Gambling Help Online: Program Update, Client and Counsellor Feedback

Transcription

1 Gambling Help Online: Program Update, Client and Counsellor Feedback Simone Rodda Kathleen Latage, Renata Vergara April 2011 Gambling Help Online is an initiative of the Ministerial Council on Gambling (MCG) and is funded as part of an agreement between all State and Territory Governments and the Australian Government

2 Program objectives Attract a new cohort of clients who may not otherwise access face-to-face services Extend the availability of counselling and support by addressing issues around remoteness, anonymity and after-hours availability

3 Risk Money Cognitions Self assessment Signs Readiness Strategies Helping others Introductory content Websites Service sector Exclusions Referral State Information

4 Anytime, anywhere 24/7 text based counselling Live Counselling Q&A Tell someone Self-directed Support

5 What did you originally enjoy about the gambling? Making which ever sport I was watching a lot more meaningful and also the rush you get from winning 10:06 AM 10:09 AM 10:12 AM Are there particular sports that you follow? 10:15 AM To start with I just bet on Australian sports then I found the online sports gambling forums and started betting USA sports. I almost bet $400 on baseball 5 minutes before I logged on here.

6 Website activity (Sept 09-Dec 10) Since a soft-launch on 31/8/09 Gambling Help Online website has received 29,878 website visits. The average page views were five pages per visit with an average time on site of 4 minutes and 30 seconds Page viewed Number Home page Anonymous counselling 8240 Online counselling - landing page 6584 Gambling calculator 3663 Risk assessment 2382 How the pokies work 2346 Dispelling myths 2082

7 Gambling Help Online Live Counselling - Chat (Sept 09-Dec 10) There were 1287 live counselling contacts Gamblers, CSO, Professionals, Students, Venues Average contact duration was 43 minutes Sixty-one per cent accessed anonymously More likely to register if aged between Most contacts received outside traditional business hours

8 9.0% Client contact time of day; Chat vs Victorian GHL (July-Dec 10) 8.0% 7.0% 6.0% 5.0% 4.0% 3.0% 2.0% 1.0% 0.0% 6am 7am 8am 9am 10am11am12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm11pm12am 1am 2am 3am 4am 5am GHO Helpline

9 Who is using this service?

10 Gambler Profile: n=700 Online counselling (Chat) Gamblers using chat are more often: Male (58%) Higher proportion of males from NSW (69%) *** Lower proportion of males from QLD (41%) *** Aged under 30 (44 percent) Higher proportion under 30 from NSW (52%) ** Higher proportion between from VIC (31%) ** Higher proportion over 50 from QLD (24%) *** **p<.01, ***p<.001

11 Gambler Profile: Age by Gender (Chat) 70.0% 60.0% 50.0% *** Male Female 40.0% 30.0% 20.0% *** *** 10.0%.0% over 50 ***p<.001

12 Gambler Profile: n=700 Online counselling (Chat) Gamblers using chat are more often: Gambling on EGM s (70%) Higher proportion of wagering from Victoria ** & WA a Australian (69%) Higher proportion of Asian background from NSW *** Problem gamblers (PGSI: M=21.4, SD=4.2) Females significantly higher than males *p<.05, **p<.01, ***p<.001, a sample not sufficient for sig test

13 Gambler Profile: Support (n=120) Gamblers using are more often: Female (53%) Higher proportion of females using compared with Chat* Even distribution across age groups Higher proportion males aged <30 ** & * Higher proportion females aged * & >50 *** *p<.05, **p<.01, ***p<.001

14 Gambler Profile: Age by Gender ( Support) 50.0% ** Male Female 40.0% 30.0% * * *** 20.0% 10.0%.0% *p<.05, **p<.01, ***p< over 50

15 Gambler Profile: Support (n=120) Gamblers using are more often: Gambling on EGM s (72%) Australian (68%) Higher proportion of Asian background NSW* Problem Gamblers (PGSI: M=20.6, SD=4.7) No difference by age or gender *p<.05

16 Significant Other Profile: Chat and (n=157) Approximately 16% of online clients are Significant Others. They are more often: Female (73%) Higher proportion than chat** Aged <30 (47%) Concerned about EGM gambling (66%) 18/20 partners using for EGM concerns a **p<.01, a sample not sufficient for sig test

17 Significant Other Profile: Chat and (n=157) Significant others are more often: Contacting during business hours Higher proportion than gamblers using chat during business hours ** Partner (58%) Son/Daughter (19%) Partner experiences significantly higher impact of gambling than others 1* *p<.05, **p<.01 1 Dowling et al., (2009). The development of a brief scale to evaluate the impact of problem gambling on significant others for the national Gambling Help website.

18 The Problem Gambling Significant Other Impact Scale (PG-SOIS) Have you or your family experienced financial hardship as a result of the other person s gambling? Have you experienced feelings of sadness, anxiety, stress or anger due to the other person s gambling? Has the quality of your relationship with the other person been affected by his/her gambling? Has your or your family s social life been affected by the other person s gambling? Has your ability to work or study been affected by the other person s gambling? Has your physical health been affected by the other person s gambling?

19 What happens in a live chat session: Managing the differences

20 Social presence The ability of the online counsellor to project sensitivity, empathy, warmth, understanding and a willingness to assist in the textual environment which has few visual or contextual clues. It represents an important element in facilitating effective online counselling.

21 Hi Bob, so you are saying that Hmm, so you what you are saying is that Ok, and I am wondering here Look, you are right, and in saying that now, I am thinking here if by any chance you have considered WOW! So you are saying that

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23 I am calling because my wife made me contact you. I don t think I have a problem I am wondering if I have a problem my gambling is destroying me I have a problem and want to stop gambling

24 My husband is a gambler Hi, okay are you able to tell me a bit more about how his gambling has been a problem? He keeps lying to me about what he does with our money And then I realise that he gambles more than I thought he does It broke my heart to know that he lies to me constantly I m sorry to hear you find yourself in this situation. I m wondering how long it has been

25 The real problem started around 2 years ago.. I would say the fun betting started 3 years ago Okay, I know when I speak with other partner/family members it is usually a huge shock when they find out that the gambling is more serious than previously thought. It sounds as if that was the case for you Yes it was a big shock for me especially that we got married 3 years ago And we have plans to buy a house and everything else

26 Ok, so you have used of those techniques in the past, and how did that work for you Ok, so you are saying, right, and what about I understand this situation is very stressful for you, I am wondering how long you ve been feeling like that?

27 I have had enoufth, have to stop NOW!!! Tell me what to do!!! Ok, I can see gambling is a problem for you, do you mind telling me a little bit more Started 2-3 years ago with the pokies and it has increased Dramatically over the last year higher bets and losses Wanting to win back the losses Ok, 2-3 years ago when you first started, how did it happen?

28 LOL Good on ya! ZZZZZZZ GTG

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30 Counsellor upskilling: a peer supervision model

31 Online Peer Support The demand of immediacy and perceived distress How to best support counselors managing the challenges of encouraging positive and purposeful change with a client.

32 Development of a Peer Support Group New opportunities for counsellor support Developed in addition to the usual clinical individual and group supervision within the organization.

33 Background Format of the peer support group Journal articles discussing themes arising from online counselling were distributed two weeks before meeting.

34 Group readings Fletcher-Tomenius & Vossler (2009). Research in the role of trust and the therapeutic relationship online Lange et al., (2001). Effectiveness of online counselling in reducing presenting problems Chechelle & Stofle (2004). Clients who will not seek f2f - seek therapy online with evidence of a therapeutic relationship being formed

35 Group Process Opportunity to reveal, discuss, reflect and reinterpret online experiences Commonly identified themes

36 Experiences of Online Counsellors I feel scared that I am going to lose the client I worry that I am going to get it wrong Sometimes it feels as if I am just waiting to wear the client s anger There are times when I feel so frustrated with the client I don t feel that they are really trying.

37 Group Outcomes Increased the therapeutic distance with the client. Naming thoughts lead to recognizing the need to work differently.

38 Learnings from new model Development of strategies to support counsellors in dealing with the complexities of online contacts. Development of innovative ways in supporting skill development for online counsellors Usefulness of peer support forum

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40 Survey of client satisfaction and help seeking experiences

41 Help Seeking patterns GHO selfreported (n=264, Nov10-Feb11)

42 Why choosing online? Previous treatment seekers I needed to talk to someone about places to go for face to face help (Female, 20-24, EGM, chat from this site) I felt more comfortable and relaxed as I was able to have some time to give thought to where I was having a problem. Sometimes when I am face to face with a person my thoughts tend to vanish (female, 45-49, EGM, metro, face-to-face)

43 Why choosing online? Current treatment seekers I like face to face but can only get a once a fortnight session which is not enough. This is a good option to fill the gap (female partner, 40-45, regional Qld) Easy to use in comfort of home, safe, less confrontational (Female, 25-29, EGM s, Metro Vic)

44 Why choosing online? New treatment seekers I think people would be less likely to go to the other sources first. Online is accessible and isn't too shocking to begin with. Embarrassed about the problem, so I like the anonymity of online for the moment (Male, 25-29, Metro NSW) it was a decision that I was comfortable to do as it is my first time to do anything about the gambling problem that has affected me for 10 years (female, regional QLD) A sense of anonymous. Convenience also (Male, 30-34, Indigenous)

45 Exit survey In an overall general sense, how satisfied were you with the session today? Not at all satisfied Extremely satisfied Is online your preferred method of accessing help or support? Not at all Very much so

46 What s next? Current exit survey: Session evaluation, service satisfaction Levels of distress, readiness to change Probable Possibilities Therapist moderated forums, Therapist assisted self-help via mobile phone technology

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