AOD & GAMBLING ASSUMPTIONS & BIASES IN COUNSELLING. Carol Rowe Kathleen Orr Caroline Long

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1 AOD & GAMBLING ASSUMPTIONS & BIASES IN COUNSELLING Carol Rowe Kathleen Orr Caroline Long

2 Why Gambling? A high proportion of problem gamblers will have AOD issues & vice versa Neurobiology is similar Treatment options can be effective for both AOD & Gambling Under same category Addictive Disorder in DSM V *Hing, N., et al., A comparative study of men and women gamblers in Victoria. 2014, Australia: Victorian Responsible Gambling Foundation: Melbourne

3 Definition Gambling = the placing of a wager or bet in the form of money (or something of value) on the outcome of an uncertain event that may involve elements of skill and chance Problem Gambling and Treatment centre (PGRTC), Guideline for screening, assessment and treatment in problem gambling. 2011, Monash University: Clayton.

4 Forms of Gambling Gaming Machines Lotteries, Keno Card games Racing Sports Betting Casino Games Online games Cultural games (Mah-jong, cockfighting) Stock Market

5 Problem Gambling a chronic failure to resist gambling impulses that results in disruption or damage to several areas of a person s social, vocational, familial or financial functioning a level of gambling expenditure that is considered to be higher than can be reasonably afforded relative to the individual s available disposable income and as a result produces financial strain Blaszczynski et al (1997)

6 Prevalence 14% of people seeking AOD treatment also experienced problem gambling Cowlishaw % of problem gamblers report AOD issues 50 70% of problem gamblers have a co-occurring alcohol use disorder Prevalence of problem gambling increases with increases in weekly alcohol consumption More than a quarter of problem gamblers experience alcohol abuse & severe mental health disorders Department of Justice 2009 p.191

7 Gambling Harms Financial difficulties Impact on family Psychological difficulties Poor employment outcomes Criminal activity Erosion of social activities Suicide

8 Why people Gamble Money chasing losses & to improve finances Excitement (adrenaline rush) Social contact self esteem Stress management Medication side effects Entertainment Escapism / Distraction Safe environment Cultural activity Availability Problem Gambling Resource Kit, Vic. Dept. of Justice, 2007

9 Why this workshop? Values & assumptions impact on your work AOD workers choose to work in AOD not gambling Have you considered what biases you may have about gambling, money, luck? This workshop = an opportunity to explore your attitudes

10 Stigma The reason people don t easily access help for problem gambling What is this stigma about?

11 Discussion Stigma

12 Workers views of Stigma Labelling people as problem gamblers = stigmatising Loss of control about money & self Gamblers do not understand how they became addicted Seen as A debt issue not an addiction Less severe / easier to recover than substance addiction Impact on family more or less severe Difficult to address cognitive distortions

13 Gamblers view of stigma SHAME & EMBARRASSMENT GUILT FEEL STUPID

14 SELF REFLECTION Rationale: Your perspective on gambling is likely to impact on the way you talk about it with clients Ideas about gambling, money, luck, winning and losing are relevant Self reflection choose one set of values and consider how you would answer

15 Values Gambling Money Luck Winning Losing Risk

16 How to ask DIRECTLY INDIRECTLY

17 DIRECTLY Screening tool questions: If you gamble are you concerned about your gambling? Y / N Are you currently receiving support for any gambling issues? Y / N Alternative direct questions Are you affected by gambling? Lie/Bet Questionnaire Have you ever lied to people important to you about how much money you gambled? Have you ever felt the need to bet more and more money?

18 INDIRECTLY How do you spend your money & time? Are there problems which are contributing to how you are feeling now? I notice you regularly don't have money for food/bills. Can we talk about this? I have a number of clients in similar situations where gambling is an issue. We have been able to work on this together

19 Follow Up How will you now ask about gambling? Self Reflection How can you use this information / awareness in your own practice? What would you need to be more confident in discussing gambling with a client?

20 SUMMARY Forms of gambling High correlation between AOD & Gambling Clients less likely to disclose Stigma Direct vs. Indirect questioning Awareness of your own values helps the client

21 Coming Soon AOD worker resource: Slots & Shots the Wrong Mix: (tentative title) Interventions for clients with AOD & Gambling issues Due June 2015 Accredited Gambling Skill Set Odyssey House Victoria

22 AOD Worker Gambling Resource Topics Similarities & Differences Interactions Signs & Symptoms Specific populations Treatment what works for both Neurobiology Referral Resources

23 Free Training for AOD workers Would your service like to be involved? We are looking for 2 AOD services to participate in free half day training in April/May to assist staff to better understand the parallels and differences between gambling and AOD addictions if you are interested (or talk to us after)

24

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