I do have office hours in North San Diego

Dear W--

Thanks for getting back to me. I do have office hours in North San Diego County (Poway) 3 days a week: Tuesdays, Fridays and Saturdays. I have the Saturday hours because I know how hard it is for some people to have to take off work to see a doctor---and because I don't have evening hours right now.

You mentioned you have been in treatment for other issues. That makes sense since "escape-relief" gamblers, like yourself, who favor the machines are at a high probability of having an affective disorder. Research shows that 70% or more of escape gamblers suffer from major depressive disorder or are bipolar. You may be gambling to "self-medicate" your depression. Also, escape gamblers lose control especially because of unresolved underlying issues. For example: incidence of separation and divorce, loss of a family member or friend, loss of a job, or relationship issues, etc. Of course, it could be as simple as boredom. There is something that "drives" you to escape into the casino to "avoid" dealing with whatever is really bothering you. The gambling sets-up a "smoke screen" of sorts so the real problem doesn't get dealt with.

W, good for you for giving up the credit cards---one big pain you can live without. You made a large decision to do that---and demonstrated control--to keep it!

As far as face-to-face therapy versus online---I tend to agree with you. The added therapeutic input from visual cues cannot be denied, especially from a therapist's viewpoint. It is one of the major drawbacks of online treatment. However, there are a lot of gamblers out there who live nowhere near a credentialed and competent gambling counselor. Or even a gambling treatment program. Some of my patients drive from as far away as Los Angeles, Newport Beach, Huntington Beach, Palm Springs and Temecula to my Poway office. It takes strong motivation for a better life and to defeat gambling to make those long drives.

Basically, the online treatment program was developed for gamblers outside the San Diego driving area like Sacramento, Fresno and San Francisco. They have no treatment programs or certified gambling counselors in their area. Their only option is GA--and research shows that GA is not as effective because it isn't "treatment" per se--but it complements treatment. Others with gambling problems are Seniors who don't drive---you know, here in San Diego County where we have 10 Indian casinos (the most in any county in the US), the casinos have daily bus service that actually goes to retirement communities early in the morning, picks up the Seniors, gives them a coupon for lunch, transports them to the casino and takes them home in the evening so they don't have to drive! Certainly it contributes to the fact that Seniors have the highest gambling rate of any other age group.

OK, now W---let's do it! 1-866-40-NOBET or in San Diego 619-806-7453.