Recognizing Problem Recognizing Problem GamblingGambling
Developed by Nicole Corbin, LPC, CADC IDeveloped by Nicole Corbin, LPC, CADC I
Presented by Richard Johnson, MA, CGAC II, CADC III, Presented by Richard Johnson, MA, CGAC II, CADC III, NCGC IINCGC II
Gambling Outreach/PreventionGambling Outreach/Prevention
Goals for presentationGoals for presentation Understand gambling in Oregon; Understand gambling in Oregon;
prevalence among youthprevalence among youth
Differences/similarities with substance Differences/similarities with substance abuseabuse
Indicators and impact of problem Indicators and impact of problem gambling on youth and families gambling on youth and families
Assessment Assessment
Become familiar with resources to Become familiar with resources to address problem gamblingaddress problem gambling
Gambling in Oregon is Gambling in Oregon is GrowingGrowing
Spirit Mt. Casino has replaced Multnomah Falls as our #1 tourist attraction
Societal Acceptance = More Societal Acceptance = More GamblersGamblers
Industry perpetuates a vision of gambling as entertaining, Industry perpetuates a vision of gambling as entertaining, glamorous and as a means of achieving financial freedom.glamorous and as a means of achieving financial freedom.
Recent surge in reality TV gambling showsRecent surge in reality TV gambling shows High use of internet gaming sites among those under 18High use of internet gaming sites among those under 18
Oregon NumbersOregon Numbers
2002 2002 Oregonians spent $1.18 billion on all Oregonians spent $1.18 billion on all forms of gambling, $447 per adult forms of gambling, $447 per adult 25% more than the national average*25% more than the national average*
2003 2003 Legislation made way for a 20% increase Legislation made way for a 20% increase in Video Lottery Terminals in Video Lottery Terminals
20042004 A ninth tribal casino opened in OregonA ninth tribal casino opened in Oregon
20052005 The Lottery expanded into video slotsThe Lottery expanded into video slots
20062006 Lottery exceeds $1 billion in sales, video Lottery exceeds $1 billion in sales, video lottery sales up 24% over previous yearlottery sales up 24% over previous year
Source: * Eco Northwest, 2005Source: * Eco Northwest, 2005
Affected OregoniansAffected Oregonians
More than 74,000 Oregon adults (2.7% of all More than 74,000 Oregon adults (2.7% of all adults in the state) are believed to meet the adults in the state) are believed to meet the criteria for being criteria for being currentcurrent problem or problem or pathological gamblers (Moore, 2007)pathological gamblers (Moore, 2007)
1.3% of Oregon youth are problem 1.3% of Oregon youth are problem gamblers, and an additional 4.6% are at-risk gamblers, and an additional 4.6% are at-risk gamblers. That means there are between gamblers. That means there are between 1,100 and 6,300 adolescents with severe 1,100 and 6,300 adolescents with severe gambling-related difficulties (Volberg, 2007)gambling-related difficulties (Volberg, 2007)
More Casinos?More Casinos?
Oregon Gambling: SummarizedOregon Gambling: Summarized
Oregon has Oregon has moremore forms of legalized forms of legalized gambling and offers gambling and offers easiereasier access to access to gambling than almost any other stategambling than almost any other state
- AND - - AND - Oregon is a nationally recognized Oregon is a nationally recognized leaderleader
in prevention, harm reduction and in prevention, harm reduction and treatment for gambling problemstreatment for gambling problems
Source: National Ctr for the Study of Gambling, 2006
What is Gambling? What is Gambling? (G.A. Definition)(G.A. Definition)
Any betting or wagering, for self or others Any betting or wagering, for self or others whether for money or not, no matter how whether for money or not, no matter how slight or insignificant, where the outcome is slight or insignificant, where the outcome is uncertain or depends upon chance or “skill” uncertain or depends upon chance or “skill” constitutes gambling.constitutes gambling.
What is Gambling? What is Gambling? (A definition for clients)(A definition for clients)
Playing a game of chance or “skill” where Playing a game of chance or “skill” where money, or something of value, is placed at money, or something of value, is placed at risk based on the uncertain outcome of a risk based on the uncertain outcome of a future eventfuture event
ChanceChance, , SkillSkill, , MoneyMoney, , RiskRisk, , Uncertain Uncertain Future?Future?
What is Problem Gambling?What is Problem Gambling?
All patterns of gambling behavior that All patterns of gambling behavior that compromise, disrupt, or damage personal, compromise, disrupt, or damage personal, family, educational or vocational pursuitsfamily, educational or vocational pursuits
Pathological gambling is the most severe Pathological gambling is the most severe pattern of excessive or destructive pattern of excessive or destructive gamblinggambling
Pathological gamblingPathological gambling
Synonymous with “compulsive”, “addicted”, Synonymous with “compulsive”, “addicted”, “clinical”, “diagnosable” and “Level 3”“clinical”, “diagnosable” and “Level 3”
Classified in DSM-IV as an Impulse Control Classified in DSM-IV as an Impulse Control DisorderDisorder
Diagnostic criteria is similar to that of Diagnostic criteria is similar to that of Substance Abuse/DependenceSubstance Abuse/Dependence
DSM-IV Diagnostic Criteria for DSM-IV Diagnostic Criteria for Pathological GamblingPathological Gambling
Persistent and recurrent maladaptive Persistent and recurrent maladaptive gambling behavior as indicated by five or gambling behavior as indicated by five or more of the following:more of the following:
1)1) Is Is preoccupiedpreoccupied with gambling with gambling2)2) Needs to gamble with Needs to gamble with increasing amountsincreasing amounts of money of money
in order to achieve the desired excitementin order to achieve the desired excitement3)3) Has Has repeated unsuccessfulrepeated unsuccessful efforts to control, cut efforts to control, cut
down, or stop gamblingdown, or stop gambling4)4) Is Is restless or irritablerestless or irritable when attempting to cut down when attempting to cut down
or stop gamblingor stop gambling5)5) Gambles as a way of Gambles as a way of escaping escaping a problem or of a problem or of
relieving a dysphoric moodrelieving a dysphoric mood
DSM-IV Diagnostic Criteria for DSM-IV Diagnostic Criteria for Pathological Gambling cont.Pathological Gambling cont.
6) After losing money gambling, often returns another 6) After losing money gambling, often returns another day to get even (“day to get even (“chasingchasing” after one’s loses)” after one’s loses)
7) 7) LiesLies to family members, therapist, or others to to family members, therapist, or others to conceal the extent of involvement with gamblingconceal the extent of involvement with gambling
8) Has committed 8) Has committed illegal actsillegal acts, such as forgery, fraud, , such as forgery, fraud, theft, or embezzlement to finance gambling theft, or embezzlement to finance gambling
9) Has 9) Has jeopardized or lostjeopardized or lost a significant relationship, a significant relationship, job, or educational or career opportunity because job, or educational or career opportunity because of gamblingof gambling
10) 10) Relies on othersRelies on others to provide money to relieve a to provide money to relieve a desperate financial situation caused by gamblingdesperate financial situation caused by gambling
Pathological Gambling: Pathological Gambling: Comparison Comparison to Substance Abuseto Substance Abuse
–SimilaritiesSimilaritiesLoss of ControlLoss of ControlPreoccupationPreoccupationNegative impact on major life areasNegative impact on major life areasToleranceTolerance Immediate gratificationImmediate gratificationAgent used as avoidance tool (e.g., Agent used as avoidance tool (e.g.,
pain)pain)
Pathological Gambling: Pathological Gambling: Comparison Comparison to Substance Abuseto Substance Abuse
–SimilaritiesSimilaritiesWithdrawal SymptomsWithdrawal SymptomsSelf-help groupsSelf-help groupsBiopsychosocial/spiritual disordersBiopsychosocial/spiritual disordersFamily involvementFamily involvementUse of ritualsUse of rituals
Pathological Gambling: Pathological Gambling: Comparison Comparison to Substance Abuseto Substance Abuse
–DifferencesDifferencesGambling is not self-limitingGambling is not self-limitingBehavior not attributable to Behavior not attributable to
intoxication / chemical intoxication / chemical ingestioningestion
More intense sense of shame More intense sense of shame and guiltand guilt
Greater denial and stronger Greater denial and stronger defensesdefenses
Pathological Gambling: Pathological Gambling: Comparison Comparison to Substance Abuseto Substance Abuse
–DifferencesDifferencesUnpredictable outcomeUnpredictable outcomeFantasies of success /quitting is Fantasies of success /quitting is
giving up hopegiving up hopeNo biological testNo biological testEasier to hideEasier to hide
Indicators of problem Indicators of problem gamblinggambling
Increase in gambling time and placesIncrease in gambling time and places
Increase in size of bets Increase in size of bets
Increase in intensity of interest in gamblingIncrease in intensity of interest in gambling
Working up special occasions for gambling Working up special occasions for gambling
Boasting about wins; not talking about lossesBoasting about wins; not talking about losses
Exaggerated display of money and other Exaggerated display of money and other possessionspossessions
With teens, increase in computer useWith teens, increase in computer use
More IndicatorsMore Indicators Gambling when there is a crisisGambling when there is a crisis
Drop off in other activities/interestsDrop off in other activities/interests
Frequent absences from school, work and homeFrequent absences from school, work and home
Diversion of funds earmarked for other purposesDiversion of funds earmarked for other purposes
Hidden FundsHidden Funds
Personality changes (irritability/hostility/moodiness)Personality changes (irritability/hostility/moodiness)
Withdrawal from familyWithdrawal from family
Decline in school performanceDecline in school performance
New friends; isolation from old friendsNew friends; isolation from old friends
Missing possessions (may have been pawned)Missing possessions (may have been pawned)
Costs of problem gambling Costs of problem gambling 25 - 50 percent of spouses abused25 - 50 percent of spouses abused 10 to 17 percent of children neglected or 10 to 17 percent of children neglected or
abused abused FY 07-08 of 2,012 receiving treatment in FY 07-08 of 2,012 receiving treatment in
Oregon:Oregon:average gambling debt was $22,000 (underestimated) average gambling debt was $22,000 (underestimated) combined debt from gambling over $37 million; 99 combined debt from gambling over $37 million; 99
clients had debts of over $100,000clients had debts of over $100,00057% jeopardized or lost a significant relationship or job 57% jeopardized or lost a significant relationship or job 21% committed illegal acts to obtain gambling money21% committed illegal acts to obtain gambling money28% had alcohol problems; 12% drug problems28% had alcohol problems; 12% drug problems21% reported suicidal thoughts and 7% reported 21% reported suicidal thoughts and 7% reported
having having made an attemptmade an attempt
The More Problem Gamblers, the The More Problem Gamblers, the More Gambling Related CrimesMore Gambling Related Crimes
Moore & Marotta ( 2006). Moore & Marotta ( 2006). – 43% of women and 38% of men entering gambling 43% of women and 38% of men entering gambling
treatment reported to have committed an illegal act related treatment reported to have committed an illegal act related to their gambling.to their gambling.
National Gambling Impact Study Commission (1999).National Gambling Impact Study Commission (1999).– A third of problem and pathological gamblers had been A third of problem and pathological gamblers had been
arrested, compared to 10% of low-risk gamblers and 4% of arrested, compared to 10% of low-risk gamblers and 4% of non-gamblers non-gamblers
Samuel Hopkins, Pastor of First Samuel Hopkins, Pastor of First Congregational Church, Montpelier Congregational Church, Montpelier
Vermont on April 19, 1835Vermont on April 19, 1835 ““Let the gambler suffer this persecution. Lay Let the gambler suffer this persecution. Lay
upon him the biting lash of public odium. Let him upon him the biting lash of public odium. Let him be conscious that… he must bear the superadded be conscious that… he must bear the superadded curse of unrestrained abhorrence; that whatever curse of unrestrained abhorrence; that whatever else may be tolerated, there can be else may be tolerated, there can be nono tolerance tolerance and no and no ccourtesy for a vice so foul as his” (Hopkins ourtesy for a vice so foul as his” (Hopkins 1835:15). 1835:15).
StigmaStigma of PG remains today – a clinician of PG remains today – a clinician needs to understand the social stigma that needs to understand the social stigma that remains with this disorder. We are not far remains with this disorder. We are not far removed from Pastor Hopkins.removed from Pastor Hopkins.
Co-occurring DisordersCo-occurring Disorders
Substance use disorders:Substance use disorders: About 30% of About 30% of problem gamblers report a current substance problem gamblers report a current substance use disorder at intake.use disorder at intake.
Mood disorders:Mood disorders: About 50% of problem About 50% of problem gamblers report significant depression gamblers report significant depression symptoms at intake.symptoms at intake.
Suicide:Suicide: About 10 percent of pathological About 10 percent of pathological gamblers report frequent suicidal ideation at gamblers report frequent suicidal ideation at intake.intake.
Co-occurring Disorders (Continued) Co-occurring Disorders (Continued)
Personality Disorders:Personality Disorders: Problem gamblers Problem gamblers in the general population were over 6 times in the general population were over 6 times more likely to meet criteria for ASPD than more likely to meet criteria for ASPD than non-gamblers. Youth have a higher non-gamblers. Youth have a higher incidence of ODDincidence of ODD
Anxiety disorders:Anxiety disorders: 12 - 28% of treatment 12 - 28% of treatment seekers met criteria for an anxiety disorder.seekers met criteria for an anxiety disorder.
Irrational Ideas about Gambling Irrational Ideas about Gambling
Held by Some Gamblers.Held by Some Gamblers. 1. Gambling is an important human activity1. Gambling is an important human activity
2. Gambling is an easy way to earn money2. Gambling is an easy way to earn money
3. Those who do not gamble are stupid, slow or frightened3. Those who do not gamble are stupid, slow or frightened
4. Dedicated gamblers are usually bright and creative4. Dedicated gamblers are usually bright and creative
5. Gambling is healthy recreation5. Gambling is healthy recreation
6. My gambling is under control, or can be controlled with 6. My gambling is under control, or can be controlled with some effortsome effort
7. I do not have to quit; I can just cut down and ration my 7. I do not have to quit; I can just cut down and ration my gamblinggambling
8. I can win it back8. I can win it back
9. I’m smart; I have a system to beat the odds9. I’m smart; I have a system to beat the odds
10. People respect a heavy bettor10. People respect a heavy bettor
Irrational Ideas about Gambling Irrational Ideas about Gambling
Held by Some Gamblers.Held by Some Gamblers. 11. Someday I’ll score a really big win and quit with honor11. Someday I’ll score a really big win and quit with honor
12. Gambling will be the solution to my problems12. Gambling will be the solution to my problems
13. Expensive presents will make up for past 13. Expensive presents will make up for past disappointmentsdisappointments
14. Gambling makes me feel better14. Gambling makes me feel better
15. Money is my problem15. Money is my problem
16. I will pay it back16. I will pay it back
17. Borrowing to gamble is okay17. Borrowing to gamble is okay
18. Stealing to gamble isn’t really stealing18. Stealing to gamble isn’t really stealing
19. The more money I have to gamble with the more I can 19. The more money I have to gamble with the more I can winwin
20. Even if I only have a few bucks, I’m better off taking a 20. Even if I only have a few bucks, I’m better off taking a shot at winningshot at winning
Irrational Ideas about Gambling Irrational Ideas about Gambling
Held by Some Gamblers.Held by Some Gamblers. 21. Somebody will be there to bail me out if things go really wrong21. Somebody will be there to bail me out if things go really wrong
22. If only I knew why I gamble, I could stop22. If only I knew why I gamble, I could stop
23. Will power is the answer23. Will power is the answer
24. I always win in the long run24. I always win in the long run
25. I’m just a lucky person when I win and really just unlucky when I 25. I’m just a lucky person when I win and really just unlucky when I loselose
26. What’s the use, I can’t stop26. What’s the use, I can’t stop
27. Sometimes I think I am really two personalities, a gambler and a 27. Sometimes I think I am really two personalities, a gambler and a non-gamblernon-gambler
28. Suicide would solve all my gambling problems28. Suicide would solve all my gambling problems
29. I can’t afford to pay for treatment or take time off from work to 29. I can’t afford to pay for treatment or take time off from work to get helpget help
Irrational Ideas about Gambling Irrational Ideas about Gambling
Held by Some Gamblers.Held by Some Gamblers.
30. I have to make as much money as I can as 30. I have to make as much money as I can as quickly as I canquickly as I can
31. I am luckier than most people.31. I am luckier than most people.32. Gambling is a good way to forget about my 32. Gambling is a good way to forget about my
problems.problems.33.33.My gambling isn’t hurting anybodyMy gambling isn’t hurting anybody34.34.Gambling will solve my family’s problemsGambling will solve my family’s problems
[Adapted from “In the Shadow of Chance,” and Internet book [Adapted from “In the Shadow of Chance,” and Internet book by Julian I. Taber, 1998.]by Julian I. Taber, 1998.]
Problem Gambling Problem Gambling Screening ProceduresScreening Procedures
The Lie-Bet Questions:The Lie-Bet Questions:
1)1) Have you ever felt the need to bet more and Have you ever felt the need to bet more and more money?more money?
2)2) Have you ever had to lie to people important Have you ever had to lie to people important to you about how much you gambled?to you about how much you gambled?
If yes to one or both, further assessment If yes to one or both, further assessment is indicatedis indicated
Screening techniquesScreening techniques
Ask on intake about gamblingAsk on intake about gambling– Also ask during collateral contactsAlso ask during collateral contacts
Assess financial issues in familyAssess financial issues in family Ask “How often…” and “How much…”Ask “How often…” and “How much…” Ask about Leisure and recreational interestsAsk about Leisure and recreational interests Ask if parents or siblings gambleAsk if parents or siblings gamble
Gambling Treatment in OregonGambling Treatment in Oregon
Oregon has 27 outpatient gambling Oregon has 27 outpatient gambling treatment programstreatment programs
3 crisis-respite programs3 crisis-respite programs 1 residential treatment program1 residential treatment program Free TreatmentFree Treatment for gamblers and for gamblers and
family membersfamily members
Problem Gambling Help Line:Problem Gambling Help Line:Free and confidential; staffed by professional counselorsFree and confidential; staffed by professional counselors
Phone: 1 (877) MY LIMIT (1-877-695-4648)Phone: 1 (877) MY LIMIT (1-877-695-4648) 1(877)-2-STOP-NOW (1-877-278-6766)1(877)-2-STOP-NOW (1-877-278-6766)
Online: 1877mylimit.org (chat, IM, email)Online: 1877mylimit.org (chat, IM, email)
ConclusionsConclusions Problem gambling is a real and growing Problem gambling is a real and growing
concern concern Affects about 1 in 37 adults and 1 in 45 Affects about 1 in 37 adults and 1 in 45
youthyouth Help is available for gamblers and family Help is available for gamblers and family
membersmembers 81% of clients reported either no gambling 81% of clients reported either no gambling
or reduced gambling at 6-months post-or reduced gambling at 6-months post-treatmenttreatment
Treatment is Treatment is freefree, , confidentialconfidential and and effectiveeffective
