Article

Traitement du jeu pathologique à l'aide de la réalité virtuelle : la verbalisation de stratégies face aux situations à risque / Virtual Reality Relapse Prevention for Pathological Gamblers: Strategies for Dealing with Risky Situations

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Abstract

Il est d’usage, au cours d’un traitement, d’aider les joueurs pathologiques à développer et à mettre en pratique différentes stratégies pour prévenir les rechutes. Le traitement du jeu pathologique a connu des avancées dans les dernières années en utilisant la réalité virtuelle (RV) pour exposer les joueurs à leur envie de jouer. L’influence de cette modalité de traitement sur les stratégies de prévention des rechutes reste toutefois à évaluer. Notre étude visait donc à identifier et à classifier les stratégies proposées par les joueurs pour gérer leur envie de jouer lorsqu’ils sont confrontés à des situations à risque d’une exposition à la RV. Des enregistrements de dix joueurs pathologiques ayant pris part à une séance de prévention de la rechute en RV ont été transformés en verbatim. Le contenu du verbatim a fait l’objet d’une analyse de type déductif et inductif validée par une procédure d’accord interjuges. Les résultats ont révélé six stratégies comportementales et sept stratégies cognitives proposées par les joueurs, avec une moyenne de dix stratégies différentes par joueur. Les stratégies cognitives montrent l’influence possible de la restructuration cognitive qui a eu lieu lors de la thérapie. De plus, l’évitement semble être l’une des stratégies comportementales clés pour les participants, lorsque confrontés à un environnement de bar. Cette étude appuie le potentiel de RV en prévention de la rechute. La spécificité des stratégies provenant de la RV, en comparaison avec l’exposition en imagination, ainsi que l’efficacité des stratégies abordées en séance de RV devraient faire l’objet d’autres études.AbstractIt is common practice, during treatment, to help pathological gamblers develop and implement different strategies to prevent relapses. Treatment for pathological gambling has made progress in recent years and now uses virtual reality (VR) to make gamblers aware of their gambling urges. However, the impact of this treatment method on relapse prevention strategies has yet to be evaluated. This study aims to identify and classify strategies to manage gambling urges as proposed by gamblers when faced with risky situations during exposure in virtual reality. Recordings taken of ten pathological gamblers during a virtual reality relapse prevention session were transcribed verbatim. The verbatim was the subject of a deductive and inductive analysis validated by a procedure agreed upon by the judges. The results reveal six behavioural and seven cognitive strategies proposed by the players with an average of ten strategies per player. The cognitive strategies show that the cognitive restructuring used during treatment had a possible impact. Furthermore, in bars, avoidance seems to be one of the key behavioural strategies for the participants. This study supports the potential of virtual reality in relapse prevention. The specificity of the strategies proposed during VR exposure compared with imaginary exposure as well as the effectiveness of the strategies addressed in VR sessions should be studied further.

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