Strategies For Addressing Behavioral and Financial Issues Related to Problem Gambling in Treatment

Gina HuttoEsther Maddux

Handouts

• 2 case studies– Jack and Jill (will be used to demonstrate PEFT scan)– The High Cost of Client Secrets (will be used to demonstrate financial

consequences)• The Departments of Life• Composition of the Metaphysical Self• PEFT Scan• A Chart of Compulsive Gambling and Recovery• Financial worksheets

– Net Worth Statement– Paycheck Planning– Debts/Liabilities

Entering Treatment• Entering Treatment

– Who is client? Person with problem; significant other– What is client’s role in family?– Presenting issues at entry to treatment process

• Primary situation leading to mandate - is gambling primary or secondary disorder3? • Role of gambling in client’s life

– Source of income as one’s profession – Social or recreational activity

– Is treatment mandated by someone such as court, hospital, family member or did client voluntarily enter?

– Source of funds for payment• State funds (varies by state and types of gambling in state)• Insurance• Self-Pay

Two Issues in Treatment

• Formation of Behavioral Structuring– Client– Significant others

• Financial status– Income – Expenses

Purpose of Treatment Interventions

• Image situation to sort out specific problem areas related to– Formation of behavioral functioning– Financial issues manifesting as a result of the

formation of behavioral functioning

Imaging Personal Behavior in Relation to How We Use Money

• Managing the self in relation to how we use money– Behavior Scan - Image how we organize the self– Financial Scan – Image how we use money

Imaging Personal Behavior in Relation to How We Use Money

• Dimensions of observation– Who is the client? –

• Person with gambling problem• Persons impacted by the person with the gambling problem (significant other,

family members, friends, employer)– What is the diagnostic impression – mild, moderate, severe (DSM V)? – What level of treatment is indicated - .5, 1, 2.1, 2.5 (ASAM 2013 Level)? – Where is treatment available? – in Georgia, outside Georgia (for higher

levels of care)– How does the counselor assess the metaphysical and financial functioning

formation of the client and/or significant other?– How does the client view the metaphysical and financial functioning

formation of the self or significant other?– How do the significant others view the metaphysical and financial

functioning formation of the self or the problem gambler?

Imaging Personal Behavior in Relation to How We Use Money

• Roles of counselor– Establish trust with client– Establish image of functioning pattern of client– Present image of functioning pattern to client– Choose and use appropriate tools and techniques

• to facilitate guiding the client in evolving his or her personal capacity – to release self-defeating behavioral formation – to replace with life-enhancing behavioral formation when

responding to life opportunities

Imaging Personal Behavior in Relation to How We Use Money

• Managing the self in relation to how we use money– Behavior Scan - Image how we organize the self– Financial Scan – Image how we use money

Imaging Personal Behavior in Relation to How We Use Money

• Managing the self in relation to how we use money– Behavior Scan - Image how we organize the self

• Family Genogram – Role in family of origin– Role in current environment

• The Departments of Life• Composition of the Metaphysical Self• PEFT Scan

– We pass along behavior patterns just as we pass along a money inheritance.

– What is the dominant functioning pattern the client and the significant other is expressing?

Behavior ScanThe Departments of Life

Behavior ScanComposition of the Metaphysical Self

• How we form self when relating to people,places, and things including money

– The healthy self• Focus attention within • Connect to creative source within/Join with

others• Manage Character Operating System• Distribute Energy• Activate Energy• Meet needs in a way that is satisfactory to all involved

Behavior ScanPEFT Scan

• Observe – Observe where presence, power, and energy are

expressed in a financial transaction• Where naturally reside• Where placed

– Identify the components of a financial transaction– Observe distribution and activation pattern to

determine whose power and energy is active in each component of the transaction• Within the individual • When interacting with others

Behavior ScanPEFT Scan (Cont)

• Assess– Where each person’s presence is active in the transaction

• Balanced – both parties are consciously engaged from beginning to end of transaction

• Imbalanced – act separately in transaction (isolate); crossover and cover

– Focus of attention – I/You; We– Belief system in operation – reality, illusion, delusion– Level of consciousness of presence that is activating – conscious

ownership or transfer; unconscious interference or deference– Connection of presence, power, and energy

• Include/exclude; allow/deny; attach/detach; congruence/discord

Behavior ScanPEFT (Cont.)

• Assess– Intensity of exchange

• With ease, gentle but firm, with force, with excessive force (physical force , non-physical force and/or both)

– Timeline of exchange or deal• At what point in transaction does exchange of presence occur

– Quality of outcome• Healthy inclusion and exclusion

– Each person’s opinion is expressed, valued, considered, and included from beginning to end of transaction

• Unhealthy exchange (behavioral mutation)– Separation/Enmeshment (crosses over and covers)

The Progression Downward or Upward

• A Chart of Compulsive Gambling and Recovery• http://www.lostbet.com/images/

gambling_charts1.gif

A Chart of Compulsive Gambling and Recovery

• The Chart of Compulsive Gambling and Recovery may be found at this website:– http://www.lostbet.com/images/gambling_charts

1.gif

Treatment Strategies

• Develop new way of living– Hope – there can be better life outcomes– Accept and activate ownership of creation of what

one does from beginning to end of transactions one step at a time• In all departments of life including money

Imaging Personal Behavior in Relation to How We Use Money

– Financial Scan – Image how we use money• The Money Departments

– Net worth worksheet – the amount of money we have at any point in time

– Paycheck planning – the amount of money we have coming in and going out

– Debts/liabilities – the amount of money we owe, how much, when due

The Financial Dilemma

• When do financial issues need to be addressed– Reality – action has to be taken to pay bills; someone has to pay

them or client will not have access to that resource– If client is not able to pay the bills (institutionalized or

incarcerated); who will pay them until client can– Assets need to be protected so they are not unnecessarily depleted

• Who will address financial issues• When is client ready to address financial issues

– Healing process begins when client begins to take ownership for filling own needs from beginning to end of transactions rather than bargaining with someone else to do it or relying on old behavior (gambling) as the solution for finding the way out

Financial Scan

• Tools for Conducting Financial Scan– Net Worth Statement: Assets - Liabilities– Cash Flow Statement: Income – Outgo– Debt/Liabilities Inventory

The Money Departments

• Communication about money• Legal Issues• Financial records• Cash flow – income and outgo• Credit and Debt• Insurance• Savings/Investment Assets/Retirement Plan• Taxes• Estate plan

Financial Scan

• Communications about money– Lies– Secrets

Financial Scan

• Legal issues– Law of Nature and Law of Land

• When law of nature is violated and there is harm to self or others, law of land becomes involved

– If incarcerated or institutionalized, who has authority to act on behalf of client if client is not allowed to act for self• Personal representative appointed by court• Power of attorney for health care• Power of attorney for finances• Living will• How are tasks completed if there is no advance directive?

Financial Scan

• Legal Issues– Types that may occur• Theft• Embezzlement• Writing bad checks• Prostitution to pay for habit• Bankruptcy

Financial Records

• Where are all financial documents located?

Financial Scan

• Cash flow – income and outgo• Problem symptoms– Always short of money even if good income– Disappearance of cash– Where is the stash

Financial Scan• Income – Work related issues

– Missing work, coming in late, leaving early– Takes long lunches and breaks– Fails to finish projects properly or on time– Takes excessive interest in office pools– Borrows money from coworkers– Heavy telephone use not related to work– Uses sick days when not sick– Makes or takes gambling calls while at work– Uses computer at work to gamble– Asks for advances in pay– Caught stealing or embezzling– Takes cash advances with company credit card

Financial Scan

• Credit and Debt– Overdue; unpaid bills– Cash advances from credit cards– Home equity loans– Increase in number of active credit cards; only able to pay

minimum due or not enough money to make payments– Payday loans, loans from friends or relatives or other

entities– Bill collectors are calling, or property is being repossessed– Credit may be denied

Financial Scan

• Credit and Debt– Have the client get a copy of the credit report for

each family member including children– https://www.annualcreditreport.com/index.action– Tool for setting up debt repayment plan

• https://powerpay.org/

– Credit Counseling • http://www.nfcc.org or 1-800-388-2227• www.gamblersanonymous.org or 1-626-960-3500

– GA or Gamanon

Financial Scan

• Insurance– If there is no health insurance; if hospitalized, how

will medical bills be paid; will assets have to be depleted; which ones and in which order

– Life insurance – who owns• Term - no cash value; has death benefit• Whole – cash value; has death benefit

Financial Scan• Checking/Savings/Investment Assets/Retirement Plans;

Personal Assets• Dilemma: can be source of money to gamble with; can be

source of money to bail out; can be source of future financial security – How can assets be protected before depletion– Checking accounts– Personal, business– Savings accounts; certificates of deposit– Investments

• Individual stocks and/or bonds, mutual funds, ETFs, retirement accounts – Pension plan, 457, 403b, 401k, SEP

• College tuition• Real estate

Financial Scan

• Checking/Savings/Investment Assets/Retirement Plans; Personal Assets– Money may be pulled from accounts– Money may be used for high-risk investing or

frequent trading– Bouncing of checks, postdating of checks– Personal assets may be sold or pawned for cash

Financial Scan

• Taxes– Transactions may incur taxable consequences– Taxes must be paid or there will be consequences– There can be tax penalties if assets depleted from

retirement accounts and interest due on owed amount

– There can be property liens if taxes are not paid

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Financial Scan• Estate Planning

– Advance directives needed if admitted to institution or incarcerated in trauma state• Power of attorney for health care• Living will• Power of attorney for finances

– Estate transfer techniques – Sources of concern• By law – Joint tenancy with right of survivorship• Wills – The Will becomes operational at death - is executor willing to

represent client?; there is a problem if client has burned bridges with loved one

• Trust – Trust funds (taxes have to be paid; how do you negotiate old family patterns when determining distributions and who pays taxes)

• Gift – tax consequences – can give up to $14,000 per person in 2014• Contract – life insurance, retirement plans

Financial Behavioral Treatment Goal

• Facilitate development of ability to begin and complete personal transactions one step at a time in all departments of one’s life including financial

• Start somewhere and create one success one step at a time over and over again

• Repeat this new pattern one step at a time when the next opportunity arises

Contact Information

• Esther M. Maddux • Ph.D., CFP®, GCAC-II, KLAC, KCGC-I• Phone: 785.215.2116• Email: emaddux101851@msn.com