Inpatient treatment and rehabilitation centers
1. Indications for hospital treatment
Multiple relapses despite outpatient therapy and self-care.
Serious financial and social consequences: debts, loss of work, family conflicts.
Concomitant mental disorders (depression, panic attacks) or suicide threat.
The need for an integrated approach: drug correction, round-the-clock control, intensive psychotherapy.
2. Formats of hospitals and rehabilitation centers
3. Treatment Program Structure
1. Reception and diagnosis (1-3 days):- Complete mental and physical evaluation.
- Laboratory tests, questionnaires (Gambling Severity Index).
- Drawing up an individual plan.
- Selection of SSRIs, dopamine antagonists, anxiolytics.
- Monitoring of side effects and dose adjustment.
- Cognitive behavioral therapy (CBT) - 3-5 sessions per week.
- Group therapy - daily group trainings on a 12-step or SMART model.
- Family therapy - including loved ones to restore support.
- Training in breathing practices, mindfulnes, "thought stopping" techniques.
- Developing a list of "triggers - response strategies."
- Outpatient visits to a psychotherapist 1-2 times a month.
- Participation in mutual assistance groups (GA, SMART Recovery).
- Taking medications as prescribed and monitoring the condition.
4. Hospital selection criteria
1. Personnel qualifications: license of the Ministry of Health, specialized psychiatrists and certified psychotherapists.
2. Methodical protocols: the presence of a CBT protocol for ludomania, 12-step or SMART programs.
3. Physician to patient ratio: optimal not more than 1:5 for individual attention.
4. Living conditions: separate or double rooms, a minimum number of provoking factors.
5. Cost and payment methods: public places, insurance policies, subsidy programs, private tariffs.
6. Reviews and results: statistics of successful completions (at least 50-60% without relapses after six months).
5. Terms and cost
Government centers: free or with a small fee in the direction, queue from 1-4 weeks.
Private clinics: from 4,000 ₴/sutki (Ukraine) or from $150/day (Russia and CIS countries), packages from 4 to 12 weeks.
Guarantees: preliminary agreement, clear description of services, possibility of termination by agreement.
6. Evaluation of effectiveness and exit from the hospital
1. Clinical indicators: reduction in the severity of dependence on questionnaires (by 50% by the time of discharge).
2. Robustness of skills: demonstration of work with triggers and reports on the use of techniques.
3. Post-discharge plan: visit schedule, contact persons, support groups.
4. Emergency response mechanism: telephone hotline of the center, the ability to "get through" in a crisis.
7. Possible risks and how to minimize them
Disruption after returning home. Solution: a clear plan "fixing triggers - instant strategies," regular "check-ins" with a therapist.
Resistance to programs. Solution: preliminary motivational conversation, contract with the participant.
Psychological "abandonment." Solution: organizing telephone support and online groups from the center.
8. Conclusion
Inpatient treatment and rehabilitation for gambling addiction is the most complex and effective way for people with severe ludomania. The correct choice of the center, a clear program structure and a well-functioning stage after discharge ensure the maximum likelihood of long-term abandonment of the game and a return to a full life.