Understanding and addressing problem gambling

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Understanding and addressing problem gambling

• Plenary Session III Experiences Helping Problem
  Gamblers and their Families

5-6 July 2007 Samson Tse
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All about hope
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All about hope
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Remain hopeful? Part 1
Dangerous consumption Toxic environment Abundan
ce, Availability, Accessibility Advertising
We need to adopt a contextual/ ecological
approach
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Remain hopeful? Part 2

• Culturally responsive problem gambling
  counselling services

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New Zealand intervention study Research Project
Core Group (April, 2006- Nov 07)

• Associate Professor Samson Tse (Principal
  Investigator, Centre for Gambling Studies,
  University of Auckland)
• Professor Alun Jackson (School of Social Work,
  University of Melbourne)
• Mr Andrew Jull (Clinical Trial Research Unit,
  University of Auckland)
• Dr Lorna Dyall (Maori Health Studies, University
  of Auckland)
• Ms Lana Perese (Pacific Researcher, PhD
  Candidate)
• Ms Lisa Campbell (Project Coordinator, Centre for
  Gambling Studies, University of Auckland)
• Dr Robin Shepherd (Researcher, Centre for
  Gambling Studies, University of Auckland)

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Project aims

• Identify different problem gambling intervention
  services
• Analyse the range of tasks and therapeutic
  techniques undertaken by practitioners
• ? What constitute a helpful intervention As
  perceived by clients (people who gamble, family
  members, relatives)

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Agencies involved

• Problem Gambling Foundation of New Zealand
  (PGFNZ)
• Gambling Helpline
• Oasis Centre/Salvation Army
• Te Rangihaeata Oranga
• Pacific Mental Health, Alcohol, Drugs and
  Gambling Services Tupu Team
• PGFNZ Asian Services

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Data collection (phase ONE)

• Ethnic interviewers
• Measurement Instruments
• Semi-structured interview guidelines
• People who gamble
• Relatives, families, whanau
• Clinical Task Analysis (CTA) for practitioners
• Standardised questionnaire document practice,
  theories
• Semi structured interview guidelines

Phase TWO- randomised clinical trial
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Ethics approval

• The University of Auckland Human Ethics Committee
  approved the ethics application (Ref 2006 / 036)
  (for 3 years)

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Participants

• Practitioners and Clients recruited through the
  problem gambling intervention services

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Data analysis

• The questionnaire itself formed the framework for
  analysis (case comparative method general
  inductive approach Thomas, 2006)
• Complex process and multiple layers of analysis
  eg respondents category, use of services,
  ethnicity
• Read thru the scripts and identified key themes
• preliminary findings were discussed in TAG
• core team members
• ethnic interviewers advisors
• drafted/commented on overall interpretation
  discussion

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People identified a number of reasons why they
sought help

• Lost too much
• Pressure from family to seek help
• Being sick of lying to families and friends
• Pacific and Maori people after seeing the
  problem gambling services in media
• Some Asian people as part of self-exclusion
  procedures, knowing someone (counsellors
  someone received help)

Applicable to all four population groups
Compare MCYS National Gambling Prevalence
Survey of Singapore Residents, 04-05
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What contributes to successful outcomes
(explore treatment specificities)?

• Individuals who gamble
• Good counsellors, someone to talk to ()
• Receive specific info advices
• Are being referred to other specialised services
• Have access to group interventions
• Receive financial advices have limited access to
  money

Applicable to all four population groups
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Contd

• Family members
• Good counsellors I am the reason she is seeing
  me ()
• Have access to individual couple therapy, whole
  family involved
• Learn how to support members with gambling
• problems protect the family from harms

Compare Jackson et al., 2000 2003 Raylu
Oei,2007
Applicable to all four population groups
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Contd
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What do counsellors think?
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Problem gambling interventions 1) Interventions
- gambling other associated problems/concerns
2) Use of specific approaches 3)
Characteristics of the services e.g. mobile
services
Clients cultural needs are met
Client Readiness motivation to make changes
Social and family support 1) Support changes 2)
Prevent relapses
Counsellors 1) Personal qualities e.g.
empathetic, empowering 2) Their professional
skills 3) The interactions with clients e.g.
non-judgmental
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Work with individuals with gambling problems
their family members

• Asian peoples cultural myths about gambling
  (or problem gambling)
• The government is to blame
• It is a part of the fate or luck
• Counselling, talking never works
• PG is a result of lack of willpower
• Once people G problems, they are gamblers for
  life
• Gamblers have no choice but to bottom out

• Cultural leverage (or baggage) for effective
  intervention
• Collectivism
• Desire for harmony
• Desire for balance
• Spirituality/ religion (organised or folk)
• Respect for authority/ elders, knowledge
• Concern about face
• Connection/ relationship

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Useful references

• Ledgerwood, D. M. Petry, N. M. (2005). Current
  trends and future directions in the study of
  psychosocial treatments for pathological
  gambling. Current Directions in Psychological
  Science, 14(2), 89-94.
• McCown, W. G., Howatt, W. A. (2007). Treating
  gambling problems. New Jersey John Wiley Sons
  Inc.
• Raylu, N., Oei, T.P.S. (2007). Factors that
  predict treatment outcomes in a community agency
  for problem gamblers. International Journal of
  Mental Health Addiction, 5, 165-176.
• Tan, R., Wurtzburg, S. (2004) (Eds.). Problem
  gambling New Zealand perspectives on treatment
  (Social work theory into practice series).
  Wellington, New Zealand Steele Roberts Ltd.
• Toneatto, T. Ladouceur, R. (2003). Treatment of
  pathological gambling A critical review of the
  literature. Psychology of Addictive Behaviors,
  17(4), 284-292.
• Jackson, A., Thomas, S., Blaszczynski, A.
  (2003). Best practice in problem gambling
  services. Melbourne Gambling Research Panel.

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HOPE COMES TRUE