-
7/31/2019 Gambling Research Reveals - Issue 4, Volume 9 - April
/ May 2010
1/4
gambling
research
reveals
T Alrta Gaig Rarc
Ititut i a crtiu
t Uivriti Alrta,
Calgar, a Ltrig.
It riar ur i
t urt a rt
rarc it gaig agalig i t rvic.*
ourmission
T igifcatl irv
Alrta kwlg
w galig act cit
1
VoLUme 9 / IssUe 4ApRIL / mAy 2010
A Report on the Institutes9th Annual Conference on
GamblingResearch:Emergent Clinical Issues
in Problem GamblingApril 2010As has become tradition, the
Institutes annual conerence was hosted by The Ban
Centre in Ban, Alberta rom April 8th to 10th, 2010. The Centres
frst-class acilitie
and awe-inspiring mountain location were enjoyed by all despite
the rather sudden
arrival o a spring snowstorm. Conerence organizers, Dr. David
Hodgins and Ms. Vicki
Williams, arranged a diverse and distinguished group o experts
to present research
fndings to the 80+ people in attendance. In addition to
traditional plenary sessions
this years event introduced a number o exciting modifcations to
the conerence
ormat. These included a pre-conerence symposium on womens
problem gambling
concurrent sessions eaturing longitudinal studies and invited
participant papers
a debate on how gambling problems are conceptualized, and a
banquet to celebrat
the Institutes 10th anniversary.
The South Australian StatewideGambling Therapy Service:Exposure
as the Model ofTherapy
Prior to discussing his exposure model
o therapy or problem gamblers, Dr.
Malcolm Battersby o Flinders University
provided background about the gam-
bling environment in his home city o
Adelaide, South Australia. Adelaide is by
ar the states largest and most populous
city and home to one major casino and
hundreds o smaller electronic gaming
machine (EGM) venues. Taxation o gam-
ing machine revenue generates roughly
$300-million or the state governments
coers and studies indicate that about
2-3% o the population is aected by
problem gambling.Dr. Malcolm Battersby
-
7/31/2019 Gambling Research Reveals - Issue 4, Volume 9 - April
/ May 2010
2/4
2
The exposure treatment model used at the South Australian
Gambling Therapy
Service is based on an anxiety disorder principal. The model
itsel has developed and been
continually refned over the past ourteen years. Battersby
explained that it seeks to
identiy internal and external triggers (e.g., money, bills) that
lead to gambling arousa
(e.g., excitement, increase in heart rate, sweating) and then to
actual gambling
activity. Once a problem gamblers triggers are identifed, the
goal o the treatment pro
gram is to de-link and extinguish the gambling urge using
repeated reinorcemen
techniques. Exposure treatment itsel is graded or problem
gamblers and begins mildl
(e.g., showing the gambler a picture o a gaming machine) and
then gradually progress
es to real-world scenarios involving, or example, taking the
gambler inside a gambling
venue with a small amount o money.
Since its inception as a statewide service in 2007, the program
has grown to the point
where it is now treating about 500 people per year. The clients
served have been
predominantly people rom lower socio-economic backgrounds who
have oten had a
gambling problem or fve years or more. Sel-rated outcomes rom
individuals who took par
in therapy show signifcant reductions in overall levels o
gambling and declines in both
urges to gamble and comorbid behaviour. A ormal evaluation o
outcomes was also un
dertaken with 127 persons who had received treatment.
Individuals retained in treat
ment (60% o whom completed six months or more) showed much
better outcome
than those who dropped out. One unexpected fnding rom the study
was that people
regularly reported cognitive changes in how they perceive
gambling despite not havin
any ormal cognitive therapy.
In concluding, Battersby recognized that, It could be seen as
counterintuitive to bring
someone up to a gaming machine and have them sit in ront o it
with credits on the
machine and then not gamble. Despite his concern that the
exposure-based mode
o problem gambling treatment is unpopular with those who equate
it to taunting the
devil, his experience leads him to believe that, The urge to
gamble is actually increased by
[gambling] avoidance and that, over time, the urge to gamble can
be lowered with
exposure treatment.
Conference presentations are available from
http://dspace.ucalgary.ca/handle/1880/47796
Internet-based Treatment for Problem Gamblers
Internet-based treatment or problem gambling was the ocus o two
separate presenta
tions at this years conerence. Ms. Sally Gainsbury (nee
Monaghan) o Southern Cros
University presented an inormative overview o existing evidence
and models while
Mr. Thomas Nilsson rom Swedens Spelinstitutet described lessons
learned over the fv
years his centre has oered online treatment options.
The two main types o online treatments identifed by Gainsbury
rom her reviewwere Internet therapies and online interventions.
Internet therapies (e.g., GamAid
Finlands Addiction Link) incorporate techniques that use the
Internet as a medium
to oer therapy. Examples o specifc treatment resources included
on these types o
website are sel-paced treatment materials, access to trained
therapists, and exercises tha
incorporate automated-response eedback. Contact with therapists
happens via email
telephone, discussion orum, video conerencing, or through some
combination o th
above. Gainsbury pointed out that there is a growing body o
evidence demonstratin
that Internet therapies are eective in treating
substance-related problems like smoking
and alcohol abuse.
Ms. Sally Gainsbury (nee Monaghan)
The two main types
o online treatments
identifed by
Gainsbury rom
her review were
Internet therapies
and online
interventions.
-
7/31/2019 Gambling Research Reveals - Issue 4, Volume 9 - April
/ May 2010
3/4
3
Online interventions (e.g., Know the Score,
CheckYourGambling.net) are also becoming
increasingly available or the treatment o problem gambling. They
dier rom Internet
therapies in that the ocus is on sel-help. Website visitors are
normally oered a choice
o identiying themselves through registration or anonymous
participation. Once ques-
tions relevant to a persons gambling behaviour are answered,
clients receive an automat
ed report that provides an indicator o where they ft in
comparison to the population
as a whole. Otentimes, website users are also provided with
normative eedback, content
tailored to their personal situation, and a suite o tools and
educative exercises based
upon their earlier responses. When someone enters a treatment
program, it is importan
that they be directed to the rightplace or them which makes
tailoring helpul in keeping
people on a program, said Gainsbury. She noted that online
interventions now do this
automatically by making use o computer algorithms which also
makes them an eective
adjunct to treatment.
In his presentation, Thomas Nilsson described Spelinstitutets
problem gambling treat-
ment program which combines elements o both Internet therapy and
an online interven-
tion. The program originated through Nilssons interest in
creating a sel-help book or
problem gamblers based on motivational interviewing techniques
and sel-help manuals
(e.g.,Becoming a Winnermanual by David Hodgins & Karyn
Makarchuk). Nilsson adapted
his sel-help program or the Internet ater being inspired by
positive research results
rom studies on Internet treatment that were undertaken by Dr.
Per Carlbring at Swendens
Linkping University.
Swedes in Sweden and living abroad interested in receiving
assistance rom the Spelinsti
tutet website are directed to it though online advertisements,
reerrals rom the Swedish
gambling help telephone line, and links rom Internet gambling
sites. Once there, visitors
are screened using 115 questions to determine i treatment is
suitable or them. Nilsson
indicated that, though the number o questions appears onerous,
he has ound that,
When people are motivated to seeking help they dont have a
problem going through
the screening instruments. I people decide to then pursue
treatment, they are oered
a program o eight weekly modules delivered online with available
telephone support
The frst and longest module involves a 40-60 minute telephone
session with a clinician to
develop alternative strategies or lie goals. At this time, a
client also determines i his/
her personal goal involves reducing gambling or abstaining
altogether. Results o treat-
ment have been promising as clients completing the program show
signifcantly reduced
scores on all gambling screening measures.
In her summary o uture directions or Internet-based problem
gambling treatment,
Gainsbury reported that there are implementation issues that
still need to be resolved
in order to enhance outcomes. Examples o these issues include an
understanding that
online treatment is unsuitable or some individuals, potential
clients are oten unawarethat this orm o treatment exists, and that
treatment attrition remains a stumbling block.
Likewise, Nilsson touched upon similar implementation challenges
when talking about
his program and also discussed how they were addressed. Both
Gainsbury and Nilsson
stated that individuals now have an expectation that treatment
services will be oered
online and that many actually preer that option. They also
cautioned that, while online
programs are not or everyone, they are certainly eective or
individuals who might not
otherwise seek help or who are unable to access in-person
treatment.
Conference presentations are available from
http://dspace.ucalgary.ca/handle/1880/47796
Nilsson adapted his
sel-help programor the Internet
ater being inspired
by positive research
results rom studies
on Internet treatment
that were undertaken
by Dr. Per Carlbring at
Swendens Linkping
University.
Thomas Nilsson
-
7/31/2019 Gambling Research Reveals - Issue 4, Volume 9 - April
/ May 2010
4/4
4
ALbeRTA GAmInG ReseARChInsTITUTe boARd o dIReCToRs
Dr. Nady el-Guebaly, Chair,University o Calgary
Dr. Daniel Weeks,University o Lethbridge
Dr. Douglas West,University o Alberta
Dr. Chris Hosgood,University o Lethbridge
Mrs. Sheila Murphy,Public Member
Dr. Erin Gibbs Van Brunschot,University o Calgary
Dr. Renee Elio,University o Alberta
exeCUTIVe dIReCToR
Vickii Williams([email protected])
node CooRdInAToRs
University o Alberta:Dr. Garry
Smith([email protected])
University o Calgary:Dr. David Hodgins([email protected])
University o Lethbridge:Dr. Robert
Williams([email protected])
InsTITUTe LIbRARIAn
Rhys Stevens([email protected])
Your comments and queries are welcome
either by e-mail: [email protected]
phone: 780.492.2856
Rhys Stevens Writer
Vickii Williams Editor
Epigrafx Design/Layout
Media queries 780.492.2856
* The Institute is unded by the Albertagovernment through the
Alberta Lottery
Fund.
ISSN 1499-2647
AGRI 2010
Banquet Recognizes InstitutesDecade of Achievement
Banquet participants were treated to a series o
brie speeches highlighting the Institutes major
achievements over the frst decade o itsexistence. Board Chair
Dr. Nady el-Guebaly
recognized Mrs. Sheila Murphy or her dedica-
tion to the Institute Board and then introduced
Mr. Gerry McLennan, CEO o the Alberta Gaming
and Liquor Commission (AGLC) Mr. McLennan acknowledged the
contribution o the Insti
tutes research to his organizations work and afrmed his ull
support or a continuin
partnership.
The fnal speaker at the banquet was longtime gambling research
pionee
Dr. Garry Smith o the University o Albertas Faculty o Extension.
Dr. Smith explained
the genesis o the Institute and detailed the involvement o
certain oundationa
individuals whose behind-the-scenes work resulted in its
ormation. He also discussedseveral key individuals afliated with
the Alberta Gaming Research Institute and
recognized their unique characteristics and attributes which he
elt were pivotal in
contributing to the Institutes overall record o research
success.
Pre-conference Symposium: Understanding Women Problem
Gamblers
On Thursday, April 8th, one day prior to the start o the main
conerence, a group
o approximately 25 people were involved in a symposium entitled
Behind the Mask
Understanding Women Problem Gamblers. This event was organized
by Dr. Nolla Piquette
Tomei o the University o Lethbridge and brought together
researchers, practitioners, and
students to discuss the clinical issues regarding women problem
gamblers.
The symposium morning session eatured presentations by Dr.
Piquette-Tomei Femaleproblem gamblers: Context and considerations,
Dr. Rob Williams Characteristics o Cana
dian emale gamblers: A comparative overview, Dr. David Hodgins A
Brie Introduction to
Gambling Interventions, Mr. Rhys Stevens Strategior locating
research resources related
to problem gambling and Dr. Matt Tata In search o the neural
correlates o gambling
Evidence rom human neuroimaging. In the aternoon, participants
broke into smal
groups to acilitate uture planning and potential research
partnership opportunities.
Award Recipients for Best OralPresentation and Poster
This year there was an award presented or
both the best participant paper oral presen-tation as well as or
best research poster.
Congratulations to Ph.D. Student Ms. Terri-
Lynn MacKay rom the University o Calgary
who presented her paper entitled Cognitive
Distortions as a Major Risk Factor in Online
Gambling as well as Dr. Jennier Buckle rom
Sir Wilred Grenell College, Memorial Uni-
versity o Newoundland or her poster en-
titled Personality actors associated with
gambling behaviour in university students.
Dr. Garry Smith
Terri-Lynn MacKay receives award.
