Prevention of Problem Gambling: Addressing Special Populations Jim Wuelfing Owner and Principle...

Prevention of Problem Gambling: Addressing Special Populations

Jim WuelfingOwner and Principle AssociateThe New England CenterJim.Wuelfing@gmail.com

2014 Prevention and Recovery ConferenceInspiration. Connection. Motivation.

Oklahoma City, Oklahoma

Have your prevention work based in tested theory, research and data

Use a tested prevention planning model Using multiple strategies over multiple

domains Use evidenced-based strategies Reduce risk and enhance protective factors Utilizing best practices

Assessment Capacity Building Planning Implementation Evaluation All under the umbrella of cultural

competence and sustainability

Information Dissemination

Prevention Education

Alternative Activities

Community-Based Processes

Environmental Approaches

Problem Identification and Referral

Individual Peer Family School/work Community Society/environmental

Protective factors – Factors that decrease the chances of someone (or a community) developing health and behavioral problems are called protective factors. Having multiple protective factors can override risk factors.

Risk factors - Factors that increase the chances of someone developing health and behavior problems are called risk factors. Individuals, families and communities which possess these factors are considered at risk. Those that possess several are considered high risk.

The next thirteen slides are taken from the research of:

Dr. Robert WilliamsProfessor, Faculty of Health

Sciences Coordinator, Alberta Gaming

Research InstituteUniversity of Lethbridge;

Lethbridge, Alberta

Young Age (18 – 25) Young people engage in high-risk behavior more than

other age groups Today’s is the first generation in many years to be

raised with legal gambling widely available.

Males Males tend to take more risks than females

Started gambling at an early age

Friends that gamble

Parents that are heavy or problem gamblers PGs 3–8 times more likely to have parent, brother, or

sister with a gambling problem.

Having an early big win at gambling Most problem gamblers had the misfortune of

experiencing a big win when they first started playing.

Playing rapid forms of gambling with a high frequency of betting and reinforcement

EGMs, table games

Availability of gambling opportunities Related to legality and/or proximity

Societal acceptance of gambling

Race/Ethnicity Indigenous people Asian ancestry

Reasons for Gambling To escape To win money

Importance of Money as a measure of ‘success’ as a way to solve problems

Gambling Fallacies Not understanding how gambling works or having

erroneous beliefs about how gambling works

Impulsivity ADHD and risk-taking tendencies also related

Mental Health Problems Particularly Mood Disorders and Anxiety Disorders

Having other addictions Majority of problem gamblers are smokers High rates of co-morbid alcoholism and drug abuse

1. You are born with biological propensities that increase or decrease your susceptibility of engaging in gambling and/or developing problem gambling.

Self-controlled ↔↔ Impulsive

Risk aversive ↔↔ Risk seeking

No predisposition to addiction ↔↔ Predisposition to

addictionNo predisposition to mental

health problems ↔↔ Predisposition to mental health problems

2. These propensities shaped by environmental experience to either further increase or decrease risk.

Nurturing/Disciplined upbringing ↔↔ Abusive/Neglectful upbringing

Parental nongambling ↔↔ Parental gambling

Peer group nongambling ↔↔ Peer group gambling

Societal nonacceptance of gambling ↔↔ Societal acceptance of gambling

Gambling not readily available ↔↔ Gambling readily available

High income ↔↔ Low income

Safe provision of gambling ↔↔ Unsafe provision of gambling

Low stress & high support ↔↔ High stress & low support

3. Continued involvement influenced by biological propensities and environmental experience, combined with psychological makeup and early learning.

Lack of knowledge about gambling

Gambling fallacies

Gambling serving a psychological need

Positive/Rewarding early gambling experiences

5. Whether the behaviour remits or the person progresses to problem gambling depends on the:

Strength of biological propensities + environmental experience + psychological make-up + early learning + and behavioural conditioning

RELATIVE TO

Strength of the negative consequences person begins to experience

Substance Abuse

Antisocial Behaviour

School/Work

Problems

Problem Gambling

Psychological Problems

(depression, anxiety, low self-esteem, poor decision making skills,

poor coping skills)

Poor Health Practices

Interpersonal Problems

People who progress to problem gambling will usually have many associated comorbidities.

Substance Moderation or

Abstinence

Prosocial Behaviour

Positive School/Wo

rk Functionin

g

Non Problem Gambling

Good Psychological

Health (positive self-esteem,

achievement motivation, good decision making skills,

good coping skills)

Good Health Practises

Good social skills and

social support

Similarly, people who do not become problem gamblers often have many associated ‘strengths’.

What are some of the ways that students gamble?

What is the legal age for sports betting in Oklahoma? 18? 21? Other?

What is the legal age to buy scratch tickets or play the lottery in Oklahoma? 16? 18? 21? Other?

What is the legal age for playing cards for money in your home Oklahoma? 16? 18? 21? Other?

Gambling in an increasing phenomena and warrants attention and concern

Gambling at a casino has become a new rite of passage for many students turning 21

Most youth learn to gamble from their parents with an average age of onset of 11.5 years

There is a belief that as gambling becomes more accessible and convenient for teens and young adults, problems will increase

Gambling problems among teens and young adults can remain hidden for a long time, and many school faculty, coaches, and staff are not asking questions of students that might surface these problems

Students gamble for a variety of reasons. Those cited most often include: seeking excitement, a rush, a high…and to

decrease boredom the powerful influence of advertising and

television parental influence and role models teacher/environmental influence and role

models

Parental gambling can lead to serious problems for younger children who are neglected when one or both parents gamble

Gambling by students is common and has led to negative consequences for over 5% of 12th graders

Gambling risk behavior is associated with other risky behavior

There is nearly universal consensus about the need for prevention efforts to prevent future problems. Some respondents to surveys also identified the need for expanded services for youth affected by gambling problems in schools and youth groups.

Other ideas focus on reducing gambling advertising, creating a “higher profile of gambling problems” within local communities as they occur, and to increase the availability of healthy and positive activities for youth so they would not feel bored and be as attracted to gambling

Gender (male) Age (initiation and

game) Substance use Anti-social behavior Parental gambling Depression

Male Competitive Intelligent Risk takers High energy Good students

With part time jobs Popular Usually participates

in athletics Many times children

of substance abusers or gamblers

Little research data on prevalence and consequence.

Anecdotal accounts suggest increasing number of teens/young adults in trouble with gambling. Increasing calls to gambling help lines regarding

teen/young adult gambling Reports of unmanageable debt, problems in school,

violence and resorting to criminal activity to pay debts

Need to be careful not to pathologize a fad, yet recognize that: Although most teens/young adults will not develop

gambling problems, the sheer numbers of those playing will increase the numbers of those needing help.

Poker, like other forms of gambling, carries some degree of personal risk and can lead to a range of negative consequences.

Studies show that students who gamble are more likely to engage in a number of high risk behaviors.

Estimated 6000+ sites and growing daily Estimated 35+ billion dollars in revenue >70% of worldwide Internet gambling

coming from U.S. bettors Illegal in the United States but confusion

around players or sites Available 24/7

Needs credit card or account to play Losses charged to credit card Wins credited to credit card, cashier

check or accounts

Ready access to credit (if over 18) Little awareness of credit issues Computer literacy 24/7 availability Among the highest addiction rates Internet gambling often comes in low

on a list of gambling activities yet high in terms of problems associated with it.

Debt and credit card problems Interpersonal conflict and anger surrounding

lost/owed money Violence (dating violence and violence around debt

collection) Losing and chasing losses Magical and “quick fix” mentality Progression

Frequency of gambling Amount of money Form of gambling

Negative consequences Limited circle of friends, loss of friendships Family conflict School problems (truancy, slipping academic

performance, policy violations) Lying Stealing Loss of self-esteem Depression and suicidality

Adolescent brain development Students who show:

Impulsivity Poor concentration Hyperactivity A need for excitement and risk taking Involvement in other risk behaviors such

as alcohol, tobacco and other drugs

At-risk for a substance abuse problem Having a parent, sibling, relative, friend,

or significant person with either a gambling problem or substance use problem

Having or knowing peers with substance use problems is a risk correlate of youth problem gambling

Anxiety High risk propensity Low perception of risk regarding problem

gambling Early onset of gambling behaviourYOUTH GAMBLING PROBLEMS: THE IDENTIFICATION OF RISK AND PROTECTIVE FACTORS::Report to the Ontario Problem

Gambling Research Centre: Laurie Dickson, M.A.Jeffrey L. Derevensky, Ph.D., Rina Gupta, Ph.D.

Child of a compulsive gambler

Belief that skill is involved

An early big win Feeling that one

must chase gambling loss with more gambling

Early age of onset (8.5 years for pathological gamblers; 11.5 years for non-pathological gamblers)

Large first bets Otherwise addicted

A relationship with a caring adult role model

Having an opportunity to contribute and be seen as a resource

Effectiveness in work, play and relationships

Healthy expectations and a positive outlook

Self-esteem and an internal locus of control

Self-discipline Problem solving and

critical thinking skills A sense of humor

Family connectedness Designing school-based prevention

programs that seek to develop student’s attachment, trust, and identification with larger groups (e.g., school clubs and sports teams, Scouts or Guides).

YOUTH GAMBLING PROBLEMS: THE IDENTIFICATION OF RISK AND PROTECTIVE FACTORS:: Report to the Ontario Problem Gambling Research Centre: Laurie Dickson, M.A.Jeffrey L. Derevensky, Ph.D., Rina Gupta, Ph.D.

For fun or recreation, never for financial gain

Knowledge that over time nearly everyone loses

Socially with family and friends, not alone

Limited time – frequency and duration

With predetermined limits for losses

Acknowledging that knowing a lot does not make you a better gambler

Always bet with a predetermined amount of money to be lost

Never borrow money to gamble Never gamble illegally Know your personal risk factors Know where to get help Be willing to help others

Gambling is not a risk-free activity. The choice to abstain from gambling as a

regular practice is a legitimate choice that many people make.

We do not want you to gamble illegally ever. If you still choose to gamble, we want you to

know enough about gambling so that you can lower your risk of gambling problems.

CAPS (Creative Activities in Probability and Statistics)

Based on research that showed High rates of incidence and prevalence in

students Critical thinking skills are a protective

factor in the development of addictive disorders

A connection between gambling behavior and knowledge of math

Kinesthetic learning often aids in retention

Twelve Activities

Deal or No Deal Basketball Court Cover-up Target Ball Shoot and Score Parachute Yahtzee Liar’s Dice

Number Mania Ice Cream

Adventure Who Won It? Lifeopoly Delta Three Scavenger Hunt

Examples

Basketball Court Cover-up M&M’s cover a

picture, the pictures cover a newspaper page, the newspaper pages cover a basketball court all in an effort to understand large numbers

Ice Cream Adventure Three flavors of ice

cream, four toppings, five sauces; a delicious exercise in counting possibilities

CAPS Example

Lifeopoly A life-sized board

game where students discover an understanding of number sense, risk and critical thinking

CAPS Example

Parachute Yahtzee Play the games in

teams with large dice and a parachute to demonstrate number sense and predictions

Teens About Gambling (T.A.G.)

Youth empowerment model employed Did own research on youth gambling Attended trainings Developed own vision and mission

statements Developed video and training

curriculum.

T.A.G. Vision and Mission

Vision Statement

We envision a Massachusetts where all teens are empowered to make responsible gambling decisions thus reducing the negative consequences to themselves, their families, and the community.

T.A.G. Vision and Mission

Mission Statement Teens About Gambling (TAG) seeks to

accomplish its vision by: Raising awareness about problem gambling. Providing information and skill development

that supports responsible decision making. Providing resource information. Empowering other teen groups to do the

same.

Evidenced-based curriculum for the prevention of problem gambling among teens and young adults.

Created by Robert Williams, Ph.D., Alberta Gaming Research Institute and Robert Wood, Ph.D., University of Lethbridge, Alberta

Teaches young people to approach life as smart risk-takers, weighing the pros and cons of their actions to determine the odds of achieving positive results.

Teach young people the facts about gambling and related risks.

Encourage responsible decision making.

Prevent young people from becoming problem gamblers.

Six multi-media 35-45 minutes sessions Session 1-3 focus specifically on

gambling Sessions 4-5 more generally about risk

and decision making Session 6 is a booster session designed

to help students retain knowledge and skills learned. It should be delivered a few weeks after the first five sessions

“College Class President Charged in Bank

Robbery”

“Police say 19-year-old Lehigh University student admitted the crime”

0

2

4

6

8

10

12

14

16

% of post-secondarystudents gambling

each week

2002

2005

Annenberg Public Policy Center 2002

0

5

10

15

20

25

30

2002 2005

% FemaleStudents

% MaleStudents

72% of student of all student athletes have gambled at least once since entering collegeOne in 20 male student athletes admitted:• providing inside information for gambling

purposes• betting on a game in which they

participated, or• accepting money for performing poorly in a

gameStudent athletes who gambled on sports with bookies gambled an average of $225 per month

Cross & Vollano, University of Michigan

4.1%

5.6%

2.3%1.2%

0%

2%

4%

6%

Adolescent College General Adult Pop. Elderly

Carlson & Moore, 1998; Shaffer & Hall, 2001; Moore, 2001; Volberg, 2001

Rate of problem gambling among college students is about 5.6 percent

About 15 percent of college students are at risk for developing gambling problems

Shaffer & Hall 2001

Increased Availability Increased Accessibility Increased Acceptability Increased Marketing

Casino Gambling Online Gambling Sports Betting State Lottery

The casino “that never sleeps” supports its customers 24/7

About 30% of U.S. college students will gamble on sports this year (NCPG)

Only a few states where sports wagering is legal

More than 5,000 Internet casinos All offshore Challenges

Not much oversight Difficult to monitor use Open 24 hours

Among college problem gamblers, significantly greater: tobacco, alcohol, and marijuana use binge drinking number of negative outcomes from

drug and alcohol use binge eating and efforts at weight

control

Engwall & Steinberg, 2003

College Athlete Outreach and Training Research indicates that college students are a

high risk group and student athletes are a particular high risk subgroup.

NCAA regulations support addressing the issue. Local campus needs assessment supplied data

and direction for one hour training curriculum development

Training for athletes and coaches Added FBI video Evaluation of program shows promise.

Focus on Older Adults

Gambling in older populations is on the rise The percentage of older Americans who gamble has

doubled in the past 25 years Older adults are aggressively targeted by the gambling

industry Sometimes gambling problems can be hidden for a long

time.

Many older adults do not understand addictions

Older adults may be drawn to gambling to fill their time or to be with other people

Older adults who have gambled away their pensions and savings may have little chance of getting their money back.

Older adults may be more likely to hide their gambling because of the stigma associated with it.

Many older adults have suffered some type of loss such as the death of loved ones or isolation from family and friends; gambling may help fill that loss

Some older adults may have cognitive impairment that interferes with decision-making

Many older adults have limited funds and may see gambling as a way to supplement their finances

Older adult/loved ones may not be aware gambling can be a problem

Shame/ embarrassment attached to stigma May be unwilling to give up their main

entertainment activity Information about problem gambling not

readily available, smaller social circle means less people who may recognize a problem in behavior

Withdrawal from family and friends

Gambling with money meant for other necessities

Gambling on credit Missing personal or

household items Borrowing from family

and friends

Gambling alone Already struggling

with some form of addiction

Lying about or hiding gambling

Only talks about wins, not losses

Betting more than he/she can afford to lose

Recent loss of spouse/partner or friends Retirement Isolation Depression Dementia or other cognitive impairments Chronic illness Financial worries Ease of access to lottery tickets, bingo, and casinos

“Bait and Hook” Staff training “Making the Most of Your Leisure Time”

Any additional questions or comments?