area is the role of therapist characteristics in the treatment of problem gambling behaviors. In addition, the effect of treatment settings is unclear. Although favorable outcomes have been reported from both inpatient and outpatient programs, their differential effects are still unknown. More research on treating spouses of pathological gamblers is also called for (Lesieur, 1998). It is typical for spouses to be directed to Gam-Anon programs to help deal with their partner's gambling. Given the view that a spouse may be involved in the gambling addiction, it has been argued that the treatment of husband and wife together is a necessary component to the rehabilitation process for married couples (Heineman, 1987; Steinberg, 1993).

Pharmacotherapy research needs to be expanded to determine if this approach has an important role in the treatment of pathological gamblers. We still do not know if medications provide therapeutic effect by ameliorating the pathological gambler's cravings, ruminations, or negative feelings.

Research persuasively demonstrates that one of the most reliable predictors of treatment outcome for substance abuse addiction is the patient's readiness to change, regardless of treatment strategy (Prochaska et al., 1992). Consequently, the pathological gambling treatment field should direct research attention to studying the patients' overall readiness to change and the specific stage of change as predictors of treatment outcome.

Adkins, B.J., J.I. Taber, and A.M. Russo 1985 The spoken autobiography: A powerful tool in group psychotherapy. Social Work 30:435-439.

American Gaming Association 1998 Responsible Gaming Resource Guide, Second Edition. Washington, DC: American Gaming Association.

American Psychiatric Association 1980 DSM-III: Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. Washington, DC: American Psychiatric Association.

Arribas, M.P., and J.J. Martinez 1991 Tratamiento individual de jugadores patologicos: Descripcion de casos. Analisis y Modificacion de Conducta 17:255-269.

Bannister, G., Jr. 1977 Cognitive and behavior therapy in a case of compulsive gambling. Cognitive Therapy and Research 1:223-227.

Front Matter (R1-R12)

Executive Summary (1-6)

1: Introduction (7-14)

2: Gambling Concepts and Nomenclature (15-62)

3: Pathological and Problem Gamblers in the United States (63-106)

4: Research on the Origins of Pathological and Problem Gambling (107-155)

5: Social and Economic Effects (156-191)

6: Treatment for Pathological Gamblers (192-236)

7: Organization and Technology of Gambling (237-268)

Appendix A: Gamblers Anonymous Twenty Questions (269-272)

Appendix B: Diagnostic and Statistical Manual of Mental Disorders Criteria for Pathological Gambling (273-282)

Appendix C: Legal-Age Gambling Opportunities and Restrictions (283-312)

Appendix D: Summary of Treatment Literature (313-316)

Appendix E: Gamblers Anonymous Meetings by State (317-318)

Appendix F: Biographical Sketches (319-325)

Index (326-340)