Behavioral Couples Therapy

Behavioral couples therapy is a therapy for drug abusers with partners. Behavioral couples therapy uses a sobriety and abstinence contract and behavioral principles to reinforce abstinence from drugs and alcohol. Behavioral couples therapy is additional therapy to individual and group therapy and typically involves 12 weekly sessions, lasting approximately 60 minutes each. Many studies support the efficacy of behavioral couples therapy with alcoholic men and spouses. Four studies support the efficacy of behavioral couples therapy with men and women who use drugs and the significant others. Behavioral couples therapy produces higher treatment attendance, naltrexone adherence and rates of abstinence than individual treatment. Successful behavioral couples therapy also shows fewer legal and family problems after one year. Recent research aims to make behavioral couples therapy more accessible by adapting the delivery of therapy into fewer sessions and in a group format. Research is underway demonstrating the cost-effectiveness and therapy effectiveness according to therapist training.

Nicotine Replacement with Behavioral Treatment

Doctors recommend pharmacotherapies in combination with behavioral interventions, including group and individual therapies, as well as telephone quit lines to help people quit smoking. Through behavioral skills training, patients learn to avoid situations of relapse and to plan strategies to cope with such situations when necessary. Coping techniques include cigarette refusal skills, assertiveness and time management skills that patients practice in treatment, social and work settings. Doctors urge patients to undergo combined behavioral and pharmacological treatments. By dampening craving intensity, medications can give patients a leg up on enacting new strategies and skills.

Pan

Pan is short for Panguingue

Playing Pan

Panguingue is a rummy-type game played with eight standard 52-card decks with the 8's, 9's, and 10's removed, for a total of 320 cards. No jokers are used. Cards in each suit rank king (high), queen, jack, seven, six, etc. with aces being low. The cards are dealt counterclockwise

Players strive to meld eleven cards in valid sets of three or more cards. There are two kinds of melds: a rope which must be string of cards of matching suits, squares consisting of the ranks 2, 3, 4, 5, 6, 7, Jack or Queen. Squares must be either all cards of different suits or all the same suit. Squares consisting of Kings or Aces qualify regardless of suit. There are no betting rounds in the game.

Each player is dealt 10 cards to meld into sets and sequences with certain cards having special values. Each player, in turn, draws either a card from the top of the remaining deck or from the top of an adjacent discard pile. This sequence of play continues until one player goes out with a total meld of eleven cards, including the card(s) just drawn. Melds (or spread) must be at least three cards, and it may be as many as eleven. The melds are classified as ropes and squares. The rope is any three cards in sequence of the same suit. A square is a set of three cards in the same rank and of different suits or of the same suit. All 3s, 5s and 7s are valle cards (cards of value). Cards of other rank are non-valle. Any three aces or any three kings form a set, regardless of the suit.

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Problem Gambling

People sometimes call problem gambling ludomania. Problem gambling is an urge to gamble despite harmful negative consequences or personal desire to stop. Problem gambling often means that the gambler hurts other people. Severe problem gambling is clinical pathological gambling if the gambler meets certain criteria. Although the term gambling addiction is common in the recovery movement, pathological gambling is an impulse control disorder and is therefore not an addiction according to the American Psychological Association.

A study by the United Kingdom Gambling Commission, called the British Gambling Prevalence Survey 2007, found that approximately 0.6% of the adult population had problem gambling issues, the same percentage as in 1999. The highest prevalence of problem gambling is amongst those who participated in spread betting 14.7%, fixed odds betting terminals 11.2% and betting exchanges 9.8%.

Research by governments in Australia led to a universal definition of problem gambling, which appears to be the only research based definition not to use diagnostic criteria. Problem gambling involves many difficulties in limiting money and/or time spent on gambling which leads to adverse consequences for the gambler, others or for the community. Most other definitions of problem gambling can usually be simplified to any gambling that causes harm to the gambler or someone else in any way. However, these definitions are usually coupled with descriptions of the type of harm or the use of diagnostic criteria. According to DSM-IV, pathological gambling is separate from a manic episode. When the gambling occurs independent of other impulsive, mood or thought disorders is becomes its own diagnosis.

Available research seems to indicate that problem gambling is an internal tendency and that problem gamblers will tend to risk money on whatever game may be available, rather than a particular game being available. However, research also indicates that problem gamblers tend to risk money on fast paced games. A problem gambler is much more likely to lose a lot of money on roulette or slot machines, where rounds end quickly and there is a constant temptation to play again or increase bets, as opposed to a state lottery where the gambler must wait until the next drawing to see results.

Most treatment for problem gambling involves counseling, programs with steps to recover, self help, peer support, medication or a combination of these. However, no one treatment is most efficacious and the United States Food and Drug Administration has not approved medications for the treatment of pathological gambling.

Cognitive behavioral therapy helps reduce symptoms and urges related to gambling. This type of therapy focuses on the identification of the thought processes, mood and cognitive distortions that increase the vulnerability of the gambler. Additionally, cognitive behavioral therapy approaches frequently utilize techniques that build skills geared toward relapse prevention and assertiveness.