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Jan 19
Brain Connections: Clinical Handouts That Will Excite You!

​Contributed by Deirdre Querney, Registered Social Worker with the City of Hamilton’s Alcohol, Drug & Gambling Services and Instructor at the McMaster Centre for Continuing Education

Brain Connections

Does this scenario sound familiar? You have a client in front of you who is trying to change her gambling behaviour but she is plagued by strong urges, demoralized by how difficult the change process is and feels betrayed by her brain that seems to tell her that gambling is still desirable, even in the face of terrible consequences. The client says to you “What’s wrong with my brain? What is happening to me??”

Your heart sinks a little bit at the question. After all, the brain is complicated. You want to answer her question but the answer is not all that clear, even to you. So, you take a deep breath and weave together an answer that is a patchwork of ideas from the last conference you attended, an article you read, something a learned colleague said and your own anecdotal evidence. You hope that what you are saying makes sense to the client and helps her feel less frustrated and ashamed. You also hope that what you have said is accurate, but you’re not entirely sure.

I have been a problem gambling counsellor at the Alcohol, Drug & Gambling Services (ADGS) in the City of Hamilton for 17 years and I have been asked questions about the neurobiology of problem gambling hundreds of times. My answers have changed over the years as I have picked up new information from various sources but what hasn’t changed is my worry that what I was saying was not completely evidence-informed. As the consulting psychiatrist for our program once told me “Deirdre, you tell a good story and it probably is helpful to your clients. I just don’t know if it’s actually true.”

In an effort to correct my “patchwork quilt” approach to answering these important questions, I became involved in a project funded by the Gambling Research Exchange Ontario (GREO) called Brain Connections. My team included Dr. Iris Balodis and her graduate student, Fiza Arshad from the Peter Boris Centre for Addictions Research as well as my ADGS colleague and fellow problem gambling counsellor, Andrea Strancaric. Together, we set out to answer five of the most often-asked questions about the brain and problem gambling and then to turn those answers into clinical handouts designed to enhance treatment sessions with clients.

The five questions are:

  1. How is problem gambling like an addiction to alcohol or drugs from my brain’s point of view?
  2. Why do people keep gambling even when it’s not fun anymore?
  3. Why is it hard to say “no” to an urge?
  4. When I’m not gambling, why does it feel like nothing else―even activities I used to enjoy―will ever be fun again?
  5. Why do people sometimes switch from gambling to another addiction?

We are very excited to unveil the result of Brain Connections, which is five high quality, person-centered and visually appealing clinical handouts.

Each handout has four parts to it: (1) a summary of the research to answer the question at hand, (2) an activity to help clients understand the information in the handout, (3) a discussion question to help clients think about how the information might personally apply and (4) a take-home message summarizing the main ideas in the handout. We have also developed a single summary sheet of all the information for people who just want to hear the bottom line without reading all the handouts.

We invited clients from ADGS to tell us what they thought about the handouts. What they told us is that these handouts can serve many purposes. They can:

  • Be comforting when it feels like the brain is on auto-pilot and working against the treatment goal
  • Help prevent relapses by providing information about urges and substitutions
  • Prepare people to have a realistic sense of what to expect from the brain as it heals from a gambling addiction
  • Give hope that change is possible.

To download the handouts, please go to

You can also see GREO’s promotional video about Brain Connections.

Sign up for one of our webinars hosted by the CAMH Problem Gambling Institute of Ontario on May 16th or May 28th, 2018 when we will be discussing how to best use the handouts in your clinical practice.

Thank you for taking the time to learn more about Brain Connections. If you try our handouts and want to give us feedback about your experience, we would love to hear from you! Please see our contact information on our website.


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