relapsed into gambling. However, through sheer perseverance and support from his wife, whom he had met through AA, Jim organised the first-ever meeting of GA, with one fellow addict, at his apartment in 1956.

Gamblers Anonymous in the UK

After starting up in the USA, GA soon took off in several other countries and now has chapters in the UK, other European administrations, Australia, New Zealand, Brazil, Israel, Africa (e.g. Kenya and Uganda) and Asia (including Korea, Japan and India). It appears to have arrived in the UK in 1964 and there are now meetings around the country on most nights of the week. Box 1 lists key guiding principles of GA, and further information about the organisation is available at www.gamblersanonymous.org.uk.

Gamblers Anonymous as a way of life

It goes without saying that committing to the GA programme entails much more than attending meetings. The fellowship is considered a way of life where the individual himself grows personally and spiritually. It helps others to do the same, fosters friendships and bonds built on empathy and shared understanding, and is an opportunity to socialise – some even consider the group their ‘family’.

The 90-day plateau

Ninety days of commitment to the fellowship, including regular attendance and abstinence from gambling, is often seen as a ‘plateau’ – a stage at which a member has reached some degree of stability in his life. In these 3 months, the member will have benefited personally and gained sufficient understanding about the programme to help others still addicted to gambling (i.e. to give back to the fellowship in any way possible). This may include chairing meetings, helping with public relations, doing twelfth-step work and being a sponsor.

Twelfth-step work

Twelfth-step work is about reaching out to those who are still addicted to gambling and encouraging them to attend GA meetings by explaining the benefits. This is often referred to as making the ‘twelfth-step call’ – preferably made in person rather than by post or by phone. Those making the call are reminded that their purpose is merely to explain what GA is about and to share their experiences rather than to ‘sell’ the programme. Such calls can be made to both prospective and current GA members. The fellowship also urges that, wherever possible, these twelfth-step conversations are one to one and are kept simple, rather than overloading the gambler with information.

Sponsorship

Sponsorship goes beyond making the twelfth-step call and is a longer-term commitment to helping a compulsive gambler. It entails helping the sponsored person to adhere to the programme and to attain recovery. Sponsors must be aware of their own roles, strengths and limitations, always remembering that it is the fellowship that aids recovery and not their individual attributes. Being a sponsor may include encouraging attendance at meetings, ensuring that the sponsored member understands what the programme is about, being empathetic and being available in times of crises. To be a sponsor, one needs a great deal of maturity and commitment and although sponsorship primarily helps the person being sponsored, it also helps the sponsor in his recovery journey.

Learning to deal with addiction

Patterns of success

Some studies have also followed up GA attendees for drop-outs and predictive variables. Using a combined retrospective and prospective study design, Reference Stewart and BrownStewart & Brown (1988) studied 232 GA attendees in Scotland and noted abstinence rates of 8% at 1 year and 7% at 2 years. Disappointingly, they also found high rates of drop-outs after the first meeting: between 22 and 41%. In another study in Scotland, Reference BrownBrown (1987) specifically studied GA drop-outs and identified characteristics/features that differentiated them from regular attendees. He found that those who dropped out early saw their own gambling as less problematic, believed they could control it (and hence did not see the need to totally abstain), had underlying feelings of inferiority and said the group was unsympathetic when they reported ‘slips’. Based on the above, Brown concluded that GA was better suited to those with severe gambling problems than those with less severe problems and that it worked better for those with few or no relapses than those with several relapses.

Oei & Gordon (2008) looked at the role of seven variables among 75 GA attendees in Australia, in predicting abstinence or relapse:

1. • meeting attendance and participation;

2. • social support;

3. • belief in God;

4. • belief in a higher power;

5. • working the twelve steps of recovery;

6. • gambling urges; and

7. • erroneous cognitions.

They found that meeting attendance and participation and social support increased the chances of abstinence; greater gambling urges and erroneous cognitions increased the chances of relapse.

Patients seeking professional treatment for gambling problems may or may not have attended GA. More often than not, gamblers seeking professional treatment have a prior and/or ongoing history of GA attendance. This raises two vital, clinically pertinent questions: does it affect treatment outcomes and is GA attendance compatible with other treatments? A US study by Reference PetryPetry (2003) looked at 342 such pathological gamblers presenting to treatment and looked at their patterns and correlates of GA attendance. Of the sample, 53.8% had attended one or more GA meetings before seeking professional help. These GA attendees were older, had had gambling problems for longer, had more severe gambling problems and had accrued larger debts. They also had fewer concurrent drug problems but more severe family/social/psychiatric problems. Finally, prior GA attendees were also more likely to re-engage with GA in the 2 months after treatment, more likely to better engage in professional treatment and, importantly, more likely to be abstinent from gambling 2 months into treatment. Petry concluded that ‘those gamblers entering professional treatment with a history of GA attendance differ from those who do not, and these differences may impact treatment recommendations and outcomes’.

Gamblers Anonymous and other interventions

In an interesting exploration of GA and cognitive-behavioural therapy (CBT) in treatment of gambling addiction, Reference ToneattoToneatto (2008) analysed each of the twelve steps of GA. In this Canadian study, he concluded that, despite the apparent linguistic differences between CBT and GA, the underlying concepts and strategies are comparable. He further added that the differences merely reflect different traditions rather than different underlying concepts and called for elements of GA and CBT to be combined. To substantiate this point, he highlighted the similarity between the first steps in GA and CBT:

1. • Step one in GA: ‘We admitted we were powerless over gambling – that our lives had become unmanageable’

2. • Step one in CBT: ‘We realised that our belief that we could control or predict gambling outcomes was illusory and that uncritical belief in this illusion had led to severe gambling-related problems in all of the important areas of our lives.’

Hence, it seems reasonable to infer that GA is very much an intervention that can be offered alongside or integrated with other psychological interventions. Furthermore, some studies (e.g. Reference Russo, Taber and RamirezRusso 1984; Reference Taber, McCormick and RussoTaber 1987; Reference Lesieur and BlumeLesieur 1991), albeit subject to numerous methodological limitations, even suggest that the effectiveness of GA can be improved by concurrent attendance at other professional treatment programmes, be it outpatient or in-patient.

Dispelling myths

Two of the criticisms that are often levelled at GA are that it exclusively caters to men and that it ignores the emotional lives of individuals, focusing almost exclusively on abstinence from gambling and practical issues, such as debt. In a qualitative ethnographic study comprising interviews with 23 GA members and observations of 42 GA meetings, Reference Ferentzy, Skinner and AntzeFerentzy and colleagues (2006) noted that 20% of attendees were women and that members are encouraged to discuss emotions and life issues. Although this study was limited to Canada, anecdotal reports from UK GA attendees also lend support to the observation that GA, these days, focus more on twelve steps and spirituality than on practical aspects, such as debt and legal problems.

Studies in this field are, however, riddled with methodological problems that limit the validity of their findings and GA is a long way from having a robust supporting evidence base. Further studies are warranted that evaluate the effectiveness of GA, profiling of gamblers who are likely to respond best to GA and the ingredients of GA that are essential for success.