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![Page 1: Oregon Gambling Treatment System Jeff Marotta, PhD Problem Gambling Services Manager Alberta Gaming Research Institute’s 6th Annual Conference Banff, Alberta.](https://reader036.fdocuments.us/reader036/viewer/2022062409/5697bf9a1a28abf838c920e9/html5/thumbnails/1.jpg)
Oregon Gambling Treatment
System
Jeff Marotta, PhDProblem Gambling Services Manager
Alberta Gaming Research Institute’s 6th Annual ConferenceBanff, Alberta
March 31, 2007
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Gambling treatment in the context of emerging evidenced based practices.
This presentation will offer the Oregon experience in piecing the puzzle together:
• Identifying challenges• Employing strategic models• Overview of the Oregon treatment system• Viewing system measures
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• 158,337 square KM
• Population 3,690,505– 2006
• Major Industries - timber, paper products, farming (wheat, cattle), mining (coal), computer equipment, electronics
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Oregon Gambling Expenditures (2005) $1.3 billion*
In 1986 this figure was $95 million
Source: Eco Northwest, 2007 http://www.econw.com/
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Oregon Gambling: Summarized
Oregon has more forms of legalized gambling and offers easier access to gambling than almost any other U.S. state
- AND - Oregon is a nationally recognized leader in
prevention, harm reduction and treatment for gambling problems
Source: National Ctr for the Study of Gambling, 2006
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Efforts to Address Problem Gambling
• 1% of Lottery revenues dedicated to a Gambling Treatment Fund administered by DHS
$4,656,000 USD2006-07 Oregon Problem Gambling Services Budget
Information Management2%
Outpatient Treatment56%
Treatment Enhancement2%
Administration6%
Workforce Development2%
Statewide Public Health & Gambling
3%
Community Prevention/Public Health
18%
Gambling Helpline4%
Minimal Intervention (GEAR) 1%
Residential Treatment5%
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Designing a treatment system in a young field.
Challenges:• There have been few gambling treatment outcome studies.
Therefore, data to date may not represent the full spectrum of recovery modes.
• Few randomized clinical trials in PG treatment research - meaningful comparisons across treatments difficult.
• Unclear how different subgroups of PGs, including comorbidity profiles, respond to different treatment approaches
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Where to start
• Without a menu of evidenced based treatments must rely on theory driven and monitored approaches – Philosophical Models– Surveillance and feedback systems– Flexible design structure to respond to
data driven performance measures
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Strategic Plan: Oregon Problem
Gambling Services
Released September 19, 2000Influenced by:
– Stepped-care approach to treatment• Sobell & Sobell (1999)
– Public health approach to gambling• Korn & Shaffer (1999)
Oregon Problem Gambling Services
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A Stepped Care Approach
• Treatment should be individualized.• The treatments selected should be
consistent with the contemporary research literature.
• The recommended treatment should be least restrictive but still likely to work.
Sobell, M.B., & Sobell, L.C. (1999). Stepped care for alcohol problems: An efficient method for planning and delivering clinical services. In J.A. Tucker, D.A. Dovovan, & G.A. Marlatt (Eds.), Changing addictive behavior: Bridging clinical and public health strategies (pp. 331-343). New York: Guilford Press.
Three fundamental principles of health care (Sobell & Sobell, 1999)
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Public Health Approach(Korn & Shaffer, 1999).
Adoption of strategic goals for gambling preventing gambling-related problems protecting vulnerable groups promoting balanced and informed attitudes, behaviors, and policiesEndorsement of public health principles prevention is a community priority, with appropriate allocation of resources incorporating a mental health promotion approach fostering personal and social responsibility for gambling policies and practicesAdoption of harm reduction strategies. healthy-gambling guidelines for the general public vehicles for early identification flexible treatment goals surveillance and reporting systems Allocation of resources to identify and treat level 2 gamblers.
Korn, D., & Shaffer, H. (1999). Gambling and the health of the public: Adopting a public health perspective. Journal of Gambling Studies, 15, 289–365.
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System Components
• Treatment• Prevention and outreach• Quality control and evaluation• Workforce development• Partnerships
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Treatment
Continuum of Care– Gambling Evaluation and Reduction
Program (GEAR)– Corrections Program– 27 outpatient treatment centers – 3 crisis-respite programs– 1 residential treatment program
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Oregon Problem Gambling Services
Updated 9/20/06
Symbol Key
Outpatient Clinic
Satellite Office
Residential Treatment
Crisis Respite Program
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Oregon Problem Gambling Help Line (05-06):
2,129 calls for help
93% resulted in referrals for service
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Gambling Treatment in Oregon:An Evidenced Based Process
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Evidenced Based Process
• Program development is data based and systematically monitored
• Less concern about component analysis• Focus on outputs and outcomes• Require programs to adapt and develop their
approach to optimize outcomes
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Quality Improvement Report
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Demographics of Gambling Treatment Centers
Participants in Oregon
Total clients: 1,714 Gamblers / 345 Clients in Family Programs
Gender, Gambler Clients
Males 47.4%
Females 52.6%
Gender, Family Clients
Males 33%
Females 67%
Average Age
44.6 years
Average Household Income
$36,495
Race/Ethnicity
White 87%
Marital Status
Married 36%
Divorced 25.5%
Primary Locations for
Gambling
Lottery retailer (video) 69.9%
Casino 17.3%
Primary Gambling Preference
Video poker 69%
Slot machines 14%
Cards 7%
Average Gambling-Related
Debt
$ 23,331 Source: Moore & Marotta, in press
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System Evaluation Results
• Treatment is working– 81% of clients reported either no gambling or reduced
gambling at 6-months post-treatment1
• The system is working:– Oregon is one of the few states that appears to have averted
a significant increase in problem gambling prevalence while expanding legalized gambling2
1. Moore & Marotta, in press2. National Center For the Study of Gambling, 2006.
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Putting it all together
We need more work to establish evidence based approaches, in the
meantime, data driven processes can and must make do!
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Thank You
Further information can be found at:http://www.oregon.gov/DHS/addiction/gambling.shtml
Or contact:
Jeff Marotta, PhDProblem Gambling Services ManagerOregon Department of Human ServicesAddictions and Mental Health Division503 945-9709