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Am J Psychiatry 166:1325-1330, December 2009
doi: 10.1176/appi.ajp.2009.08081235
© 2009 American Psychiatric Association
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Clinical Case Conference

Cognitive-Behavioral Therapy for Pathological Gambling: Cultural Considerations

Mayumi Okuda, M.D., Iván Balán, Ph.D., Nancy M. Petry, Ph.D., Maria Oquendo, M.D., and Carlos Blanco, M.D., Ph.D.

Pathological gambling is a common disorder with severe consequences for patients and their families. This case study describes cognitive-behavioral therapy (CBT) for pathological gambling and its general principles and provides an example of a modification of CBT techniques in the treatment of a 51-year-old immigrant Afro-Caribbean woman. The case depicts the contribution of beliefs, especially those that are part of a cultural system, to the perpetuation of a patient’s disorder; the influence of family members’ attitudes, moved by their cultural beliefs and values, in shaping the patient’s behavior; and the consideration of these issues in guiding specific interventions, such as challenging irrational thoughts or helping patients devise strategies to change their behavior in a culturally congruent manner.







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