1. Current therapies
1.1. cognitive-behavioural therapy
1.2. Individual vs. group
1.3. self-help
1.4. 12-step
1.5. social constructionist
1.5.1. solution-focused brief therapy
1.5.2. narrative therapy
1.5.3. motivational interviewing
2. Sociocultural/Symbolic Elements
2.1. Gender
2.1.1. stereotypical roles
2.1.1.1. caregiver
2.1.1.2. provider
2.2. Media
2.2.1. Glamorized portrayal (poker shows)
2.2.2. Negative (intervention, cinema)
2.3. Oppression
2.4. Peer pressure
2.5. Race
2.6. Shame/Guilt
2.7. Social acceptance
2.8. Socioeconomic status (SES)
2.9. Stigma
2.9.1. societal
2.9.2. self
2.9.3. professional
2.9.4. therapeutic
2.9.5. religious
2.9.6. multiple
2.10. Use of labels
3. Types of Gambling
3.1. Poker
3.2. Video lottery terminals
3.3. Horse/dog
3.4. Online
3.5. Casino games
3.6. Lottery
3.7. Sports
4. Revelations
4.1. Client
4.1.1. "Keeping a therapy journal helped me in recovery"
4.1.2. "Further meetings/conferences between client and counsellors"
4.1.3. New appreciation for therapeutic intention of counsellors"
4.1.4. "Need to take responsibility for own actions"
4.2. Counsellor
4.2.1. "Important to use common language with this client population"
4.2.2. "Not all gambling activities are the same"
4.2.3. Acknowledgement of reasons for client resistance
4.2.4. Need to increase research into therapy for problem gamblers
4.2.5. "Better understanding of how culture impacts recovery for problem gamblers"
4.2.6. "It is not enough to say that I am a trained counsellor"
4.2.7. Need to challenge existing literature on PG"
4.2.8. Client inclusion in setting therapeutic goals
4.2.9. Further training in order to work with PG population
4.2.10. Learning from clients
4.2.11. Importance of client feedback
4.2.12. Ability to see uniqueness of client issues not 'condition'
4.2.13. Increasing awareness of multiple stigmas attached to problem gambling
5. Client Agency
5.1. "I am not an addict"
5.2. "It is not their role to make me better"
5.3. "Resistance is not resistance"
5.4. Acceptance
5.5. Asserting individuality
5.6. Changing focus/topics
5.7. Conflict
5.8. Contrary positions
5.9. Correcting the therapist
5.10. Disagreement
5.11. Giving and taking advice from other gamblers
5.12. Interference
5.13. Interrupting
5.14. Moral accountability
5.15. Moral management
5.16. Offering counter points
5.17. Personal responsibility
5.18. Placating
5.19. Realizing own strength
5.20. Reframing issue
5.21. Refusal
5.22. Rising to challenges/realizing personal strength
5.23. Showing frustration
5.24. Taking a stand
5.25. Therapeutic negotiation
5.26. Use of anger
5.27. Using different language
5.28. Using silence
6. Related Discourses
6.1. 12-Step discourse
6.1.1. "Keeping up with the Joneses"
6.1.2. Powerlessness
6.1.3. "Hitting rock bottom:
6.1.4. Sense of community
6.2. Disease
6.3. Dominant Addiction
6.3.1. Being an "addict"
6.3.2. Pathology
6.3.3. Medicalization
6.4. Empowerment
6.5. Health & Illness
6.6. Identity
6.6.1. Identity work
6.6.2. Public vs. private
6.6.3. Personal identity
6.6.4. Stigmatized identity
6.7. Institutional
6.8. Morality
6.8.1. addiction
6.8.2. problem gambling
6.9. Normality
6.9.1. Stereotypes
6.9.2. 'Myth' of the problem gambler
6.9.3. Deviancy of PB
6.10. Postmodernism
6.11. Recovery
6.12. Relationship
6.13. Religion
6.14. Resiliency
6.15. Resistance
6.16. Sobriety/Abstinence
6.17. Success
6.18. Therapy
6.18.1. Willingness vs. wilfullness
6.18.2. Meaning-making
6.18.3. Pain vs. suffering
6.18.4. Curiosity
6.18.5. Use of mindfulness
6.18.6. Humor
6.18.7. Triggers
6.19. Treatment
7. Emerging Questions
7.1. Are attitudes towards problem gamblers different according to the discipline of the health care practitioner?
7.2. Are the emerging types of gambling more damaging?
7.3. Are there alternatives to therapy for the problem gambler?
7.4. Can action research help facilitate positive change for problem gamblers?
7.5. How do clients support views of themselves that are not always available in sessions?
7.6. How does a counselllor repair a ruptured therapeutic alliance with this population?
7.7. I s there any acknowledged personal growth from the PB clients as a result of engagement in therapy?
7.8. Is it possible to separate problem gambling from addiction?
7.9. Is online couneelling a viable option for some problem gamblers?
7.10. Is there a split between academia and practice in this field?
7.11. What constitutes conversational agency in this investigation?
7.12. What is the impact of the changes in the DSM for clients?
7.13. What role does natural recovery play in answering the research question?
7.14. Why is there such little mention of discursive therapies?
8. Collective Human Elements/Actors
8.1. 12-step programs
8.1.1. Lifering
8.1.2. Umbrella
8.1.3. GA
8.1.4. NA
8.1.5. AA
8.2. Academics/reserachers
8.3. Canadian health care system
8.4. Discourse Interest Group: University of Calgary
8.5. Employee assistance counselling (EAP)
8.6. Government
8.7. Health care practitioners
8.7.1. Registered clinical counsellors
8.7.2. Psychiatrists
8.7.3. Psychologists
8.7.4. General practitioners
8.7.5. Social workers
8.7.5.1. Nurse therapists
8.7.6. Nurse therapists
8.8. Other problem gamblers
8.9. Problem gamblers
8.10. Supports
8.10.1. Family
8.10.1.1. Parents
8.10.1.2. Partner
8.10.1.3. Children
8.10.1.4. Siblings
8.10.1.5. Extended family
8.10.2. Peers
8.10.2.1. Coworkers
8.10.2.2. Friends
8.11. Therapeutic alternatives
8.12. Vancouver Island Health Authority (VIHA)
8.13. Workplace
8.14. Workplace
9. Spacial elements
9.1. Groupspace
9.2. Casinos
9.3. Office
9.4. Furniture
9.5. Distance traveled for help
9.6. Clinic
9.7. Waiting rooms
9.8. Victoria, BC
9.9. Downtown
9.10. Racetrack
9.11. Hospital
9.12. Church
9.13. Public vs. private
10. Temporal Elements
10.1. Follow-up sessions
10.2. Single sessions
10.3. Short vs. long term therapy
10.4. Accumulation of financial burden
10.4.1. Bankruptcy
10.5. Maturation of client
10.6. Changes in lifestlye
10.7. Increase/decrease in gambling behaviour
10.8. Changes in perception of self over time
10.9. Type of gambling influenced by age and income
10.10. Client change
10.11. Decline in personal health
10.12. Relapse
11. Major/Contested Issues
11.1. Client
11.1.1. Safety
11.1.2. Openness of therapist
11.1.3. "I knew nothing about the therapist"
11.1.4. Counsellor background
11.1.5. Counselling showing empathy
11.1.6. Cousellor education
11.1.7. "I felt like I did something bad"
11.1.8. Being 'fixed' not 'helped
11.1.9. Counsellor competency
11.1.10. "Harming' vs. 'helping'
11.1.11. Judgment
11.1.12. Trust
11.1.13. "Coaching' vs. 'counselling'
11.1.14. Being understood
11.1.15. Confusion about therapeutic process
11.1.16. Personal ability to verbalize concerns (Shyness)
11.1.17. Relevancy of therapeutic conversation
11.1.18. Importance of personal story/narrative
11.2. Counsellor
11.2.1. "reckless" clients
11.2.2. "what the textbook says vs. what actually happens in therapy"
11.2.3. challenging client behaviour
11.2.4. "Firing" clients
11.2.5. Sticking to therapeutic plan
11.2.6. Need for empirically-supported treatment
11.2.7. Evidence of "other" addictions
11.2.8. Expectations of clinic
11.2.9. View that practitioner is responsible for changing clients
11.2.10. Client indifference
11.2.11. Keeping clients accountable
11.2.12. Comfort over not being liked by clients
11.2.13. Other presenting concerns
11.2.14. "Healthy" therapeutic dialogue
11.3. Shared
11.3.1. Being "out of sync"
11.3.2. Is problem gambling a mental health issue?
11.3.3. Age discrepancy of client/counsellor
11.3.4. Directive vs. client centered approach
11.3.5. Impact of substance use
11.3.6. Homework
11.3.7. Personality mismatch
11.3.8. Congruency b/n values and beliefs
11.3.9. Previous counselling/ counsellors
11.3.10. Expectation of results
11.3.11. Awareness of various types of gambling
11.3.12. Diagnosis
11.3.13. Readiness for change
11.3.14. "Teaching' ciient
11.3.15. Severity of problem
12. Political Elements
12.1. Billing
12.2. Client rights
12.3. Culture/subcultures
12.4. Decline in government spending on health care issues
12.5. Ethical responsibilities
12.6. Harm-reduction
12.7. Lack of clear regulation of treatment services
12.8. Systematic inequalities
12.9. The economy
13. Non-Human Elements
13.1. Participation screening for study
13.2. Participant recruitment for study
13.3. Focus groups
13.4. Individual interviews
13.5. Teleconference
13.6. Digital recorder
13.7. Internet
13.8. Emails
13.9. Primary researcher memos
13.10. Primary researcher journal
13.11. Member/accuracy checks
13.12. Consultation
13.13. Medication
13.14. Drugs/alcohol
14. Individual Actors
14.1. Academic supervisor
14.2. Colleagues
14.3. Erving Goffman
14.4. Participant clients
14.5. Participants therapists
14.6. Primary researcher
14.7. Stakeholders
14.8. Workplace coordinator
15. Other kinds of elements
15.1. Barriers to treatment
15.2. Ability to pay for sessions
15.3. Mood
15.3.1. Sadness
15.3.2. Fear
15.3.3. Apprehension
15.3.4. Depression
15.3.5. Anxiety