AN INFORMATION RESOURCE FOR MEMBERS OF …AN INFORMATION RESOURCE FOR MEMBERS OF THE NATIONAL...

AN INFORMATION RESOURCE FOR MEMBERS OF THE NATIONAL COUNCIL ON PROBLEM GAMBLING SUMMER2008•VOL.11,ISSUE2

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de 4 Featured Programs 12National

ConferenceRecap

Executive Director’s Letter: Another Successful Conference

President’s Message: Changes

(President, continued on page 2)

15The Counselor’s Corner

At its annual meeting in Long Beach this June, the membership of the National Council on Problem Gambling elected a new Board of Directors, the first Board under the new Bylaws. Shortly thereafter, the new Board elected officers for one year terms running from June 2008 to June 2009. I was selected as President and BruceRoberts was elected President-Elect. Carol O’Hare

is our new Secretary, and Caleb Cooley returns as Treasurer. Only the President is not eligible to run again, as the President-Elect moves into that position 12 months hence. Thus, I am already a lame duck.

The new structure was called for under the NCPG’s recently adopted Strategic Plan 2007–2014. After over a year of review, the old NCPG Board adopted Bylaws that established a Board of Directors with 15 seats, down from the previous 56. A total of nine seats are designated for Affiliate Members, and nominations for these seats must come from Affiliate Members. The same nominating procedure

applies to the three seats for Organizational Members, and the three for Individual Members. Candidates are then elected by a majority vote of the entire membership. Board Members serve for staggered three year terms. A roster of the new Board and their terms are noted on page 2.

I have been a member of the NCPG Board since 1982, and I have observed considerable change in both the NCPG and the extent and nature of legal commercial gambling in America. The NCPG is still a small organization that addresses issues of importance regarding problem gambling and its impacts on society, as was the case when the National Council was founded by Monsignor Dunne and Dr. Custer in 1972. However, the industry that the NCPG shadows has grown dramatically—both intensively and extensively—during my tenure on the Board, from a $10 billion industry (in gaming rev-enues) in 1982 to a $90 billion industry in the United States today. Furthermore, in 1982, one could find legal casinos only in Nevada

NCPG staff spend more time and energy on the annual national conference than on any other project, but we believe the effort is worth it. Each year the conference grows bigger and better, and this year we set an all-time attendance record with 515 registrants, 23 hours of continuing education (including CME’s for psychiatrists), 83 presentations and more than 125 presenters. All this is even more remarkable when we con-

sider that high gasoline prices and economic downturn had a major impact on everyone’s travel and budget. We met and exceeded the revenue and attendance goals set by the Board of Directors for the meeting. There were a number of “firsts” at this event that we will carry forward for future conferences, including: using barcoded badges to track session attendance; the “Green” initiative to conserve natural resources (see p. 14) and, of course, the Family and Commu-nity Day. We developed a day-long track on recovery issues—includ-ing panels and workshops on recovery for problem gamblers and their family members, grief and forgiveness—and developed a special one-day registration for the public. We worked with our contacts in

the California recovery community to reach out and spread the word and were gratified by the large turnout.

Running such a large conference would be impossible without the efforts of the host chapter, the California Council on Problem Gam-bling, the Conference and Program Committees and the volunteers. We also are grateful to our sponsors (see p. 16) who not only pro-vided generous donations, but, in many cases, provided as much or more in assistance and in-kind contributions. I’d specifically like to thank: the hardest working man in California over the past few months, CCPG Executive Director Bruce Roberts; CCPG President Tom Marriscolo who single-handedly cut our meal costs in half; CCPG Training Manager Marc Lefkowitz for his great program and presenter ideas; CCPG staff Tonya Farrugello and Lindsey Rhein for their hard work and grace under pressure. To all of the volunteers a big thanks, especially to Michael Barnard, Nancy Lantz, Louise Leck-litner and Carl Robinson. Jesse Ortiz of Pro Audio/Video did a tremendous job with A/V, and Joel Howard and Justin Somers with Qleads were incredibly helpful with barcodes, scanning and more.

(Executive Director, continued on page 2)

8Seniors on a Roll5Assessing

Internet Gambling

2 National Council on Problem Gambling

(President, continued from page 1)

National NewsNATIONALCOUNCILONPROBLEMGAMBLING

The National News is published by the National Council on Problem Gambling.

National Council on Problem Gambling 730 11th Street, NW, Suite 601 Washington, DC 20001Office 202-547-9204 • Fax 202-547-9206 [email protected] www.ncpgambling.org

Executive Director: Keith WhyteProgram Manager: Linda AbonyoAdministrative Assistant: Melissa Martin

and Atlantic City. Today, we can find com-mercial casinos, racinos, and tribal casinos in over 35 states, not to mention the relatively new presence of VLTs, video poker machines, and Internet gambling, all of which were non-existent in the early days of the NCPG. There seems to be legal gambling almost around every street corner. The world has indeed changed.

It is important for the NCPG to keep up. This is undoubtedly a good time for the NCPG to undertake a significant reorgani-zation that will permit more streamlined decision-making by the Board and better allocation of its limited resources, as well as bestowing greater authority and responsi-bilities to the various Committees that answer to the Board. Most of the active members of NCPG agree that the previous structure was too unwieldy to be an effective working Board, so much of the hard lifting was allocated to the Executive Committee, and to Keith Whyte and his staff. We do not plan on letting Keith nor the staff off the hook, but our hope is to make the entire Board and Committee structure much more effective in dealing with the challenges ahead.

The Board will now be meeting monthly (telephonically) rather than semi-annually. In order to provide members more access to our governance process, and to work toward a high level of transparency in our delibera-tions, our monthly meetings will be captured in audio files that will be available to dues-paying members via the web page, along with minutes, agendas, staff reports and reference documents. All will be available free of charge to any member. (We will also hope-fully set up blog pages on the web site in the

near future that will allow ongoing commen-tary from members and non-members alike.) We also plan on having at least three face-to-face Board meetings a year as well.

My personal objective, which I believe is uniformly shared by the Board, is to make the Board an effective and goal-oriented working body which can utilize the best of modern technologies and management practices to communicate well, to monitor and measure opinion and sentiment from our various constituencies, and to achieve a variety of important objectives that contrib-ute to NCPG’s over-all mission.

We face a number of challenges in the com-ing year—from the continuing efforts in building an active and effective Board and strengthening the Committee structure, to meeting our program and financial goals in these trying economic times. I believe we are well positioned to meet these challenges with your support. Don’t be surprised if you are asked—leaned upon—to do something important for NCPG this year and into the future. There is much talent and experience among our membership that has not been fully utilized in the past. We would like to harness these talents and experiences in the pursuit of important goals and ideals, and to effectively utilize them in the pursuit of our commonly-shared organizational mission.

This is also an appropriate place to thank all those who have served on the Board of the NCPG since its inception. The NCPG has always depended on the dedicated efforts of volunteers who serve without pay and have given generously of their time and energy over these past 35 years. Board members from the “Old Board” were presented with a plaque during the Awards Lunch at the 22nd National Conference. As Executive Director Keith Whyte noted during the presentation, these Board members who were recognized have contributed over 450 years of service to NCPG and to addressing the challenges of problem gambling.

Sincerely,

Bill Eadington, PhD President

OFFICERS OF NCPG

• President: Bill Eadington, PhD

• President Elect: Bruce Roberts

• Treasurer: Caleb Cooley

• Secretary: Carol O'Hare

THE CURRENT BOARD

• PaulAshe(2008–2010)

• CalebCooley(2008–2009)

• BillEadington,PhD(2008–2010)

• SethEisenberg,MD(2008–2009)

• DonFeeney(2008–2010)

• JudithHerriff(2008–2010)

• ConnieJones(2008–2011)

• ChuckMaurer(2008–2011)

• ReeceMiddleton(2008–2011)

• JoyMitchell(2008–2009)

• RenaNora,M.D.(2008–2011)

• CarolO’Hare(2008–2009)

• BruceRoberts(2008–2010)

• RogerSvendsen(2008–2011)

• AlanYandow(2008–2009)

Last, but certainly not least, NCPG’s Linda Abonyo and Melissa Martin continue to do a tremendous job handling all aspects of the conference planning and administration.

The majority of the articles in this edition of the newsletter were submitted by members of NCPG. We are extremely pleased to use the newsletter as a forum for your concerns and comments and welcome all contributions.

Sincerely,

Keith S. Whyte Executive Director

(Executive Director, continued from page 1)

Toll-Free Helpline (800) 522-4700 3

By Ed Ramsey

Joseph L. Kellerman in his booklet, Grief: A Basic Reaction to Alco-holism, suggests that grief is a very basic and normal reaction to addictions. He says that, “All members of a family suffer from acute grief on a repeated basis and life with chronic underlying grief at all time. Children in alcoholic and/or dysfunctional families suffer grief not only from the loss of the chemically dependent parent, but also from the loss of the other parent who is preoccupied with the ad-dicted spouse. Later in life many adults still suffer from unresolved grief from their childhood experiences.”

Detachment as a grieving process is not only a major reaction to addic -tion by the family, but by the addict also. Detaching emotionally from an addictive relationship is important for the family and the addict in order to recover. Detachment should not be confused with cutting off. A person can cut off by removing him/herself physically from the problem, but in order to detach, they must unhook them-selves emotionally from the problem. In order for emotional detach-ment to occur, the family member and the addict must break their codependent emotional ties to the object of their addiction be it chemical, behavioral, or relational. The detachment process involves dealing with the death of an identity. For the family, it is the death of their caretaker identity; for the addict it is the death of their addictive lifestyle and their addict identity. Grief is a normal reaction to loss;consequently, detachment is a grieving process. In order to understandthis process, it is helpful to look at the phases of the grieving process. Elisabeth Kubler-Ross in her book On Death and Dying discusses the five stages of death and dying. These stages have been adapted for this article to reflect the role of grieving in the detachment process as it applies to codependents, adult children, and addicts.

Detachment and Recovery as a Grieving ProcessThe first phase of the detachment process is AVOIDANCE. This avoidance is a result of the family or the addict’s initial experience with the realization of their problem.

The next stage of the detachment process is BLAME. This is also a questioning phase; a phase of confusion, resentment, rage, and gen-eral anger around the “whys”: “why me,” “why has this happened to me,” “why does my family have to be this way,” “why am I an ad-dict,” and “why can’t I be like everyone else.”

The next stage of the detachment process is MANIPULATION. Manipulation is the “Let’s make a deal” phase.

Then comes the SEVEREGRIEF, which is the low point of the detachment/recovery process in that it generates a tremendous amount of pain and anxiety.

The final stage of the detachment process is SELF-RECONCILIA-TION. This begins with letting go of the control and with the admis-sion of one’s powerlessness over the addiction and/or the addict.

By Keith Whyte

Since Linda Berman and Mary-Ellen Siegel first published this book in 1992, there have been great strides in many areas of the problem gambling field. There are now 36 state chapters of the National Council on Problem Gambling, over half of states have some sort of public funding for problem gambling services, myriad websites are available to provide help for problem gamblers, and research contin-ues to provide clearer understanding of prevention, treatment and re covery. Advocates, led by the National Council on Problem Gam-bling, continue to press government and gaming operators to develop a comprehensive set of policies and programs to minimize the harm from out-of-control gambling. However, the majority of these ser-vices continue to be oriented to the actual gambler. Family members and others closely associated with these gamblers still have few re-sources to help them understand and address the problems that arise.

For many years this book has remained the standard reference for family members of problem gamblers. This is a testament to the practical advice herein, but also an indictment that for all the progress in the field, there remains little material to help those who are

affected by the gambling problems of others. Currently there are an estimated six to nine million individuals who meet the criteria for a gambling problem, and we can conservatively assume that the conse-quences of this addiction are felt by many more millions of family members, friends, business associates and others. Families are particu-larly hard hit by devastating financial losses, bankruptcy, criminal justice and mental health costs, neglect and divorce. Yet recognition of these important negative consequences on an individual, commu-nity and national level has not kept pace with the expansion of gam-bling in America. Family members of problem gamblers often face personal and public stigma and shame rather than sympathy. This perception, often exacerbated by cultural influences, may discourage them from seeking help. As a result few family members seek or receive services.

The resources in this book will help family members and loved ones of problem gamblers take action to address a gambling problem in your family. Behind the 8-Ball remains as important today as ever for all those who seek to recognize, understand and address the conse-quences of this bewildering and devastating disorder.

Book Review: Behind the 8 BallFrom the Foreword to the Revised Edition

Massachusetts Council on Compulsive Gambling’s Prevention Resource Library

Boston,Mass.–TheMassachusettsCouncilonCompul-siveGamblingispleasedtoannouncethelaunchofournewPreventionResourceLibrary.Wehavecompiledproblemgamblingpreventionmaterialsfromacrossthecountry,anddevelopedaresourcelibraryofmaterialsforpublicuse.Pleasevisitwww.masscompulsivegambling.org/services/prevention.php.


Positive Pathways in PittsburghBy Dr. Arthur Merrell

For over 50 years, the Onala Recovery and Rehabilitation Group in Pittsburgh’s West End has been one of the premier meeting centers for Alcoholics Anonymous and Narcotics Anonymous groups in Pennsylvania. Approximately 2,000 persons in recovery utilize these facilities every month. In addition to the AA and NA groups, there have long been support programs for persons with cocaine addiction and dual diagnoses.

Positive Pathways LLC, a privately owned clinic, has been working with Onala since September of 2007 to develop a mental health resource for people who have “dropped between the cracks” of our mental health delivery system.

For several years now, there has been another problem emerging — one that had never been addressed. Since the arrival of the Meadows Casino in Pittsburgh’s southern suburbs we have been meeting with ‘trio’ diagnoses people, those with gambling problems and drinking/drug problems and depression or anxiety issues. Of course, there have always been individuals who bet too much at the track or on the lottery, but the new casinos licensed by the state seem to have magnified the problem tremendously. Now, with the impending opening of the Pittsburgh Casino (actually only a couple hundred feet away across the river) we realize that we must prepare for an influx of problem gambling cases.

In addition to our current target population (people who already suffer from one or more addictions and are susceptible to another), we have already been preparing to move out into several forums with our message of hope to those trapped in any addictive behavior. We are glad to add problem gambling to the list—reaching out to more people in need. We are hoping, in the near future, to establish teams of people in recovery (from alcoholism, drug addiction, problem gambling and mental health issues) to go out to regional colleges, working places, correctional institutions and high schools. These teams will bear witness that all of these problems, which are disrupt-ing the lives of so many people, can be solved—and that there is help available to solve them.

Featured Programs

Although these presentations will be focused on our approach (offeringboth 12-step programs and supportive therapy), we realize that somepeople need to start on other paths (inpatient treatment, pharmaceuti-cal support and legal counsel). We will make information and literaturefrom any legitimate helping agency available to those who request it.

In order to ready our own agency for this challenge, the management of the Onala Group and Positive Pathways met last December and proposed that the following steps be taken:

■ The Management of the Onala Group has contacted the head-quarters of Gamblers Anonymous, informing then that we would like to host GA groups and activities. GA indicated that they would be interested, but have not set a date for implementation of an agreement as of this time.

■ Positive Pathways has enrolled two of our therapists in the Univer-sity of Pittsburgh’s program to receive National Certification as Problem Gambling Therapists. They have both finished the train-ing and practice requirements of the program and are preparing for the final examinations.

■ The director of Onala has also applied for the certification pro-gram and will be joining the Positive Pathways clinicians as a certified therapist.

■ Literature and educational materials about problem gambling have been obtained and are already available to all of our clients through our public information program.

■ The counseling program at Onala has already seen 10–12 people with gambling problems, giving us the opportunity to receive some degree of clinical supervision and training from the Univer-sity of Pittsburgh Gambling program.

■ We have offered to make Onala available as a training facility where mental health and addictions professionals could do their internships in the future. In addition to providing support and treatment to people in Recovery, such a program would also en-able us to offer educational and gambling assessment services to the general public.

Payne County Counseling ServicesBy LaDonna McCune

Payne County Counseling Services of Still-water, Okla. employs three counselors trained to treat problem gambling issues.Dr. LaDonna McCune, Licensed Alcohol/Drug Counselor and Claudia McGurk, Certified Alcohol/Drug Counselor have recently become certified as National Gam-bling Counselors. To be certified, they were required to pass a national exam after com-

pleting 60 hours of training. Additionally, they were required to provide 100 hours of gambling counseling under the supervision of a board approved clinical consultant. Both are members of the National Council on Problem Gambling and are now qualified to assess and treat problem gambling issues. Joanna Coser is a Licensed Alcohol/Drug Counselor and has also completed the 60

hours of training. A gambling therapy group meets on Tuesday evenings from 5:30 to 6:30 p.m. at Payne County Counseling at 801 S. Main, Suite 5 in Stillwater. There is no charge for those admitted into the outpatient gambling program for anyone 18 years or older. Friends and family members are en-couraged to participate.

FeaturedProgramsFeatured Programs


Assessing Internet Gambling: Risk and RegulationBy Jessica McBride, MA, International Centre for Youth Gambling Problems and High-Risk Behaviors, McGill University

In 2006, The Unlawful Internet Gambling Enforcement Act (UIGEA) came into effect in the U.S. The UIGEA prohibits those engaged in the business of wagering, as well as credit card companies and banks, from knowingly accepting payments related to illegal online gambling transactions. This prohibition has caused more problems than it has likely prevented, mainly due to the fact that the UIGEA does not define what con-stitutes “unlawful Internet gambling,” but instead relies on existing federal and state laws. Consequently, financial institutions feel burdened by having to play a judicial func-tion to determine what exactly unlawful gambling is. The UIGEA is seen by many as unworkable, and a bill has since been intro-duced to block it.

In the background of all the legal wrangling, Internet gambling continues to grow. The American Gaming Association estimates upwards of 23 million people worldwide gambled on the Internet in 2005, 8 million of whom were from the U.S. In 2006 there were over 2,500 Internet gambling websites owned by 465 different companies. Internet gambling sites have the potential to be ex-tremely profitable; the latest estimates have revenue approaching US$14 billion, and to double by 2010. Online poker has flourished in the past five years, rising from $82 million in revenue a year in 2000 to over $2 billion in 2005.

From a public health perspective, the social costs of this growth have yet to be seen, although some disturbing trends are begin-ning to emerge. It seems that (as of yet) although fewer people are gambling online than at more traditional land-based venues, those who do are already exhibiting signs of probable pathological gambling, or are at risk for developing gambling problems. Recent research conducted by the International Centre for Youth Gambling Problems and High-Risk Behaviors, found the rates of problem gambling among a sample of 563 online gamblers were nearly 10 times higher than the general population. The latest re-sults hint that the Internet may be a medium particularly favoured by those with serious gambling problems. Compared to social gamblers, problem gamblers spend more

time gambling per session, are more likely to gamble alone, from school, or with a cell phone, gamble with more money, and lose more money gambling online. Problem gamblers are more likely to wager online while consuming alcohol or illicit drugs. Problem gamblers are also significantly more likely than social gamblers to choose to gam-ble on the Internet because it is easier to hide their gambling from others. These results hint at a disturbing and difficult relationship between the Internet and individuals with gambling problems.

On the other side of the prohibition discus-sion is the call to regulate Internet gambling. In addition to attempting to block the UIGEA, the Internet Gambling Regulation and Enforcement Act has been introduced to Congress in order to legalize, licence, andregulate online gambling. Proponents of regu -lation argue that by legalizing and regulating Internet gambling, funds could be earmarked toward establishing treatment programs, as well as education and prevention initiatives, and protection could be provided for vulner-able individuals (such as problem gamblers, underage gamblers, or those under the influ-ence of drugs and alcohol).

June Cotte at the University of Western Ontario and Kathryn Latour at the Univer-sity of Nevada, Las Vegas are both recom-mending legalization of online gambling as a way to potentially reduce its harmful effects. They conducted interviews with 20 casino gamblers and 10 online gamblers and re-ported that online gamblers gamble more frequently and more aggressively than casino gamblers. Cotte and Latour explain that the access of online gambling is as easy as the click of a computer mouse, so is much more easily integrated into daily routines, moving it out of the social realm which in turn could increase the risk of addiction.

Whether or not the Internet creates or at-tracts problem gamblers is still unclear. Nonetheless, it is clear that certain aspects of the Internet, such as the 24-hour accessibil-ity, the sheer number of sites, the high-speed play, the lack of safeguards for individuals who have been drinking or using drugs, and the ease with which one can hide a gambling

problem, make it a risk factor for gambling problems. Cotte and Latour are suggesting strategies that could be tied to online regula-tions, however it is not simply a matter of regulation—it is crucial to ensure regulations are enforced. Internet gambling is not going away and neither is regulation. Take Canada as an example—in the words of Margaret McGee of the Nova Scotia Gaming Corpora-tion, “Stay tuned!”

The Problem Gambling Library Catalogue:A quality filter for print and Internet resources

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TheProblemGamblingFoundationofNewZealand’sonlinelibraryhasover5,000resourceswhichincludereports,articles,videos,DVDs,booksandbrochures.

ThePGLibraryisaccessibleatwww.pgfnz.co.nz/libraryandthelibrarycataloguewillbeavailableathttp://pgfnz.infospecs.co.nz.

New Web Site Raises Awareness of High School

Problem Gambling

Thesitewww.BeatTheBet.com/Parentsoffersparentsessentialinformationaboutproblemgamblinganditswarningsigns,includingadviceonhowtotalktoteensabouttheissue.Parentscanalsosendane-mail

invitationto“TaketheTwenty,”a20-question,self-assessmentquizthatoffersaneasywaytohelpteensconsidertheirgamblinghabitsandwhethertheymaybeontheroadtoaproblem.


Learning Made Easy: Online Academic Courses on Problem Gambling

By Nancy Roget

The University of Nevada, Reno, through the Center for the Applica-tion of Substance Abuse Technologies (CASAT), is offering under-graduate/graduate web-based courses in problem gambling. Recently, the role that academic programs and courses play in increasing the use of evidence-based practices and training new counselors has re-ceived lots of attention as research (Crane & Hafen, 2002; Jackson, 1999) has found that most counselors adhered to practices learned during their “formative years.” Given that, access to academic pro-grams and courses becomes a critical issue. Several regions in the United States impacted by distance and sparse populations suffer from limited access to higher education. For example, in six western states; Colorado, Idaho, Montana, Nevada, Utah and Wyoming, there are a combined total of 50 four-year colleges and universities, while the state of Illinois (for comparison purposes) has 77. Online education increases access to academic programs and courses which helps train the addiction workforce.

In addition, research indicated that university/college students in online courses described the online environment as valuable to their learning (Ciba & Rakestraw, 1998; Morss & Fleming, 1998). Fur-thermore, students claimed that online courses support more equi-table class participation, both in the sense that the instructor is less likely to dominate the “airtime” than in traditional classroom discus-sion and that all class members have equal access to participate (Schallert et al., 1999; Bump, 1990; Harasim, 1990; Hiltz, 1986).

Through funding from the State of Nevada problem gambling educa-tional funds in 2006, CASAT created two undergraduate/graduate online academic problem gambling courses. By increasing access to

By David Schugar

Is there a relationship between gaming re-sponsibly and the cultural values of society? Certainly; but what might that correlation be? It is reasonable to assume that a society's values are reflected to some degree in its legis-lation, media, and commercial advertising. Understanding how a society manages itself will provide insight into how accountability is both assumed and assigned.

No one on either side of the aisle disputes the obligation of the gaming industry to operate in a socially responsible manner. This in-cludes proper training for employees, support for counseling and rehabilitation programs, and distribution of responsible gaming litera-ture and information. There is of course another responsibility that defies clear defini-tion. This is the genre of taking the high

road, doing the right thing, and applying Hoyle to not only the letter but the spirit of the law as well. When these are done every-one benefits.

However from a legal or liability standpoint this responsibility must not be allowed to trump the accountability of the individual for his or her actions. It bears consideration to question whether legislation that allows the individual to shift his or her own per-sonal accountability to another (another individual or an entity such as a casino op-eration, race track, state lottery, or local bingo, etc.) is ultimately a disservice to that individual and as a result, society as a whole.

Gaming, like many other activities, can lead to a compulsive be havior. But gaming is also unlike many other activities in that the finan-

Responsibility for Responsibilitycial consequences are indisputable; gamblers are going to lose. In my 30 years of experi-ence, I have found that in virtually every instance that a player who is playing above their head and not with their head, knows it.

All would agree that it would be ideal if everyone attained a certain level of maturity before participating in certain activities. But some individuals only learn the hard way, and by that, I don’t mean a pair of 4’s. The more society relinquishes the individual from personal accountability by shifting the onus of a person's behavior to institutions, govern-ment, and industry the less likely the indi-vidual is to feel the consequences of their actions. Ultimately this disarms the indi-vidual making them more vulnerable and susceptible to any destructive behavior.

problem gambling information through online academic courses the number of individuals applying for problem gambling counseling certification increased in Nevada thus helping to meet the goal of increasing the workforce.

Currently, the online academic gambling courses are available to all students across the United States. These courses are designed for students majoring in a health or social service fields, behavioral health treatment providers, the general public, and other helping/service professionals interested in addiction treatment as a supplement to their current field of study. These courses meet gambling certification requirements in the state of Nevada and are NAADAC approved for 15 continuing education hours (CEH) per credit. Currently, the courses are in the process of receiving CEU approval by the National Council on Problem Gambling (NCPG) Education Committee. The two online academic problem gambling courses include:

1. HumanandCommunitySciences(HCS)439/639: Exploring Gambling Behaviors (2 credits) The goal of this course is to introduce and orient students to the definitions, history, and incidence/ prevalence of problem and compulsive gambling. Students will learn the characteristics of compulsive gambling behaviors, stages of progression for patho-logical gambling disorders, distinctions and connections to other addictions, as well as problem gambling’s effect on families and communities regarding financial, legal, and social issues. No pre-requisites required.

(Learning Made Easy, continued on page 7)


By Libby Smith, MA Candidate, CADC

Pathological or compulsive gamblers learn one thing very quickly whenthey enter recovery from pathological gambling: it was NOT about themoney. The act of placing the bet—matching wit and “skills” against oneself or an adversary in a game of chance, creating a “system,” or “beating the house”—these are some of the activities that produce the high for the pathological gambler. However, as we are seeing once again in the world of professional sports with the indictment and sentencing of NBA referee Tim Donaghy, when gambling debts build up, the gambler demonstrates Lesieur’s description of the “desperate” phase: the gambler often experiences personality changes, engages in heavy borrowing (legal and illegal), and sees a marked increase in both the amount of money and time he or she spends gambling.

An addicted person develops a primary, intimate and ultimately destructive relationship with his/her drug or activity of choice. The individual addicted to gambling is no different than the individual addicted to a chemical. The addiction becomes an active, possessive entity, capable of wreaking tremendous havoc upon one’s physical, spiritual and emotional life. Many people are under the impression that a process addiction like gambling does not pose the serious con-sequences to one’s life that a chemical addiction does. The truth is an addiction to gambling is every bit as dangerous as an addiction to a chemical—just not in ways people may initially consider:

• According to The Detroit News (1/22/00) a man shot his pregnant wife and smothered his three children after losing thousands of dollars in a casino. He was reportedly $500,000 in debt.

• The Chicago Tribune (2/10/99) reported a woman allegedly suf-focated her 7-week-old daughter in 1995 to collect on a $200,000 insurance policy on the infant’s life. Fifteen months earlier, the same woman’s 17-day-old daughter also died from unexplained reasons. The woman admitted to having a gambling addiction when these incidents occurred.

• The Kansas City Star (3/10/97) reported a woman murdered her husband for life insurance money to cover her blackjack debt.

• According to the St Petersburg Times (11/28/00) The Hillsborough County, Fla. State Attorney walked into a darkened ball field carrying a gun and ended his life. He was mired deep in gambling debt and faced an investigation. He had allegedly used campaign funds to cover his gambling debts, but was still $150,000 in debt.

I do not know who first coined the phrase “desperate times call fordesperate measures,” but it certainly seems to capture the hopelessnesspeople suffering from pathological gambling experience. The tragedyof an addiction to gambling is exacerbated by the belief it is just aboutthe money. The individuals highlighted above, and thousands more like them, believed if they could just get the money to cover their debts, their problems would be over. Many individuals addicted to gambling who are experiencing financial consequences initially be-lieve they have a “winning problem;” their system needs some adjust-ing, and then they will be back on the winning track. Some gamblers incorrectly believe they have a “money problem” and as soon as they can get out from under their debt, they can walk away from the tables, or the slot machines, or whatever their game of choice was.

It is only when given the opportunity (through intervention or crisis) to enter treatment for pathological gambling that a gambler learns the truth: it was NOT about the money at all—it was about having a primary, progressive disease. Tim Donaghy was fortunate: his gam-bling activities came to light before he reached the hopeless phase of the disease. Yes, he was desperate enough to admittedly let his gam-bling debts affect his judgment and destroy his career, but he took advantage of the opportunity presented to him and acknowledged his life had become unmanageable. Tim Donaghy hopefully now realizes his 15-month prison sentence is as bad as it has to get. The ball is now in his court to take his new-found insight and use it to change his life, and the life of others like him.

Playing for Keeps

(Learning Made Easy, continued from page 6)

2. HumanandCommunitySciences(HCS)440/640: Treatment of Compulsive Gambling (3 credits) The goal of this course is to provide a research-based, comprehensive under-standing of treating compulsive gambling. At the end of the course students will be able to demonstrate the knowledge and skills to effectively assess, treat, and help individuals recover compulsive gambling disorders. Clinical and support interven-tions for spouses/partners and family members who are involved with a person with a problem or compulsive gambling disorder will be highlighted including financial and legal consequences. Prereq-uisite: HCS 439/639.

CASAT is responsible for developing the content and instructing these courses while the University of Nevada, Reno’s Indepen-dent Learning Department handles registra-tion and technology issues. Both courses will be offered this coming Fall 2008 semester, which begins August 24, 2008. These courses are scheduled to be offered every Spring (January – May) and Fall (August – Decem-ber) semesters. Currently, costs for a three credit course are between $138 per credit for undergraduate courses and $207 per credit for graduate courses. Both courses are offered at undergraduate and graduate levels and follow a semester format (e.g. 14 weeks in length). Course instructors are problem gambling experts.

Finally, with rising gas prices, and costly parking fees at universities or colleges (not to mention parking tickets), online academic courses make good sense. Besides, no one looks at you strange when you show-up for class (sign in to the website) wearing your pajamas and fuzzy slippers.

For enrollment information, please contact Independent Learning at 775-784-4046, toll free 1-800-233-8928, or visit their website at http://extendedstudies.unr.edu/ilearn.htm. For more information about course content and certification issues, contact CASAT or visit our website at www.casat.org.


We have all seen the buses full to capacity with seniors ready to gamble. There are only a handful of studies researching the impact of gambling among the elderly, but we know it is a common and frequent social activity (McNeilly & Burke, 2001). It is clear that recreational gambling increases socialization and may boost cognitive abilities of healthy seniors. Less known are the consequences recreational gambling can have on those with a history of addiction, mild cognitive impair-ment, mental illness, and other health issues that affect judgment.

About one in every eight, or 12.4 percent, of the population is an older American. The population 65 and over will increase from 35 million in 2000 to 40 million in 2010, a 15 percent increase and then to 55 million in 2020, a 36 percent increase. (Administration on Aging, 2008). The traditional game of chance for seniors is bingo, a pastime that serves as a recreational event in many com-munities. The growth of riverboat and Indian casinos, state and national lotteries, and Internet access to off-shore sports and parlor betting, has dramatically increased access for all adults including seniors. (Administration on Aging, 2007). Many older adults desig-nate a small amount of money for spending at casinos, lottery tickets, and other games of chance. Most understand that the visit to the casino is for recreation and expect nothing more than a nice bus ride and a few hours at the nickel slot machines. Many return with having had a good “outing,” but with empty pockets. Among that group there may be one or two individuals that are more susceptible to the lure of gambling and may be prone to become problem gamblers. To those indi-viduals, the innocent trip to the casino can easily become the road to ruin.

Although the elderly are not the leading group of problem gamblers, for them, the consequences of gambling can be devastatingif they become addicted and become problemgamblers. Retirees are often dependent on smaller fixed incomes and problem gamblers can risk gambling away their life savings. Most are unable to earn back the money lost. The impact is not limited to financial losses but it also has the possibility of negatively affecting a person’s physical health.

Older adults tend to have small social circles having limited contact with their families and friends. This makes the recognition of problem gambling difficult—often going unnoticed and/or delayed. Organizers of activities that involve seniors gambling should be aware that older adults too, can become problem gamblers. Aging service providers should educate staff to recognize the signs of problem gambling. A report of the National Gambling Impact Study Com-mission listed nine behavior patterns associ-ated with problem gambling:

1. Tolerance: needs to gamble with increas-ing amounts of money in order to achieve the desired excitement;

2. Withdrawal: restless or irritable when attempts to cut down or stop gambling;

3. Escape: gambles as a way of escaping from problems or relieving dysphoric mood (e.g., helplessness, guilt, anxiety, or depression);

4. Chasing: often returns another day in order to get even (“chasing one’s losses”);

5. Lying: lies to everyone to conceal the extent gambling;

6. Lossofcontrol: repeated unsuccessful efforts to control, cut back, or stop;

7. Illegalacts: commits illegal acts (e.g., forgery, fraud, theft, or embezzlement) to finance gambling;

Oxford University Press recently released Overcoming Pathological Gambling Therapist

Guide, and corresponding Workbook, byRobertLadouceurandStellaLachance

TheTherapistGuideandWorkbookformacompletetimelimitedandcosteffectiveevidence-basedtreatmentpackage.TheTherapistGuideprovidessessionbysessionprotocolsfordeliveringcognitivebehavioraltherapy(CBT)basedinterven-tionforovercominggamblingproblemsandlearningrecoveryskillsthatareusefulforalifetime.Theworkbookforclientscombinesallthepsycho-educationalmaterials,monitoringformsandother“homework”inonebookforeasieradherence

tothetreatment.Writtenbytheinternationallyrespectedresearcherswhohavespentovertwodecadesstudyingthepsychologyofgambling,thisbookmakesitpossibleforclini-cian’storeplicateinrealworldsettingswhathasbeenfoundtobemosteffectiveatcon-trollingtheurgetogamble,understandingthetruenatureofgamblinggames,andreach-ingtheultimategoalofcompleteabstinencefromgambling.

To order and save 20%, please call 1-800-451-7556 and use Promo Code: 26147

Taking a Chance, Seniors on a RollBy Jorge J. Lambrinos and Iris Aguilar, University of Southern California Edward R. Roybal Institute for Applied Gerontology.

8. Riskedsignificantrelationship: jeopar-dizes or losses significant relationships;

9. Bailout: relies on others to provide money to relieve a desperate financial situation.

In addition to recognizing the signs of prob-lem gambling, classes should be conducted so that other older adults can assist in identi-fying potential victims of problem gambling. Observation and prevention can avoid the financial and mental anguish that comes with problem gambling.

All Aboard!!

References:McNeilly, D. P., & Burke, W. F. (2001). Casino gam-

bling as a social activity of older adults. International Journal of Aging and Human Development, 52(1), 19−28.

U.S. Department of Health & Human Services, Administration on Aging. (2007). Older Adults and Gambling. Retrieved March 7, 2007 from www.aoa.gov/prof/notes/Docs/Gambling_Older_Adults.doc.

---, A Profile of Older Americans: 2007. Retrieved July 28, 2008 from www.aoa.dhhs.gov/prof/ Statistics/profile/2007/2.aspx

U.S. National Gambling Impact Study Commission. (2008). Report of the National Gambling Impact Study Commission. Retrieved July 28, 2008 from http://govinfo.library.unt.edu/ngisc/reports/finrpt.html


Note from the Editor

NPGAW 2009: What can we do for you?

NASADAD and NARMH National Conferences in Vermont

By Joy Mitchell

Have you ever considered sponsoring/exhibiting at a national event being held in your home state as a method to heighten problem gambling awareness? I would like to encourage other affiliates to be on the alert for national conferences coming to their home states. I have been fortunate enough to sponsor/exhibit at two national con-ferences in the past two years.

Last year, the Vermont Council on Problem Gambling, with funding provided by Vermont Lottery, sponsored a break and exhibited litera-ture on problem gambling both for Vermont and the National Coun-cil on Problem Gambling at the 2007 National Association of State Alcohol and Drug Abuse Directors, Inc. (NASADAD), The National Prevention Network (NPN), and the National Treatment Network (NTN) Annual Meeting Strengthening State Systems: Promoting healthy families through prevention, treatment and recovery support, held in Burlington Vermont. In 2008, NASADAD was held in Montgomery, Ala. this past June.

In August of 2008, the Vermont Council was one of the major co-sponsors, along with other Vermont state and local agencies, for the 2008 National Association Rural Mental Health (NARMH) 34th Annual Conference: “Changing Practices, Changing Rural Environ-ment.” Again, this funding was provided by the Vermont Lottery, to be held in Burlington. This sponsorship includes exhibiting space and a workshop addressing “Identifying Problem, Compulsive, Patho-logical Gamblers in your Caseload.” The exhibit table will display information for both the Vermont Council and the National Council on Problem Gambling.

This is a viable method to heighten awareness of the impact gambling.

By Jeffrey Beck

National Problem Gambling Awareness Week 2009 is scheduled for March 1–7. This is a grassroots effort to raise awareness of prob-

lem gambling within the public, government, workplace and the mental health and addiction field. The website, www.NPGAW.org, provides information via fact sheets, press releases and the like to allow individual states to run their awareness campaign this week. Leadership guides are also available, with great suggestions on how to promote the week and how to involve counselors and compulsive gamblers in the process.

NPGAW is most effective at the local level. The material on the website expands each year, providing additional information. The NPGAW Committee is open to suggestions on information that would be helpful. We would like every State council to have a repre-sentative on the NPGAW Committee, to share suggestions and help provide information, contacts, or other needs.

What is the allure of NPGAW? It has effects on several groups of constituents. State Council staffs members engage in various tasks throughout the year, including manning helplines, disseminating information on problem gambling, advocating for the compulsive gambler, providing trainings and the like. NPGAW allows a focus and priority to be placed on promotion of public awareness , it is an opportunity to direct energies and attention to one specific goal.

Counselors who work with problem gamblers usually do so an indi-vidual or group basis. NPGAW allows for outreach—to talk to the community about problem gambling. It is an opportunity to move from a micro approach to a macro approach. Public awareness re-duces stigma and thus hopefully allows more people to admit to problems and seek help.

I believe that, for the gambler and the gambler’s family, the week is about promoting awareness of the disease model. It is a chance to tell one’s story for the opportunity to raise awareness about problem gambling. The disease model treats gambling as a medical disorder. Compulsive gambling has long been considered a hidden addiction,

NPGAW allows for exposure and compulsive gamblers and their families welcome this and feel it has a therapeutic approach.

Anyone interested in serving on the 2009 NPGAW Committee, contact Jeff Beck at 609-588-5515 or at [email protected].

We welcome any article that you may find interesting to place in our newsletter! To submit an article, send it to [email protected],inordertocutdownonprintingcosts,wewillsendthenewsletteroutelec-tronically(asaPDF)forthosethathaveE-mailad-dressesandmailHardCopiesto those that do not have

E-mailaddresses.

We would like to say “Thank You” to all the members listed below who have graciously taken the time out of their busy and hectic schedules to write an article for this newsletter. If, by chance, we have forgotten to mention your name, we sin-cerely apologize in advance!

Tara BarrettJeffrey Beck

Marlene BocookRoberta Boughton

Kitty BroganBobbie Carlile

Christopher DayPaul Del Vacchio

Larry ErhardtBrian Farr

Gina FrickeJorge LambrinosLouise LecklitnerJessica McBride

LaDonna McCune

Arthur MerrellJoy Mitchell

Cathy MoonshineEdward Ramsey

Nancy RogetLanny Russikoff

Stephanie SchaeferDavid SchugarLibby Smith

Brent StachlerDeborah Stidham

Lynn StilleyHarlan Vogel


By Bobbie Carlile

Gam-Anon is a worldwide organization offering self-help recovery to anyone who has been affected by a loved one’s gambling. It is not a treatment center or a counseling agency nor is it allied with any other organization offering such services. Using a 12-step program, with our steps being similar to the GA Twelve Steps but for a few words difference, we work on ourselves, learning to recognize and work on our character defects as well as also recalling and nurturing our strengths which we have often lost sight of while we are trying to deal with the gambling problem.

When a gambler has a family member/loved one attending Gam-Anon, chances of recovery for the gambler is often enhanced. There are over 300 meeting locations in the United States. Our website address at gam-anon.org has a complete list of meetings and further

information about the Gam-Anon organization and philosophies as well as a “questions and answers” section.

Personally speaking, our family had dealt with the gambling problem for a number of years and it wasn’t until I found Gam-Anon where I learned that many of the actions I was repeating (thinking I was helping my gambler), these things were not helping my gambler get better but rather making our situation worse. Since I started attend-ing Gam-Anon and he started attending GA our relationship, our emotional health, our finances, as well as relationships with our chil-dren and extended family have all improved tremendously…and we are now living a life we had only dreamed of in years past.

We are proud to say that our Gam-Anon program is a vehicle to a better future for those affected by a gambling problem. It takes work but with the Gam-Anon framework it can happen!

A Little Bit About Gam-Anon

Problem Gambling – A New Paradigm for the Field of Addiction?By Deborah Stidham

Kansas recently passed legislation which allows for an expansion in casino gambling and, more importantly for some, also al-locates two percent of net revenues (approxi-mately 15 million dollars annually) to be dedicated to problem gambling and other addictions. This interest and anticipation of a new funding stream to address an issue that has all but been ignored in the past has prompted this writer, a state employee who was grounded in the alcohol and drug treat-ment field, to learn all she could about the exciting, developing field of problem gam-bling. Being asked to head up the team to initiate these efforts, I felt an acute responsi-bility to “get it right” by listening to states who have gone before ours, in particular their successes, trials and tribulations. This journey of learning has caused me to ques-tion some of the values, beliefs and practices I’d long highly regarded in my work in the addiction field.

In a myriad of ways, it can be said that the field of problem gambling closely resembles its closest cousin, the field of alcohol and drug addiction. Individuals who suffer from these disorders share similar behavioral symp-toms and effects on their neurophysiology, as well as similar consequences of their disorder on their families, friends and community. These similarities are comfortable ones for those in the workforce already trained and experienced in the field of addictions. This comfort level has undoubtedly helped those

suffering with problem gambling disorders by their encounters with empathetic and knowledgeable counselors (even prior to the offering of problem gambling specific train-ing and certification opportunities). While this comfort level on the part of counselors can be leveraged to increase their interest in becoming part of the developing problem gambling workforce, it is important to recog-nize the distinctions that are emerging be-tween the fields as well. These critical distinc-tions have the potential to shift the paradigm under which the addiction field operates. The American Heritage Dictionary defines paradigm as a set of assumptions, concepts, values and practices that constitutes a way of viewing reality for the community that shares them, especially in an intellectual discipline.

While paradigms can help a field define its boundaries, context and purpose for those who are a part of it, they also have the capac-ity to create artificial limitations that may remain unspoken or unchallenged for years. The field of problem gambling is developing its own paradigm which may have the unin-tended consequence of facilitating break-through results for both fields. One such critical distinction embraced by the problem gambling field is the pro-active inclusion of the gaming industry in its prevention, inter-vention and treatment efforts. One can see this inclusion in many areas such as problem gambling coalition meetings, conference sponsorships, responsible gambling pro-grams, public awareness campaigns, and research. This partnership with the industry (Paradigm, continued on page 11)

has the potential to leverage resources for breakthrough results which could never have been realized separately.

However, these partnerships with the indus-try are not always embraced, especially by those initially trained in the addictions para-digm. Most addiction professionals have never attended any meeting or collaborated on a project that included the alcohol or tobacco industry. For most, this idea had never occurred to them or if it was, immedi-ately dismissed due to perceived conflict of interests between the field and the industry. While conflict of interests may, in fact, arise from time to time, the benefits of these fledg-ling partnerships in the problem gambling field are, in many ways, yet to be fully real-ized. The early indicators of success, evident to those involved first-hand with these part-nerships, are promising approaches that have the potential to identify and effectively inter-vene with problem gamblers before their problem escalates to the compulsive level. If this outcome is realized, these collaborations will have effectively accomplished what communities have struggled to do for de-cades, to identify those “at risk” for these disorders, intervene early when the interven-tion is more likely to be successful and save the countless toll these disorders exact on the person, their families and communities.

The data collected from these promising approaches will undoubtedly continue to shift the assumptions, values and practices


Future Relationships Can Be Affected by Gambling

The National Gaming Control Commission of Korea

Representatives of the Korean National Gaming Control Commission (NGCC) visited the NCPG office on May 6, 2008 to exchange information on problem gambling and responsible gaming, and a delegation of 16 attended the conference in Long Beach, Calif. NCPG’s Executive Director Keith Whyte interviewed NGCC Chair Dr. In-Hye Yi and provided the summary below.

The mission of NGCC is to establish a sound leisure industry, prevent the excessive spread of gaming industry and enhancing prevention and recovery of problem gambling. NGCC’s goal is trying to make the gaming industry sound and healthy. NGCC was founded September 17, 2007 and has 36 employees—23 working at Division of Controlling and Managing Gam-bling, and 12 people are working at Division of Prevention and Recovery for Problem Gam-bling. NGCC carries out policy development, research, prevention, and education regarding problem caused by gambling. NGCC services include developing policies and programs for prevention and treatment of problem gambling; performing survey, research, analysis, and evaluation of problem gambling; and developing competency of counselors in the area of prevention and treatment of problem gambling. NGCC establishes networks among treat-ment organizations of problem gambling and provides support for treatment and rehabilita-tion of problem gambling. Finally, NGCC supports recovery from problem gambling by prevention, treatment and rehabilitation.

NGCC plans to host an international conference in April 2009 to increase public awareness of problem gambling to prevent addiction, introduce overseas case study for recovery and prevention of problem gambling, and find ways to establish international networks.

Massachusetts Council Offers Online Training

TheMassachusettsCouncilonCom-pulsiveGambling(MCCGhasrecentlydesignedandintroducednewadvanced-levelonlinecoursesforclinicians.AccordingtoMCCG’sProgramDirec-tor,MarleneWarner,“theCouncilwantstouseouronlinetrainingpro-gramtomeettheneedsofcliniciansinterestedinexpandingtheirknowledgebaseregardinggamblingdisordersbutwhoarefacedwiththetimeconstraintsoffee-for-servicetreatmentschedulesandmoderndaylife.”Overthepastyear,thegrouphas

offeredtwoonlinecourses:Recognizing and Managing Countertransference in Problem Gambling Clinical Work, facilitatedbyGeoffreyW.Locke,MA,MSW,ABD,CAS,aclinicianinprivatepracticeinAmherst,Mass.,whichin-cludedanintensivestudyofcounter-transferenceandhowitimpactsclinicaljudgmentandtreatment.AndThe Gambling Brain: How It Works & How to Treat It,facilitatedbyJonGrant,JD,MD,MPH,AssociateProfessorofPsy-chiatryattheUniversityofMinnesotaMedicalSchool,whichlooksattheneu-rochemistryofthebrain,itsrelationshiptoaddictions,includinggambling,andeffectivemethodsfortreatment.FormoreinformationabouttheCoun-

cil’sonlinetrainingopportunities,con-tactCouncilProgramAssistant,[email protected],phone617-426-4554.

about the prevention and treatment of the addiction and problem gambling fields. If we are to experience “breakthroughs” in both fields we must be open to information which causes us to shift our paradigm. The problem gambling field’s efforts to establish its own paradigm may be just the catalyst for a paradigm shift in its closest “cousin”—the field of alcohol and other drug addiction.

(Paradigm, continued from page 10)

By Marlene Bocook, MA LPC

This is the story of Jeanie, a 42-year-old female who has been happily married to John for one year. Jeanie and John started dating about six months after John was divorced from his first wife, Michelle. John told Jeanie about his marriage of 20 years and how Michelle had started to gamble the

last two years of their marriage. He told her that Michelle had gambledand lost everything they owned. She had taken out loans he did notknow about, sold things, maxed out credit cards, used their retirementmoney and he was in debt for half of the bills. Jeanie understood why John had his wages garnished and she worked full time to help meet their expenses, they did not have a lot but, they were happy.

One night they decided to stop in a neighborhood bar to have a few drinks. John started playing pool with some friends and Jeanie feeling a little bored walked over to a video machine and put in $5.00. She

played that and lost like she had done a few times before without giving it a second thought. She walked back to the bar where John was waiting. He was irritated and told her it was time to go.

On the way home John became enraged, he called Jeanie names, said she was just like Michelle, he said he was not going to go through all that again. He stated that Jeanie needed to get help before she became hooked or he would leave her. Jeanie called the Help-Line.

This is a story that plays out all too often in many relationships if the spouse of a gambler does not get the help needed to work through the loss, guilt and problems associated with being in a relationship with a problem gambler. The affects often continue even if the spouse leaves the relationship. We need further research on long term affects of gambling on relationships as well as resources to continue to reach out to families of problem gamblers. Problem gambling affects not only current relationships of the gambler but, also future the relation-ships of all involved.


NationalConferenceRecapNational Conference Recap

Thanks from CCPG

The California Council on Problem Gambling was pleased to host with the National Coun-cil the 22nd Conference in Long Beach, Calif.. We would like to that all those who dili-gently worked so very hard to produce a program that ben-efited all those that attended.

We also were so pleased to see all of the stakeholders come together and learn what part each plays in dealing with some of the problems associated with compulsive gambling. I was pleased to see the collaborative work by the recovery commu-nity, the clinicians, the gaming industry, the state agencies and the council in seeing that each entity has an important role to play.

On behalf of the California Council I would again like to express our sincere thanks to each an everyone of you for attending and to the presenters for the excellent presentations.

So again thanks to all.

Tom Marriscolo

President California Council on Problem Gambling

2008 AwardsNational Council on Problem

Gambling

MEDIA ProblemGamblingPublicAwareness Multi-MediaCampaign,NYOASAS

The electronic program that appeared in the past year that best raised public awareness of

problem gambling.

GOVERNMENTKarenCarpenter-Palumbo,NYOASAS

The government (or agency/program) that has demonstrated supe-rior achievement in addressing issues of problem and pathological

gambling.

DISTINGUISHEDPROGRAMAWARD DealingWithAddiction,FloridaCouncil

onCompulsiveGambling Awarded in recognition of exceptional effort to

establish advocacy for problem gamblers in their state.

OUTSTANDINGCONTRIBUTOR INTHEFIELD

LouiseLecklitner,SanDiegoHealth& HumanServicesAgency

The person, institution, organization or company outside of the NCPG structure that has demonstrated superior achievement in

addressing issues of problem and pathological gambling.

DISSERTATIONAWARD Bethany Bray, PhD,

The Pennsylvania State University, Examining Gambling and Substance Use: Applications of Advanced Latent Class Modeling

Techniques for Cross-sectional and Longitudinal Data.

MASTERSTHESISAWARD JessicaI.McBride,MA,

Department of Educational & Counselling Psychology, McGill University, Montreal, Quebec. An Exploratory Analysis of Internet

Gambling Among University Students.

PEOPLESCHOICEAWARD “ProblemGamblingBreaksMore

ThantheBank” Nevada Council on Problem Gambling

The NCPG took a num-ber of steps to make the recent 22nd National Conference more environmentally friendly and provided a reduced-paper registra-tion option for attendees. During the meeting, planning process staff worked with the hotel to eliminate bottled water and increase the number of reusable items. Every attendee received a reusable water bottle so they could easily quench their thirst from the water stations and pitchers set up throughout the meeting rooms. We worked with Goldman Productions to manufac-ture all conference promotional items (Frisbee, water bottle, luggage tag and yo-yo) from 100% recycled material. And almost one-third of the registrants utilized the “Green” discount registration option which saved almost 30,000 pages of print-ed material. These attendees re-ceived a special notebook and pen made from recycled materials for notetaking. The hotel processed all waste for recycling, separating out plastic, cardboard, glass and other durable materials. Attendees were also asked to take an extra step whenever possible by recycling, turning off the lights in their hotel room when not in use and reusing non-disposable items whenever possible. NCPG will continue to look for ways to work with vendors and attendees to save resources and promote responsible usage. As with any change, it only takes one per-son to start, but many to sustain.

NCPG Goes Green in Long

Beach

Did you know that the 24th National Conference will be

in Portland, Oregon at the Hilton Portland

& Executive Tower from June 10–12, 2010?



Thanks to our conference sponsors.

PLATINUMSouthern California Casino

Association

GOLDAgua Caliente Band of Cahuilla

IndiansAssociation of Gaming Equipment

ManufacturersCalifornia Office of Problem

GamblingCalifornia State Lottery

International Game Technology Pechanga Band of Luiseno Indians

San Manuel Band of Mission Indians

Sunland Park

SILVERCounty of San Diego, Department

of Health and Human Services

BRONZECalifornia Department of Justice,

Division of Gambling ControlHarrah’s Entertainment

Viejas Band of Kumeyaay Indians

ASSOCIATEHarrah’s Rincon

Oak Tree Racing Association Charitable Foundation

San Pasqual Band of Mission Indians (Valley View Casino)

By Paul Del Vacchio

I had the honor to attend this year’s National Council on Problem Gambling’s Annual Conference in June. This was a remarkable

conference on every level and it was equally remarkable that I was able to attend. It was an honor and a privilege being at the confer-ence, all thanks to the National Council’s Executive Director Keith Whyte.

Four months prior to the conference, I com-pleted serving a 19½-month sentence for crimes I committed as a direct result of mycompulsive gambling addiction. These crimesconsisted of embezzlement from my previous employer, which is a prominent resort and casino. I had a great position in the equally great company, yet I obliterated the trust in -stilled in me so I could perpetuate my com-pulsive gambling addiction. All of this came crashing down on me over three years ago.

I was an executive at a resort and casino, but this did not preclude me from falling prey to the disease of problem gambling. I certainly knew that the “casino always wins” because I spent 12 plus years in various finan cial posi-tions in the gaming industry. Yet this knowl-edge only caused me more damage since I thought I was smarter than the average gam-bler. I was no smarter than anyone, and, in fact,my gambling career was filled with “ah ha” mo-ments notifying me that I did have a problem.

When I was 18-years-old, I got into trouble with a local bookmaker because I had run up a significant debt betting on sports. I was able to be bailed out of this trouble and was scared enough to not gamble for my entire college career. I finished college and started working for a prestigious accounting firm. Everything was looking up, so I started gam-bling again without the thought of those previous consequences. A few years passed and once again I found myself in debt. I bailed myself out of this debt by filing for bankruptcy, and in the meantime I had taken a business trip to Las Vegas and fell in love with the “suburbia” part of the city.

I convinced my wife to move out to Las Vegas because I thought if I worked for the casinos my seemingly insatiable desire to gamble would be quelled. We did move to Las Vegas and I quickly got a job with one of the casinos in the finance department. My desire to gamble seemed to be arrested; how-

Incredible Conferenceever, as my career progressed, my desire to gamble increased. This is when I found the Internet and the complete anonymity of placing wagers on-line. I knew enough to stay away from the land-based casinos, and even the casinos on-line, but I thought I could “professionalize” my sports betting behavior. I only fooled myself because I cannot gamble for fun. I took the fun out of gambling many years ago and as I continue to gamble my wagers increased.

I was offered and accepted a wonderful posi-tion with the resort and casino in Southern California but I had a deep dark secret. My secret would be exposed about four years later. I continued to gamble on-line and I discovered something in the company’s ac-counting system which accelerated my com-pulsive gambling behavior. Instead of doing the right thing, which would be to correct the deficiency, I exploited it.

Thankfully, my devious behavior was dis cov-ered because it brought me to recovery. I havenow been abstinent from gambling for the past three years and five months. This is all thanks to recovery and the incredible people associated. I have spent two years separated from my family as I served my prison sen-tence. Prior to entering prison, I found the Gamblers Anonymous program which con-tinues to save my life. I spent 16 months fullyimmersed in GA before I was sentenced, and the great people from GA brought the meet-ings to me while I served my sentence.

I am a very fortunate and blessed person. My wife and two children have rejoined me and my life is the best it has ever been. I was indeed honored to be at the annual confer-ence and enjoyed every aspect. I especially enjoyed the final day which brought the recovery aspect to the forefront. I understand very well that gaming is here to stay and I equally understand that recovery is the only way for me. I know I can never gamble again, but there are many people who under-stand that gambling is fun. In my case, it was never fun; however, life is a great deal of fun as I savor every moment one at a time.



By Lanny Russikoff

Long Beach happened to be my second National Conference, but it will not be my last. Having been a member of a 12-step fellowship that helps compulsive gamblers for over 20 years, I want to learn more about ways that I can help compulsive gamblers.

I am a proud member of the California Council of Problem Gamblers for the last 3 years. I have gone through the classes that the CCPG offers and passed the test. I am

now a Life Coach that works only with prob-lem gamblers and their families. I have an office, liability insurance, and I am working online in getting my BA in Psychology.

If I had any complaints about the confer-ence, it would be that I could not attend every workshop. I have no idea how they could correct this concern. If anyone would like to reach me, they can email me at [email protected] or call me at 909-896-1078.

What a Great Conference in Long Beach

By Louise Lecklitner

When asked to write a brief article for the NCPG newsletter and was told that I could write about anything I wanted, my mind was filled with possibilities, including turning down the opportunity. Deciding that refusing was not an option, I will take this opportunity to share some of the activities we are accomplishing in San Diego. I write this not as a clinician or as a researcher, but as a person desiring to in-crease available resources for residents of San Diego County who are experiencing problems related to and resulting from gambling.

I recently attended the 22nd Annual National Conference on Prob-lem Gambling, and as always I was amazed by the diversity of attend-ees’ backgrounds, occupations and opinions, and yet, no matter the differences, all share the common concern of the impacts of problem and pathological gambling. I had the opportunity to interact with many people at the conference. Whether assisting with registration, facilitating a panel, listening to a speaker or participating in the Na-tive American focus group, I was constantly struck by everyone’s passion on the topic of problem gambling.

My first NCPG conference was in New Orleans and the theme was “Finding Common Ground.”.That philosophy resonated with me and has become the framework for my efforts in addressing gambling related problems. Throughout my years of recovery and working in the substance abuse field, I have been led by the slogan “look for the similarities, rather than the differences.” I have seen that collaborative efforts to address issues have accomplished greater, more lasting out-comes than those that result solely from power struggles or from an individual dictating what must be done. Conflict is healthy and can lead to wonderful results once participants are able to find the common ground.

Who benefits when people work through differences, recognize simi-larities and find common ground from which to operate? Problem

gamblers and their families certainly benefit from self exclusion pro-grams, Gamblers Anonymous, counseling and in time will be able to benefit from public, low cost outpatient treatment. The community prospers by minimizing the social, financial and health costs of gam-bling.

In the case of San Diego County residents, it has been the joint effortsof Tribal governments, County government and the California Coun-cil on Problem Gambling coming together to address impacts and issues of mutual concern. With funding from the Indian Gaming Local Community Benefit Committee (IGLCBC), the County was able to contract with the California Council on Problem Gambling for training and internship opportunities that have resulted in an increase in the number of certified gambling counselors in San Diego.

Knowing that education and awareness is also critical, I developed an educational awareness campaign for Health and Human ServicesAgency entitled “Gambling: There is More to Lose than Your Money.”The goal was to raise awareness of impacts of problem gambling to theworkplace. The campaign has been well received by agency managers and executives, and appears to have had a positive impact on staff.

The result of these efforts is the beginning of the development of an integrated system of care that will address the impacts for problem and pathological gamblers within our community. With our joint commitment to our residents we can develop a safety net for those who need our help in addressing issues caused by their gambling, and which eventually will include low cost outpatient treatment services.

I am passionate about my work and my hope is that in some small way I will be able to give back to my community and impact San Diego’s system of care for helping problem gamblers. Thanks to everyone who has played a role in my journey, and may we all remain passionate, and willing to look for similarities, so we can continue the great work we have begun. See everyone in Indianapolis in 2009.

Finding Common Ground


TheCounselor’sCornerThe Counselor’s Corner

Clearing Away the Financial Fog

By Brian H. Farr, MA, LPC, NCGC-II

Do your clients have financial problems? My gambling clients have so many financial problems they usually don’t know where to begin looking for solutions. It seems that gambling clients are almost universally lost in a financial fog when they begin treatment.

Debra was in her early 40’s when she began outpatient treatment for problem gambling. She was the manager of a successful person-nel agency and had a decent income for years. However, Debra never balanced her checkbook, she juggled her bills to make it through the month, and she frequently took advances from her boss to cover those last days before payday. Her personal finances were a tangle of confusion and panic.

Whatinterventionscanacounselorusetohelpclientsclearawayfinancialconfu-sion? When I am working with clients I use three simple tools to start the fog-clearing process: Daily Tracking Sheets, Debt Snap-shots and Monthly Snapshots. These three worksheets are easily introduced to clients of all educational levels. They organize personal financial data quickly and clearly. And these tools provide effective guidance to those clients who want to move themselves from financial confusion into financial clarity.

The DailyTrackingSheet is a small piece of paper the same size as a dollar bill. It fitssnugly into a wallet or checkbook. Clients areasked to write down every purchase of one dollar or more…and to write it down within 60 seconds of spending the money. I typically ask clients to use the Tracking Sheets for 14 days. If clients track their daily expenses for a full month or longer, that’s even better.

The Daily Tracking Sheets capture detailed information that creates an accurate picture of financial reality. If the clients write down every dollar spent, they will learn exactly how much they are spending and where. Equally important, by writing within 60 seconds of the purchase, they experience a new financial awareness as money is leaving their wallet,

checkbook, debit or credit card. Many gam-blers are unconscious as they lose money again and again. The simple act of putting pen to paper at point of purchase can shake up old habits and help a person become more conscious about their own relationship with money.

The DebtSnapshot is a one-page worksheet that collects four pieces of information for every debt: name of creditor, interest rate, total balance due and minimum monthly payment. These are the basics. When this information is listed on one sheet, clients begin to dismantle their financial confusion. Until these numbers are actually written onto a worksheet, the gambler’s mind can be a chaos of crazy calculations or blank numb-ness (often alternating between the two). As painful as it is to face this debt information, most of the gamblers I have worked with needed to know these facts before they could make real progress in their recovery.

The MonthlySnapshot captures basic detailsof household expenses and income. It is a snapshot, just a quick picture (not an intimi-dating budget). Most clients know half of these monthly expenses off the top of their head. They are able to sort out the other expenses with minimal effort. Typically, Ibegin by asking about specific categories (rentor mortgage, car payments, utilities) and then write that information into the work-sheet myself. Usually the Snapshot is 50 per-cent completed within 10 minutes. I ask the clients to finish it when they go home. Most clients have enough curiosity to complete the worksheet before their next session.

After they complete the Snapshot, clients have an easy-to-understand picture of their typical spending patterns. “So that’s where my money is going!” Many gamblers (and some counselors) are ‘flying blind’ from month to month. Financial uncertainty creates tension. Tension can create a desire to escape or numb out. Accurate financial infor-mation is liberating for everyone involved.

This is the end of Clearing Away the Financial Fog Part 1. Stay tuned for our next newsletter to catch Part 2!

Print free copies of the three financial work-sheets described in this article: go to www.bhfarr.com, click on the “Workshops” tab and scroll to the bottom of the page. Open each worksheet (PDF) and print as many as you need. If you have problems with the file, contact me directly: [email protected]

As Ubiquitous asWhite T-Shirts

By Christopher Day LCSW, DCSW

Gambling is everywhere! However, just how ubiquitous it is and just how many manifestations of it there are was never so clear until I took NCGC I training. I now notice it’s influence in every crook and cranny of daily American life as young and old alike try to turn pennies into gold in ev-ery fashionable and sometimes despicable (e.g. dog fights) way.

I can remember a time when going to the casino was a real event. I was 21 and in New Providence, Bahamas. The casino was something rare and very special back then. There was class and charm as everyone had to dress “appropriately” with jackets and ties for men and dresses for ladies. It seemed as much a social affair as a chance to lose some money.

Today, gambling is just plain common and when I stand behind the person at the convenience store reciting their Powerball numbers by memory I see that the glamour is gone and that greed and super stition are powerful motivators. I also find, coming from Canada originally, that prevention and treatment in the States for the gambling disordered client seems somewhat behind the times. I am strong advocate of harm re-duction and believe prevention should be pushed in a much more aggressive manner as it is in Canada.

I believe that the old days where casinos held their charm as fashionable venues is long gone and I now see that the chance to get rich quick by those that can least afford it is strong and ever growing. You don’t need a tie and jacket anymore to play cards or pull the slot machines. In fact, all you re-ally need is more money and perhaps some-thing to scratch your latest lottery ticket with. Perhaps while wearing a white t-shirt.



By Tara Barrett, CPGC-I

The impact of a pathological gambler’s legal actions may induce shock and anger from their spouse and family members. This is often when the gambling disorder is finally revealed, as concealed actions are brought to discovery in a lawyer’s office or court hearing. The once unknown and unaccountable behavior of the gambler has had a direct negative action against the household, and the family members are drawn into a complicated twist of legal issues to defend.

Often the gambler’s disorder is not addressed until serious legal con-sequences are involved, particularly in divorce, child custody, drug and alcohol abuse, and fraud/embezzlement actions. Addressing legal matters in court, families may be burdened by conflicting interests in order to preserve community assets. Initially, it may be clear the spouse/family could be reluctant to support the gambler in a thera-peutic sense. In fact, the family of the gambler in legal trouble may have competing goals in the legal process and this would likely be addressed in counseling of all involved. The need for the gambling

client to have effective treatment is as important as assigning different therapists to the spouse/family and the gambler.

In cases where the gambler is removed from the home (inpatient services and/or incarceration), the spouse/family may experience less anger with the gambler, as the legal and therapeutic process are con-trolled and contact with the gambler is available. When a gambler in legal crisis abandons the family home without services, they may disappear from any contact with family outside of the mandatory court-related appearances. If the gambler remains in the home, coun-seling of all involved may also improve the daily communication readily needed through the long legal process ahead.

The hope of counseling is to strengthen the family’s resolve to remain a source of support to the gambler in crisis. A slow introductory education to the spouse/family on why their loved-one has a gam-bling problem could lessen their anger and fears. However, the goal of each counselor assigned is to treat their client’s needs first, thereby establishing equity in the counseling services provided while working within the legal system.

A Focus on the Family – A Pathological Gambler in Legal Crisis

Brent A Stachler, MS, LMFT, MAC, ICAC II

“ It is possible to fail in many ways…while to succeed is possible only in one way, for which reason also one is easy and the other difficult—to miss the mark is easy, to hit it difficult.”

— Aristotle

I recently came across this phrase and thought about how this relates to our addiction profession. I have been in this profession for approx-imately 15 years and am well aware of the many attempts legitimize our profession with a licensure bill with the end result being a failure. Over those 15 years, there have been many changes, which in essence, have raised the mark. If we are to succeed in “professionalizing” the work that we do, specifically providing services to those suffering from addiction, then we must accept the fact that times have changed. We will also need to accept the fact that the mark has been raised, creating even more of a challenge to hit the target.

If a pole-vaulter, high-jumper, or hurdler wishes to qualify for the event, a minimum standard needs to be adopted. Although practice is vitally important to success, I would also argue that good coaching and opportunities for skill-development are also vitally important.

To develop (and hone) my skills as an addiction professional, I must accept the fact that academics has a vital role with establishing core competencies and accept that good coaching will only come through quality clinical supervision.

According to Dr. William F Northey, Jr., a research specialist for the American Association for Marriage and Family Therapy (AAMFT), “the dwindling workforce in behavioral health has been a concern of

policymakers for some time. Insuring a quality workforce to deliver the services needed is fueling a move towards the development of competencies throughout behavioral health.” (AAMFT, Family Ther-apy Magazine, July/Aug. 2005, p.11). He goes on to note all sectors of behavioral health have initiated competency development. This core competency movement has already been initiated by the Addic-tion Technology Transfer Centers (ATTC), Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Ser-vices Administration (SAMHSA), and NAADAC, the National Association for Addiction Professionals. TAP 21 (1998), a publication available through SAMHSA, identifies necessary Addiction Counsel-ing Competencies.

Among other reasons, this competency movement protects the con-sumer from receiving behavioral health services, specifically addiction treatment, that does not meet specific standards of care. Managed care companies and education institutions have indicated a need for standards to reflect similarities in expected requirements for the addic tion profession. Essentially, these standards aid in workforce development through higher education’s ability to implement them into corresponding coursework, practicum and internship.

The Indiana Association for Addiction Professionals (IAAP), is also a part of this competency movement in that this association was founded upon one of many purposes, which states “to elevate and maintain the standards of education for licensure and/or certification required to counsel people with addictive diseases.” The standards have been raised, and by accepting these as our standards of practice, we will be prepared to hit the mark and succeed.

Changing Times in the Addiction Profession



By Kitty Brogan, LCSW, NCGC II

On September 12, 2003, while driving to my first training session in the treatment of compulsive gambling, I was prepared to get my 7.5 continuing education credits, learn a little about compulsive gambling, and to head home. Instead, I learned a lot about compulsive gambling and was inspired to learn more by my instructor, Terri Orsini-Rebosio, LMHC, NCGC II.

Thanks to Terri, I was awakened to the seri-ousness of compulsive gambling. I became aware of the addictive properties of gambling and the often traumatic and always dramatic

effects problem gambling can have on the gambler and those close to the gamblers. My heightened awareness motivated me to con-tinue training with Terri, and I subsequently enrolled in more training sessions, eventually completing the mandatory training and supervision that qualified me to take (and pass) the national certification examination in November, 2005.

Thanks to the Florida Council on Compul-sive Gambling, I was given the opportunity to obtain the necessary training with mini-mal expense and maximum convenience. Terri worked with the professionals pursuing

Training for Treatment: A Tributetheir certification in gambling treatment to make the training sessions convenient to our work schedules. The Council provided the trainees with wonderful resources, such as the workbook series, “A Chance for Change.”

I would like to take this opportunity to encourage mental health professionals across the state to seriously consider taking advan-tage of the training offered by the Florida Council on Compulsive Gambling. Your practice will be enriched with the additional specialty, and your satisfaction in working with this population will make the time and effort seem worthwhile.

Being a New NCGC-IBy Larry Erhardt, LCSW, NCGC-I

Having attended only my second National Conference of Problem Gambling and hav-ing been a Nationally Certified Gambling Counselor-I for two years, I thought I would share my views as a relatively new counselor in the area of problem gambling.

Having met all the individuals in this field, and hearing all the stories about the prolifera-tion of the gaming industry; nothing has impacted me more, than actually seeing it. In attending this year’s conference, I chose to take an 18-day vacation and drive from Southeastern Indiana to Long Beach, Calif. I saw all the sights I’ve always wanted to see out west. What caught my attention the most though were the amount of gambling venues and billboards that dot this great nation of ours. While revisiting the Hoover Dam after some 15 years, I was surprised to find a casino about 1 mile from the dam. Driving alone you tend to pick up so much and throughout my 7000+ miles of driving I saw only one billboard regarding help for the problem gambler just outside of Kansas City, Mo. I can safely determine that I see just how important all the work we do is and how much still awaits us.

On the state level in Indiana, we have fine in-dividuals and programs. The Indiana Councilon Problem Gambling is run by Jerry Long and he has helped tremendously with sup-port and referrals through the State Hotline number. The Indiana Prevention Resource Center (IPRC) provides ongoing educationand resources for the problem gambling coun-selors. I’ve utilized the services of Mary Lay and Jennifer Kelley several times and greatly appreciate their efforts. The IPRC also pro-vides two monthly supervision calls provided by Dr. Deborah Haskins which are helpful and insightful. The Gambling Recovery Ministry’s Rev. Janet Jacobs also has provided me with the opportunity to share in promot-ing education in our area and beyond.

At the local level, I am a therapist with Com-munity Mental Health Center, Inc. in the Southeastern Indiana. Our agency covers a five county area which is mostly rural. With-in this five county area we also have the lottery, Powerball, three casinos, bingo halls. festivals. and pull tabs. Initially, providing service to the gambler was slow. With much education within our agency, as well as the public, we are beginning to see the problem gambler recognizes the need for help. Over our past fiscal year. July 1, 2007 through June 31, 2008, I counseled 16 pathological gamblers. Over a two-and-a-half year period

I am very happy with how far we, as an agency, have recognized our part in meeting the needs of our community. Community Mental Health Center, Inc. received support from the Greater Cincinnati (Ohio) Health Foundation who printed posters for local use to promote help for the problem gambler. Our assessment tools and the SOGS better help in identifying problem gamblers and, at the state level, funding for counseling is pro-vided to help those gamblers whose finances are already in peril. Our agency also had to deal with a first: e-mails seeking gambling counseling that came to my email address via the National Council of Problem Gambling’s Counselor Search. Growth also occurred with GA. In Southeastern Indiana, Gam-bling Recovery Ministries has a GA meeting the last Saturday of each mouth and just two months ago, a GA meeting began in another one of our counties.

Being a National Certified Gambling Coun-selor-I has been a challenge, and yet so re-warding. The support. I find in this field has been substantial, and always encouraging and needed at times. I thank all those who have paved this road and all of you who make up this family dedicated to improving the lives of individuals and families who have been devastated by pathological gambling.



A Nevada Case StudyBy Lynn Stilley

Jill came in for a one-hour evaluation, referred by the National Hotline. When she called, we scheduled her for the next day. She presented by herself, and filled out the paperwork before she was called in to talk. Upon reviewing the SOGS and the DSM-IV-R criteria, she was diagnosed as a probable pathological video poker gambler, having scores above 5 on both. As we talked, we made a list of the negative events in her life caused by gambling, the most outstanding one being the fact that her husband and children had moved out of the house the week before. Talking about this elicited tears from Jill. Near the end of our hour together, she was read the list of negative events we had composed from her words, about a dozen in all, and asked what she wanted to do about her gambling. Her response was, “Anything it takes.” We then discussed useful “speed bumps,” strategies that might give her enough time to reconsider her decision to gamble, such as not having access to money and not going to slippery places, as well as the longer term treatment options, for the underlying problems. She opted for our intensive outpatient program, and began attending the evening group the next night, semi-regularly, two to three times a week. She took 10 weeks to complete the 24 modules, bonding well with other members of the group, going to GA at least twice a week (once with the group), and doing her autobiography as well as her restitution plan. She did not slip while in the program. After she had done 24 groups, she did not feel comfortable attending our continu-ing care only once a week, so we agreed she could continue coming to the group twice a week, if she increased her GA attendance to three times aweek. Eventually she did her “Goodbye to Gambling” letter, had her cer-emony, and started attending continuing care once a week. Now nine months later, she has not relapsed; she chairs a GA meeting, she continues to attend group as needed, and is a valuable resource in talking to newer members.

Strategies for RecoveryAt Comprehensive Therapy Centers’ gam-bling program, located in Las Vegas, Nev., over two-thirds of our clients are women. This reflects the increasing power of the video poker machines in our casinos and community venues (bars, grocery stores, gas stations and mini-marts). Most of our refer-rals are from the hotline, word-of-mouth from previous clients, or from GA members.

Prompt scheduling of gambling clients im-proves their rate of attendance at their intake; any delay in scheduling gives them time to find a bail-out, relieving the pressure to correct their problem on a more permanent basis. Even with this promptness, our no-show rate is over 50 percent.

At our intakes, we emphasize two important points: The urgency of doing something about their problems immediately, before they do more harm to themselves, and the hope of recovery. In Jill’s case, the departure of her husband and kids alone was a great motivator, as she still had hopes that, if she quit gambling, her husband would return.

We use the SOGS to screen our clients and as a take-off point for our evaluation. As always in social services, time is limited and must be used efficiently, and the SOGS is the most effective tool that our staff has found for quickly and comprehensively understand-ing gambling issues in an individual client’s life.

“Anything it takes” is the best answer cor-relating to a client’s success in recovery. It indicates their willingness to address their own denial, at least at intake.

We have found that, for those who want to completely stop gambling, a small group is the most effective. Group cohesion addresses their attendance at GA, as does the use of peer counselors and contact with the con-tinuing care group. The group acts as a

means of accountability until the client can become accountable to GA or themselves. Moreover, it provides a group of diverse people who have the same goals as the client, and who they meet with, become open with, come to depend upon for support, and see very often (addressing their boredom and lack of social skills). We carefully monitor clients’ dedication levels, as we have relaxed our requirements from four groups per week to two or more per week; at the same time, we have begun attending GA with our clients once every two weeks. They get credit for this in our program; they ease into the GA program with friends; and any questions or dislikes about GA can be addressed immedi-ately. Moreover, going with our clients as-sures us that they actually go to a meeting and don’t lie about attendance. Incidentally, we have developed some excellent relation-ships with members. We also have eased up on the clients’ departure dates from the program, customizing their length of stay to their circumstances.

All of the above strategies for recovery from pathological gambling have lent themselves to amazing life-changes for Jill, and a high rate of recovery for many of our clients. This has led to excitement and dedication in our staff, particularly in our peer counselors; in GA in referring clients to us; and in gam-bling counselor interns. We predict only continued success in the future.



Dialectical Behavior Therapy (DBT) is an effective treatment for borderline personality disorder and other treatment resistant clients (Linehan, 1993; Moonshine, 2008). DBT has been used in treatment for addictions including substances, food and gambling. The State of Oregon, Office of Problem Gambling sponsored a pilot project to adapt DBT to problem gambling treatment at LifeWorks Northwest in 2007. The pilot project demonstrated the flexibility of the model by integrating it with other treatment components and customizing it to this population. Both the clients and clinicians enjoyed learning DBT, utilizing the skills and achieving balance in their lives. DBT easily connected with 12-Step philosophy.

DBT is largely a skills-based model that teaches clients to build im-pulse control, frustration tolerance, and healthy relationships by staying present in the “here and now” most of the time. Problem gamblers learn to be skillful in their lives by using their DBT skills to reduce their gambling and other problem behaviors. In each of the four categories there are a number of skills that clients to learn and practice in their lives.

Mindfulness sets the foundation by teaching the client to be in the “here and now” most of the time. This will be useful to gambling clients by helping them get out of the fantasy of their lives once they “win big” and let go of the ruminations about past losses and disappointments.

Distress tolerance provides the client with the tools to manage stress and difficult situations. This happens by balancing active problem solving and acceptance of reality for what it is.

Emotional regulation empowers the clients to develop emotional competencies by managing and coping with their emotions. Strate-gies include “riding the wave,” “making lemonade” and “loving dan-delions.” Self-care is a significant component of this skill category.

Interpersonaleffectiveness is achieved when clients learn to be appropriately assertive, have the ability to ask for help, invest in healthy relationships and maintain self-respect. Since many problem gamblers were raised in dysfunctional families or their adult relation-ships are significantly impaired, the skills in this category will be quite useful in changing such maladaptive relationship patterns.

Clients learn and practice skills in group or individual therapy. Clients practice and track their DBT skills on diary cares. When clients use the diary cards they will be more likely to use their skills more frequently because they are being asked to record their use of skills on a daily basis.

Skills are also useful for clinicians and staff at treatment agencies.The use of DBT skills in our work will help to reduce negativity, burnout and increase resiliency. We strongly recommend that clinicians teach-ing DBT skills use the skills themselves for these reasons. Addition-ally, clinicians will be knowledgeable about the skills, be able to assist the client in problem solving barriers to using the skills and have more credibility with the clients when they ask them to use the skills in their lives.

DBT is also about holding dialectics. Being dialectical is about having balance or a “both/and” perspective. This means seeing reality as black, white and a lot of shades of grey. Clients move away from the extreme points of view of always/never, good/bad, me/you and win/lose. For problem gamblers some areas for balance are:

• Having fun, managing money and being on the Internet without gambling

• Letting go while maintaining control• Making mistakes without shame and guilt• Investing in relationships while taking care of self• Being honest with self and others• Right now, short-term and long-term future• Accepting self, others and the world as imperfect

DBT can easily be connected with 12-Step participation. Below is a short list of some DBT skills connected to 12-Step concepts:

• Mindfulness: One Day at a Time• Radical Acceptance: Serenity Prayer & Powerlessness• Repairs: Making Amends• Turning the Tables: Service Work• Four Horsemen: Character Defects• Crisis Survival Network: Sponsor• MEDDSS: Self care & spirituality

Another core DBT tool is chain analysis. Chain analysis is similar to a functional analysis. It helps the client identify the links in the chain of events that lead to relapse or problem behaviors. At each link clients will see that they have opportunities for breaking the chain by using their DBT skills.

Other components of DBT include validation and commitment strategies, irreverent and reciprocal communication, phone coaching for clients and team consultations.

For additional information on DBT, including texts and tools go to www.Moonshine-Consulting.com.

For more resources from Dr. Marsha Linehan, go to www.behavioraltech.com.

Adapting DBT for the Treatment of Problem GamblersBy Cathy Moonshine, PhD, MAC, CADC III & Stephanie Schaefer, MA



By Gina Fricke

It is common for addicts to come into treatment saying, “I feel hope-less, suicide seems like the only answer.” The options are live with this pain or die. There are no options in the grey area. We have also seen many of these clients successfully complete treatment and begin a life of recovery. When do grey areas in life come about? Introduction to new options in therapy or in Gamblers Anonymous are a start.

I see our court system as also having this all or nothing thinking. Don’t get me wrong I respect all members of the court system, it is the system I am concerned about. I see addicts going into their pro-bation officers who are mandated to say, “If you drink, drug, gamble, etc. you will go to prison/jail.” I see this as all or nothing thinking. I would like to suggest there is another way to handle this situation.

I suggest harm reduction. But, only for the clients we know will continue gambling no matter what, who we know will gamble when off probation. The harm reduction model I use has been very effec-tive for my voluntary clients, who usually are not voluntary, but ordered by family members to attend treatment. I go over a sheet I call “Wondering How To Gamble,” (below) then I ask the client for parameters for gambling. I suggest an agreement to prevent doing anything that will create additional consequences.

Wondering How To Gamble?I. Firstmakeaneducateddecision

whethertogambleornot: A. You are at an increased risk for

developing gambling addiction if you:

1. Have a genetic link to some-one who has an addiction. If this is true for you, you have a higher risk of developing addiction to anything and therefore should prevent if possible doing things that are highly addictive.

2. Have experienced gambling addiction in the past.

3. If you have experienced another addiction or are trying to stop doing an addiction.

4. People who are or have recently experienced a traumatic event in their life i.e. recent trauma, health related problems, or a recent death or grief in this person’s close relationships.

II.Ifyouchoosetogamble:

A. Only use disposable income to gamble. 1. Disposable income is money left over after all necessary

bills and other expenses are paid. 2. Do not borrow from others including spouse, family and

friends. 3. Do not use credit cards, check cashing places, savings

accounts or take out loans for gambling. 4. Do not pawn or sell anything in order to gamble.

B. Decide the amount of money to spend before gambling and stick to it.

1. Do not bring extra money with you. 2. Do not bring credit cards, checks, debit cards. 3. Do not bring and leave these things in your car. 4. Do not bring paychecks to the casino to cash.

C. Decide the amount of time to spend gambling before going and stick to it.

1. If necessary set an alarm on your watch to remind you that it is time to leave.

D. Decide how often you will gamble and stick to it. E. Develop accountability with your gambling.

1. Tell someone about your plan to go gamble. 2. Tell them when you will return. 3. Tell them how much money you plan to spend.

Then I ask: How often will you gamble? How much money will you take? How will you ensure you will only take that amount of money? How long will you gamble? If you win what will you do with the money? Will you keep the winnings or gamble them back if you have time? Will you be accountable to someone and who? While you are doing this I recom-mend no less than 6 months of weekly appointments, are you willing to follow through with this?

I have found this to be highly effective at helping clients move from not wanting to change the gambling behavior to being ready to change it.

I believe that if the legal system allowed therapists to treat clients who are on probation and/or parole with this model

when it is appropriate, the change would be more likely to be perma-nent rather than temporary. Rather than the all or nothing thinking this method would allow the client to come to the conclusion that the addiction is not helpful.

All Or Nothing Thinking



By Harlan H. Vogel, MS, LPC, CCGC, NCGC II

As a therapist working with pathological gamblers, you likely have heard clients attributing almost magical qualities to their particular form of gambling. You see any sense of any reality associated with gambling is beyond their ability to grasp. You recognize pathologicalgamblers believe their life has value only when they are gambling. Andit is your job to help them let go of their current reality. Why is their belief so strong that the gambler keeps gambling even when faced with consequences? Why can’t the gambler just stop and walk away when the cards turn against them, or the slot machine goes cold?

In his book, The Addictive Personality, Craig Nakken refers to the human desire to feel happy and to find peace of mind and soul—and how elusive it is in nature. Nakken observes addictions can be viewed as an attempt to control the uncontrollable.

In that light, then, it makes sense that the gambler is trying to controlnature. The therapist’s secret to understanding the strong belief systemheld by their client lies in understanding (i) the difference between the two types of pathological gamblers and (ii) how each type of gambler tries to control the uncontrollable.

Action gamblers: For the action gambler, the act of gambling keeps them in play. Being in play is happiness and brings peace of mind and soul. It offers the gambler an artificial sense of fulfillment that feeds their ego. They are constantly engaged with the action, starting with the preparation associated with making the bet all the way to the uncertain outcome. Studies show that the action gambler experiences a dopamine release that is so powerful that they continue to chase the action even when losing. This dopamine release makes gambling almost impossible to walk away from, even when losing.

Escapegamblers: For the escape gambler the act of gambling offers an escape from bad relationships, work pressures or a poor sense of who they are as an individual. They often struggle with depression or other mental health issues. The trance like state from gambling is happiness and brings peace of mind and soul. A client who played slot machines confided she played the slots to achieve the trance. She and her friends would joke about it and call it “slot sleeping.” She described “slot sleeping” as the ability to disengage from the world on an emotional and mental basis for as long as her money would last. She went on to say that nothing else she had ever done made her feel so totally disengaged from life.

Professor Shane Thomas of The Problem Gambling Research and Treatment Centre stated that: “ Education programs that appeal to a gambler’s rational decision making are not going to be as effective if the real problem is associated not with behavioural choices, but with underlying depression or other mental health problem.”

Expanding on that, counselors must look at pathological gambling as a broad-based condition that needs more than symptom reduction,

crisis management and reduction of consequences. In order to help each type of gambler move beyond their need for escape, avoidance and chasing artificial fulfillment, the counselor needs to be ready to address both types of pathological gamblers who seek treatment. We first need to understand each gambler’s definition of happiness, what peace of mind and soul means to them—and help guide them to a healthier reality and the magic of a life without the illusions and consequences of gambling.

© 2008 Harlan H. Vogel

Pathological Gambling: A Broad-based Condition

SAVE THE DATE23rd Annual Conference on Problem

Gambling Prevention, Treatment, Responsible Gaming, Research

and Recovery

June 25-27, 2009Hyatt Regency Indianapolis

Organized by the National Council on Problem Gambling

Hosted by the Indiana Council on Problem Gambling

Make plans to attend the oldest and largest conference on problem gambling

in the world.

Hear from more than 100 of the top presenters from across the U.S.

and around the world on:• Prevention• Treatment

• Responsible Gaming• Research• Recovery

Go to www.ncpgambling.org/conferencefor updated information, including:

Call for PapersHotel • Program

Registration • ScholarshipsSponsorships



By Jay Ford, PhD, NIATx Director of Research1

What is the experience of consumers seeking help from your organization? Several months ago, my wife and I were shopping for a new bed and visited two national furniture chains. The contrasting customer experience was amazing. In one store, we were immediately greeted by warm and friendly staff that lis-tened to our request, answered all of our questions and, while we were with him, and kept his focus totally on us—his customers. The experience in the other store was the exact opposite. We were not greeted by friendly staff, had to weave our way through the confusing store layout to find the beds, and could not easily find anyone willing to help us because each employee worked in their own department. Guess which store got our business?

Since 2002, addiction treatment and mental health providers across the country—includ-ing providers that offer treatment for prob-lem gambling—have used a customer-fo-cused process improvement method aimed specifically at improving access to and reten-tion in treatment. This methodology is founded upon five key principals that dif-ferentiate successful versus unsuccessful organizations in implementing change.2, 3

1. Understand and involve the customer (user) of the process an organization is trying to improve.

2. Choose processes for improvement that meet an organization’s overarching goals.

3. Engage powerful and respected change agents in the change process.

4. Seek ideas and encouragement from outside the field.

5. Quickly but thoroughly test solutions before full-scale implementation.

Of these five principles, we’ve found that the first principle is the most important. Before starting any change, agencies are asked to conduct a walk-through of their intake pro-cess or their process for engaging customers. The steps are simple:

1. Select two detail-oriented people commit-ted to enhancing customer service to play the roles of a client and a family member.

2. Identify a typical presenting problem at your practice or agency.

3. Let your staff know about the walk-through and encourage them to make the experience as close to normal as possible.

4. Conduct the walk-through and experi-ence the processes from the client and family perspective by asking what might a customer be thinking and how he or she might feel.

5. Record those observations and feelings.

Here is a quick guide to help you record those observations at each potential step of the intake process.4

• Callingforanappointment:Were you told to call back or transferred to voice-mail? Were you given an appointment during your first call? How long would you have to wait for an appointment? Were you able to schedule an appoint-ment immediately? Would you have to miss work to get an appointment?

• Appointmentday:As you arrive, think about what it would be like if you have never been here before. Is transportation an issue? Are parking, directions, and signage adequate? What was the environ-ment like? Did it feel welcoming or cold and harsh? How were you greeted when entering the facility?

• Intakeprocess: During the intake process think about it from the client’s perspective or from the perspective for their family coming in for the first time. Fill out all the required forms. Were they repetitive, cumbersome and confusing or easy to complete? How long did you wait in the waiting room? Did the process engage the client’s family? Were they able to accom-pany the client through the entire intake process? Will you have to wait a long time for the next appointment?

Seeking Help – Is Your Practice or Agency Consumer Friendly?If the focus is treatment engagement, ask how easy is it to schedule the appointment? Do sessions meet the individual client needs? How welcoming are staff and other clients to new individuals? Does your organization follow-up with clients who miss their treat-ment appointment? At the end of the walk-through process, ask yourself two questions:

1. What most surprised you during the walkthrough?

2. What two things would you most want to change?

I would like to invite private practitioners and treatment agencies alike who provide treatment for problem gambling to conduct a walk-through in your organization, experi-ence the intake process from the customer’s perspective, or even ask them for feedback directly. Please share your findings by send-ing an e-mail to me at [email protected]. If we get enough responses, I will ask the NCPG to share the results with the field.

References

1 Please visit www.niatx.net for more infor-mation about this initiative.

2 Capoccia V. A., Cotter F., Gustafson D. H., Cassidy E., Ford J., Madden L. et al. (2007). Making “stone soup”: How pro-cess improvement is changing the addic-tion treatment field. Joint Commission Journal on Quality and Patient Safety, 33: 95-103.

3 Gustafson D. H., Hundt A.S. (1995). Findings of innovation research applied to quality management principles for health care. Health Care Management Review 20:16-33.

4 See https://www.niatx.net/Content/Con-tentPage.aspx?NID=32 for more detailed instructions


Calendar of EventsFormoreinformationontheseevents,

pleasevisitourwebsite www.ncpgambling.org

August 2008

NATI:CounselingthePathologicalGambler(IandII)Web-Based, On DemandContact: Elizabeth George at [email protected] or 218-722-1503

September 2008


WisconsinCouncilonProblemGambling:PhaseIIIDate: September 11–12, 2008Location: 1423 Kellogg St., Green BayContact: Rose Gruber at 920-437-8888

MidCentralAllianceonProblemGambling 2008FallConferenceonProblemGamblingand Other Counseling IssuesDates: September 17–19, 2008Location: Drawbridge Inn, Ft. Mitchell, KYContact: Mike Stone at 502-223-1823

October 2008

PennStateAlleghenyGamblingAddictionCertificationTrainingDates: October 3–4, 2008Location: Penn State Greater Allegheny, Southern PAContact: Stephanie DeMaro at 412-675-9055

WisconsinCouncilonProblemGambling:PhaseIVDate: October 9–10, 2008Location: 1423 Kellogg St., Green BayContact: Rose Gruber at 920-437-8888


National Helpline Report2nd Quarter 2008

In each issue of the National News, the National Council on Problem Gambling will provide an overview of the calls placed to the National Problem Gambling Helpline Network (800-522-4700) for the previous months along with a summary of the total calls received year to date.

The National Problem Gambling Helpline Network is a single nation wide point of access network comprised of 27 call centers, with several centers answering calls for multiple states. Each call center is staffed with professionals who are fully trained to deal with problem gambling calls including those in crisis situations.

Since January 2008, the National Helpline has received over 151,000 calls. The month of Maydepictedthehighestcallvolumewithmorethan24,000callsplacedtotheNationalHelpline;a7%increasefromMay2007.Overallthisquartersawan7%increaseincallsvolumeincomparisontoJanuarythroughMay2007.

The National Problem Gambling Helpline Network is a 24/7, 100% confidential resource that provides hope and help to problem gamblers and their loved ones. The helpline number (800-522-4700) can be dialed toll free anytime and anywhere in the United States as well as from various parts of Canada and the U.S. Virgin Islands.

Helpline Network Call Volume – 2nd Quarter 2008

Helpline Calls 2007 vs 2008 Month-to-Date

Non-Profit Org.

U.S. Postage

PAID

Washington, DC

Permit No. 2422

National Newsletter Submissions

NCPG encourages submissions for the newsletter from its members. Min. Words: 150/Max. Words: 1,000. All requests must be submitted by October1,2008for the next issue.

Send your submission to melissam@ ncpgambling.org or via mail to: NCPG, Attn: Melissa Martin, 730 11th Street, NW, Suite 601, Washington, DC 20001.

Questions? Contact Melissa at 202-547-9204 or melissam@ ncpgambling.org.

730 11th Street, NW, Suite 601Washington, DC 20001

We’re Ready to Listen.If you or someone you know has a gambling problem, give us a call.

The National Problem Gambling Helpline provides toll-free,

confidential help 24 hours a day.

1-800-522-4700

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