particular needs (McClellan et al., 1983). Clearly, there is no systematic research on the optimal, most cost-effective configuration of services for different groups of problem gamblers. To even conduct patient matching, three elements are needed: (1) comprehensive assessment tools to identify patient problems and needs, (2) placement criteria to ensure placement in the appropriate setting (e.g., inpatient versus outpatient) and intensity of care, and (3) a means of facilitating movement through a continuum of treatment services (Substance Abuse and Mental Health Services Administration, 1995). Because the gambling treatment field does not contain an adequate knowledge base pertaining to these three elements, matching patients to treatments cannot be adequately studied until the basic research regarding assessment and placement criteria has first been conducted.

Behavioral and cognitive treatment approaches appear to offer promise as effective treatments for pathological gambling. In a recent special issue of the Journal of Consulting and Clinical Psychology on empirically supported psychological treatments, cognitive-based treatments were cited as perhaps the treatment most widely studied and most highly regarded by proponents of clinical trial methodologies (DeRubeis and Crits-Christoph, 1998:38). It has also been observed that cognitive treatments are an emerging approach for the treatment of addictions (Crits-Christoph et al., 1998; DeRubeis and Crits-Christoph, 1998). Nevertheless, this is not to say that eclectic approaches to treating pathological gamblers should be ignored. As Blaszczynski and Silove (1995) and Lesieur (1998) cogently argue, there is growing recognition that multiple treatment components should be considered given the client's specific configuration of problems. Thus, clients with dysphoria should be evaluated for antidepressant medication; marital counseling may be indicated in the presence of extreme family estrangement; and substance abuse counseling may be necessary for those whose addictive behavior also includes alcohol or other drug abuse.

There is a particular need for studies of the role of Gamblers Anonymous in recovery and treatment outcomes. If there is a high dropout rate from Gamblers Anonymous, as the literature suggests, then it is important to investigate its causes and strategies for reducing it. Another important understudied research