Dr. Michael Wohl - Advances in Motivating Change Among Disordered Gamblers: Why and How Memories of the Past Self Can Facilitate Motivation to Engage in Behavioural Change Presented at the New Horizons in Responsible Gambling Conference in Vancouver, February 2-4, 2015

3. Dr. Michael Wohl
Professor, Carleton University

4. Dr. Michael Wohl
Professor

5. 5
Andrew Kim Melissa SalmonDr. Chris Davis Dr. Jamey Lister

6. objectives
1. Discuss barriers to change
2. Advances in understanding barriers
3. Using knowledge to overcome those
barriers
4. Review new research on factors that
facilitate change
5. Future directions.
6

9. 9

10. 10

11. 11

12. Transtheoretical Model of
behavioral change

13. Readiness to change
 Pre-contemplation: Will deny advantage of
quitting
 Contemplation: Characterized by ambivalence
 Preparation: May be trying to anticipate barriers.
 Action: Continues to anticipate and deal with
barriers.
13

14. Barriers to Help-Seeking (Pulford et al., 2009)
14
78%
73%
84%
85%
66
68
70
72
74
76
78
80
82
84
86
Pride Shame
Seekers
Non Seekers

16. 16
Facilitating change with the self-concept

17. Authenticity
17

18. 18
There is but one cause of human failure.
And that is man’s lack of faith in his true
self.
—William James

19. Authenticity
19Lister, Wohl, & Davis, in press, JGS

20. _________________________
Part of people’s self-concept
(sense of self) is derived
from their membership in
social groups.

21. The Dark Side of Authenticity
Sports betters who were watching the
Stanley Cup Playoffs
Measures:
1.Authenticity while gambling
2.Identification as a gambler
3.Readiness to change
Lister, Wohl, & Davis, in prep

22. Authenticity
while gambling
Readiness to
Change
Identification
as a Gambler
.20
2.01**
-.13*
.20
95% CI: -.56, -.07

23. Light in the darkness
Authenticity whilst gambling
undermines behavioral
change
Results point to the fact that
some gamblers don’t feel
authentic.
23

24. 24
Facilitating change with the self-concept

26. People who are high in self-continuity:
Report Psychologically well-being (Dunkel, 2005)
A desire to achieve and maintain well-being (Chandler, Lalone,
Sokol, Hallett, & Marcia, 2003)
Have elevated levels of self-esteem (Diehl, Jacobs, & Hastings, 2006)

27. When change has befallen the self – anecdotal evidence
from the clinical setting (Nuske & Hing, 2011)

29. Why is a focus on nostalgia innovative?
Therapy tends to focus on current negative states
(e.g., shame, guilt, avoidance).
 Negative affect propels change
Nostalgia yields a positive emotional state
Therapy tends to look toward the future;
Nostalgia focuses on the past 29

30. Self-
Discontinuity
Readiness to
Change
Nostalgia
Hypothesized path to change

31. Participants
79 Disordered Gamblers (52 males)
19-72 years old (M = 34.15, SD = 13.24, 4 unreported)
Measures
Gambling Symptomology - Canadian Problem Gambling Index (CPGI;
Ferris & Wynne, 2010)
Readiness to Change questionnaire (RoC; Rollnick, Heather, Gold & Hall, 1992)
Self-Discontinuity (Iyer & Jetten, 2011)
Nostalgia (Iyer & Jetten, 2011)
Study 1: Measuring self-discontuity
Kim & Wohl, in press, SPPS

32. Self-
Discontinuity
Readiness to
Change
Nostalgia
.68**
.67**
.47*
.42
95% CI: .03, .67

33. Study 2: Self-discontinuity manipulated
Participants
80 Disordered Gamblers (60 males)
18-62 years old (M = 30.31, SD = 8.82, 1 unreported)
Procedure
Manipulation: Self-discontinuity vs. Self-continuity
Measure: Nostalgia (Iyer & Jetten, 2011) Readiness to Change (Biener & Abrams,
1991)
Kim & Wohl, in press, SPPS

34. Gambling Can [Does Not] Change the Self
34
Recent studies published in New England Journal of Medicine suggests that,
along with [despite] the potential negative consequences associated with
heavy gambling (e.g., financial, interpersonal problems), heavy gambling can
also result in losing your sense of self [does not change your sense of self].
That is, people who gamble heavily report having undergone fundamental
negative changes to their behaviors and moods and begin to dislike the
person they have become compared to the person they were before engaging
in gambling activities [people who gamble are the same person today,
compared to the person they were before engaging in gambling activities].
We would like to see how this is true for you.

35. 4.15
3.50 3.57
1.70
2.60
1.20
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
Self-Discontinuity** Nostaliga** Readiness To
Change*
Self-Discontinuity
Self-Continuity

36. Self-
Discontinuity
Readiness to
Change
Nostalgia
2.36**
.86**
1.30*
1.25
95% CI: .58, 1.86

38. 38
How do known barriers
stack up against
nostalgia?

39. Participants
223 Disordered Gamblers (115 males)
19-72 years old (M = 34.15, SD = 13.24, 4 unreported)
Measures
Nostalgia
Shame as well as guilt
Motives for gambling (enhancement, social, coping)
Have you tried to change? Have you sought professional
treatment?
Wohl, Santesso, Salmon, & Kim , in prep

40. » Enhancement: p=.19,
Exp(B)=1.24
» Social: p=.21, Exp(B)=.82
» Coping: p=.31, Exp(B)=.86
» Shame: p=.64, Exp(B)=.89
» Guilt: p=.99, Exp(B)=1.03
» Nostalgia: p<.001, Exp(B)=2.48
Have you tried to change your Gambling?
Multiple logistic regression

41. » Enhancement: p=.78,
Exp(B)=1.08
» Social: p=.96, Exp(B)=.98
» Coping: p=.02, Exp(B)=.50
» Shame: p=.30, Exp(B)=1.61
» Guilt: p=.03, Exp(B)=.35
» Nostalgia: p<.001, Exp(B)=4.61
Have you ever sought Professional Help for
Gambling?
Multiple logistic regression

42. » Enhancement: p=.66,
Exp(B)=1.27
» Social: p=.67, Exp(B)=1.24
» Coping: p=.51, Exp(B)=.72
» Shame: p=.93, Exp(B)=1.07
» Guilt: p=.78, Exp(B)=1.26
» Nostalgia: p=.02, Exp(B)=7.19
Have you tried to change your Gambling?
Three-Month follow up
Multiple logistic regression

43. Facilitating gamblers to see the past ‘non-addicted self’
has a different (and better) version of the self motivates
readiness to change.
Of course, not everyone who feels nostalgic will believe
they have the ability to change.
43
Nostalgia is a powerful motivator

45. Believe that although people may
differ in basic aptitudes, interests, and
temperament, everyone can change,
grow, and improve.
Incremental Mindset

46. Challenges:
Obstacles:
Effort:
Failure:
Embrace them
Persist
Path to mastery
Let me learn
Incremental Mindset

47. Belief that traits such as intelligence,
ability, personality, and competence
are inborn and basically
unchangeable.
Entity Mindset

48. Challenges:
Obstacles:
Effort:
Failure:
Avoid them
Give up
Fruitless
Helpless and hopeless
Entity Mindset

49. Nostalgia, mindset and action
Participants
Time 1 (N= 347) 87 low-risk, 142 moderate-risk, 118 problem
gamblers (18-72 yrs, M=35.55; Males=210)
Time 2 (N=160): 45 low-risk, 61 moderate-risk, 54 problem gamblers
(20-68 yrs, M=36.66; Males=89)
Measures
Time 1: Nostalgia; Mindset
Time 2: Attempted change in last three months, Avenue (professions
or self-help); Manner of change

50. Attempted change
50

51. Results
Entity mindset – no relationship with nostalgia
on readiness to change
Incremental mindset – Strong positive
relationship with nostalgia on readiness to
change.
51

52. Nostalgia
Probabilityofchange Entity Mindset
Incremental Mindset

53. 53
Potential for behavioral change
Behavioralchange

54. Self-efficacy
A key MI principle is self-efficacy for change.
People need to believe they can change and
successfully reduce their gambling
behaviour. Hope and faith are important
elements of change.
54

55. 55
Nostalgia
High Self-Efficacy
Low Self-Efficacy
Probabilityofchange

56. Reasons for Self-Help
56

57.  Authenticity: As a gambler or who one used to be?
 Facilitating the gambler to see the past ‘non-addicted
self’ has a different (and better) version of the self
motivates readiness to change
 The butterfly effect: Small changes can yield
disproportionate changes elsewhere (Berg & Miller, 1992)
 Some belief in change might be good, but a lot could be
bad 57
What should I take from this?

58. EMOTION REGULATION
“… the processes by which individuals influence which
emotions they have, when they have them, and how they
experience and express these emotions.”
(Gross, 1998, p. 275)
Future Directions

59. 1. Decrease (or increase) physiological
arousal associated with emotion
2. Re-orient attention toward (or away) from the
emotion
(Some) Tasks in Emotion Regulation
(Gottman & Katz, 1990)

60. 60

61. 61

62. Dr. Michael Wohl
613-520-2600 x 2908
michael.wohl@carleton.ca

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