Gambling Harms and Gambling Help-Seeking Amongst Indigenous Australians

This paper aimed to analyze the harms arising from gambling and gambling-related help-seeking behaviour within a large sample of Indigenous Australians. A self-selected sample of 1,259 Indigenous Australian adults completed a gambling survey at three Indigenous sports and cultural events, in several communities and online. Based on responses to the problem gambling severity index (PGSI), the proportions of the sample in the moderate risk and problem gambler groups were higher than those for the population of New South Wales. Many in our sample appeared to face higher risks with their gambling and experience severe gambling harms. From PGSI responses, notable harms include financial difficulties and feelings of guilt and regret about gambling. Further harms, including personal, relationship, family, community, legal and housing impacts, were shown to be significantly higher for problem gamblers than for the other PGSI groups. Most problem gamblers relied on family, extended family and friends for financial help or went without due to gambling losses. Nearly half the sample did not think they had a problem with gambling but the results show that the majority (57.7 %) faced some risk with their gambling. Of those who sought gambling help, family, extended family, friends and respected community members were consulted, demonstrating the reciprocal obligations underpinning traditional Aboriginal culture. The strength of this finding is that these people are potentially the greatest source of gambling help, but need knowledge and resources to provide that help effectively. Local Aboriginal services were preferred as the main sources of professional help for gambling-related problems.     

Predictors of help-seeking for gambling disorder from the transtheoretical model perspective

Few gamblers seek treatment despite the severe negative impacts prolonged gambling can have. Research surrounding the predictors of help-seeking for problem gambling is often retrospective in design and inconsistent in findings. This study prospectively investigated whether transtheoretical model (TTM) constructs (readiness to change, ratings of temptations and self-efficacy, decisional balance and processes of change) have utility in predicting help-seeking among disordered gamblers. Community-recruited disordered gamblers (N = 136; 47.06% female; mean age = 44.5 years, SD = 12.8; 80.1% Caucasian) completed three assessments of TTM constructs, help-seeking behaviour, gambling problem severity, and other potential predictors of help-seeking. Informal help-seeking was common (6-month = 71.1%; 12-month = 79.6%); however, formal help-seeking was relatively infrequent (6-month = 22.7%; 12-month = 35.1%). Logistic regression demonstrated that gambling problem severity and the social liberation process of change (i.e. endorsing public awareness of gambling problems or non-gambling role models) consistently predicted formal help-seeking. Helping relationships and counter-conditioning (i.e. engaging in other activities as a replacement for gambling) processes of change uniquely predicted informal help-seeking at 12 months. Individuals most likely to seek formal help have greater problem severity and greater readiness to address problems. Seeking informal help is less predictable but more common.     

Life course analysis of gambling trajectories: an Indigenous Australian study

Traditional card gambling is a culturally acceptable recreational activity for generations of Indigenous Australians. Commercial gambling activities are popular as well. This study drew on a life course approach and a sample of 57 Indigenous Australian people to examine their gambling trajectories over time that resulted in recreational gambling or in disordered gambling. To gain in-depth insight into various gambling trajectories, this study used an interpretative phenomenological methodology. At early childhood, teenage, young adult and mature adult stages, major gambling influences appeared as dependence, independence, timing of major shifts and transitions, and rationalization, respectively. The study showed that being a recreational or disordered gambler was a shifting or fluctuating position, subject to transitions and events in people's lives rather than a one-way path in either direction. Within a complex cultural environment, the dynamic interplay between social density, context and individual choice appears to influence gambling trajectories for these Indigenous Australians.     

Experiences and Perceptions of Problem Gamblers on Cognitive and Exposure Therapies When Taking Part in a Randomised Controlled Trial: A Qualitative Study

In South Australia (SA) problem gambling is mainly a result of the widespread availability of electronic gaming machines. A key treatment provider in SA offers free cognitive and behavioural therapy (CBT) to help-seeking problem gamblers. The CBT program focuses on the treatment of clients’ urge to gamble using exposure therapy (ET) and cognitive therapy (CT) to restructure erroneous gambling beliefs. The aim of this study was to explore treatment specific and non-specific effects for CT alone and ET alone using qualitative interviews. Interviewees were a sub-sample of participants from a randomised trial that investigated the relative efficacy of CT versus ET. Findings revealed that all interviewees gained benefit from their respective therapies and their comments did not appear to favour one therapy over another. Both treatment specific and treatment non-specific effects were well supported as playing a therapeutic role to recovery. Participants’ comments in both therapy groups suggested that symptom reduction was experienced on a gambling related urge–cognition continuum. In addition to symptom improvement from therapy-specific mechanisms, ET participants described a general acquisition of “rational thought” from their program of therapy and CT participants had “taken-over” their gambling urges. The findings also highlighted areas for further improvement including therapy drop-out.     

A typical problem gambler affects six others

While the financial and psychological burden on problem gamblers can be severe, at least some of the ill effects are also passed on to family or other close social ties. The present study estimated the number of affected-others for the typical problem gambler. Australian members of an online panel with gambling problems (N = 3076) and panel members who indicated that they had been affected by someone else’s gambling (N = 2129) were asked to estimate the number of other people who were negatively affected by their gambling. Using robust statistics to analyse this data, the study found lower estimates made by problem gamblers (four affected people) compared to estimates made by affected others (six affected people, including the respondent). It was concluded that a point-estimate of six people affected is a more accurate figure since it does not suffer from self-presentation effects of problem gamblers. Low-risk and moderate-risk gamblers, unsurprisingly, affected far fewer other people (one and three, respectively). Both gamblers and affected-others most often identified close family members, including spouses and children, as the people impacted by others’ gambling problems. These results provide an approximate measure of the number of people affected, per problem gambler, to facilitate accurate accounting of the harms accruing from gambling problems.     

The Problem with Self-Forgiveness: Forgiving the Self Deters Readiness to Change Among Gamblers

Self-forgiveness is generally understood to be a mechanism that restores and improves the self. In the current study, we examine the possible deleterious consequences of forgiving the self among gamblers-specifically in regard to gamblers' readiness to change their problematic behavior. At a large Canadian university, 110 young adult gamblers' level of gambling pathology was assessed, along with their readiness to change and self-forgiveness for their gambling. Participants were 33 females and 75 males (2 unspecified) with a mean age of 20.33. Results revealed that level of pathology (at risk vs. problem gamblers) significantly predicted increased readiness to change. Self-forgiveness mediated this relationship, such that level of gambling pathology increased readiness to change to the extent that participants were relatively unforgiving of their gambling. Implications for seeking professional assistance as well as treatment and recovery are discussed.     

Gambling Participation,Expenditure and Risk of Harm in Australia, 1997–1998 and 2010–2011

Gambling-related harm results primarily from financial losses. Internationally Australia continues to rank as the largest spending nation per capita on gambling products. This would suggest that Australian gamblers are at disproportionately high risk of harm despite almost two decades of industry scrutiny and regulation, and investment in research, treatment and education programs. However, declines in participation rates, per capita expenditure, household expenditure, national disposable income spent on gambling and problem gambling rates have been cited as evidence that fewer people are gambling, that gamblers are spending less, and that gambling safety in Australia has improved. The current study investigated these propositions using national population and accounts data, and statistics from Australia’s two population-representative gambling surveys conducted in 1997–1998 and 2010–2011. Despite a falling participation rate the study found no real change in the number of people gambling overall, and increasing numbers consuming casino table games, race wagering and sports betting. Further found were increases rather than decreases in average gambler expenditure, overall, and across most products, particularly electronic gaming machines (EGMs). Potentially risky levels of average expenditure were observed in both periods, overall and for race wagering, casino table gaming, and EGMs. Changes in the proportion of income spent on gambling suggest risks declined overall and for race wagering and casino table gaming, but increased for EGMs. Finally, while problem gambling statistics were not comparable between periods, the study found double the number of moderate risk gamblers previously estimated for 2010–2011 amongst the 2 million Australians found to have experienced one or more gambling-related problems. The findings have implications for public health policy and resourcing, and the way in which prevalence and expenditure statistics have been interpreted by researchers, government and industry in Australia and elsewhere.     

Gambling and Problem Gambling in Sweden: Changes Between 1998 and 2009

Gambling participation and rates of problem gambling change over time in response to a variety of factors including gambling availability, demographic changes and adaptation at individual and societal levels. These relationship are complex and only partially understood. The major aim of the present study was to provide general population estimates of gambling participation and problem gambling for Sweden and compare these estimates with estimates from a previous national study. The study was also designed to identify risk factors for problem gambling including change in these factors over time. Data are from the first phase of the Swedish Longitudinal Gambling Study (Swelogs) in which a representative sample of 8,165 people was assessed using validated problem gambling and other measures to facilitate comparison with findings from the 1997/1998 Swedish Gambling Study (Swegs). Overall, it was found that gambling participation reduced markedly, although in some population sectors increases were evident for some forms including poker and electronic gaming machines. Lifetime prevalence of probable pathological gambling increased; however, past 12 months probable pathological and problem gambling prevalence did not. Males, younger adults and people born outside Sweden were at high risk in both studies. Significant prevalence increases were evident for people aged 18–24 and those with low levels of education. The results indicate that relationships between gambling exposure, participation and problems are dynamic with shifting implications for public health and social policy.     

Gambling over the life course and treatment-seeking

The purpose of this study is to investigate change in gambling behaviours over the life course, and, correspondingly, the treatment-seeking behaviours of 86 people who met the criteria for at-risk (participants endorsing two to four items on the South Oaks Gambling Screen [SOGS]) and problem gamblers (participants endorsing five or more items on the SOGS) over the last five years. Data were obtained from informants during semi-structured interviews using Structured Clinical Interview for DSM-IV axis I and axis II disorders (SCID I and II), SOGS and treatment-seeking interviews. The results showed three groups of gambling behaviours over the life course. A first group started gambling early on and continued participating in recreational gambling until its participants were between 40 and 50 years of age, during which time they became problem gamblers. A second group transitioned from recreational gambling to problem gambling over a short period of time; its participants were aged between 40 and 50. Lastly, a third group which was exposed to gambling later on in life, mostly after retirement, developed gambling problems quickly. Psychopathology was prevalent in all groups, given that 98% suffered from a mental health problem during their life, and 62% within the last six months. Participants who made use of the services available mostly turned to medical and specialized mental services for brief periods, usually when in crisis. In terms of problem gambling, the results argue in favour of maintaining dedication toward treatment, especially in the presence of co-morbidity.     

Risk Factors for Problem Gambling Among Indigenous Australians: An Empirical Study

Despite a long history of gambling amongst many Indigenous peoples, knowledge about contemporary Indigenous gambling is sparse. In Australia, previous studies of Indigenous gambling have been severely limited in number, scope and rigour. The research reported in this paper is based on the first Indigenous-specific quantitative gambling research undertaken in Australia since 1996 and draws on the largest sample to date. This study examined numerous aspects of gambling among Indigenous Australians. After appropriate consultations and permission, the study collected surveys from 1,259 self-selected Indigenous adults in 2011 at three Indigenous festivals, online and in several Indigenous communities. This paper draws on these data to identify problem gambling risk factors by comparing selected socio-demographic characteristics, early exposure to gambling, gambling motivations, gambling behaviour, gambling cognitions, and substance use while gambling, amongst non-problem, low risk, moderate risk and problem gamblers. A logistic regression investigated the difference between problem gamblers and all other PGSI groups. Risk factors associated with being a problem gambler were: being older, commencing gambling when under 10 years old, always being exposed to adults gambling as a child, using alcohol and/or drugs while gambling, having family and friends who gamble, having an addiction to gambling and not gambling to socialise, having a high expenditure on commercial gambling, and living in a state or territory other than NSW or QLD. Public health measures to address these risk factors are identified.     

Primed for Change: Facilitating Factors in Problem Gambling Treatment

To successfully facilitate the treatment of problem gambling, change processes should be examined in order to identify those variables that differentiate good versus poor treatment outcomes. The current study explored the change facilitating effects of certain characteristics or conditions of an individual being treated: emotional support, instrumental support, emotional awareness, GA involvement, and depressed affect. These conditions were hypothesized to be predictive of a change-oriented mindset (i.e., “resources for change”) measured by abstinence self-efficacy, motivation for change, and readiness for change. Participants were 60 outpatients (54.2% male; M age = 46.7 years) with problem gambling recruited from several treatment centres throughout Ontario, Canada. Results indicated that: (1) depressed affect and emotional support seem to influence self-efficacy for abstinence, (2) emotional support alone appears to influence motivation for change, and (3) GA involvement, depressed affect, and emotional awareness, together, seem to influence readiness for change. These findings have implications for promoting change oriented dispositions in problem gambling individuals.     

Bet Anywhere,Anytime: An Analysis of Internet Sports Bettors’ Responses to Gambling Promotions During Sports Broadcasts by Problem Gambling Severity

Promotions for online sports betting during televised sports broadcasts are regularly viewed by millions of Australians, raising concerns about their impacts on vulnerable groups including at-risk and problem gamblers. This study examined whether responses to these promotions varied with problem gambling severity amongst 455 Australian Internet sports bettors participating in an online survey. Results indicated that young male Internet sports bettors are especially vulnerable to gambling problems, particularly if they hold positive attitudes to gambling sponsors who embed promotions into sports broadcasts and to the promotional techniques they use and this heightens the risk that alluring messages contribute to excessive gambling. As problem gambling severity increased, so too did recognition that these promotions have impacted negatively on their sports betting behaviour. Because a plethora of sports betting brands and promotions are now heavily integrated into sports coverage, social marketing efforts are needed to offset their persuasive appeal and counter the positive attitudes towards them that appear linked to excessive gambling amongst Internet sports bettors.     

The South Oaks Gambling Screen Revised for Adolescents (SOGS-RA): Further Psychometric Findings from a Community Sample

The broad expansion of gambling across North America during the last two decades has generated concern about the extent of gambling and problem gambling in youth, and the need to more accurately monitor it. The South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA) is a promising instrument for screening problem gambling (Winters, Stinchfield, & Fulkerson, 1993) that requires more evaluation. Accordingly, further psychometric analysis of the instrument was conducted as part of a community survey of gambling in a sample of 1,000 male and female youth, aged 12 to 17 years. The analyses extended previous focus by including females, young adolescents, and an evaluation of youth classified as at-risk. Consistent with preliminary findings obtained during scale development, the distribution of item endorsement revealed trends of over-endorsement for some items (e.g., gambled more than intended, felt bad about the amount bet), and under-endorsement for others (e.g., criticized or told you had a gambling problem). These results suggest consideration of some form of weighting procedure, item deletion or re-wording. A factor analysis of the SOGS-RA items suggested a two-factor solution, with one factor interpreted as Control over Gambling and the other Gambling Consequences. It is proposed that the two factors may represent early versus more severe levels of gambling problems, respectively. The results highlight the need for further psychometric evaluation and refinement of instruments used to identify gambling problems in young people.     

Is more better? The relationship between outcomes achieved by problem gamblers and the number of counselling sessions attended

Abstract

This paper addresses the question of how much intervention is necessary for the effective treatment of problem gambling by exploring the relationship between the number of counselling sessions attended and the degree of problem resolution achieved for 613 individuals who attended problem gambling counselling services in Victoria. While those who achieved partial or full resolution of presenting problems attended more sessions than those who finished counselling with their problems still unresolved, problems were typically reported as being resolved in fewer than five sessions. It is concluded that for some problem gamblers a relatively brief intervention may be sufficient.     

Thoughts and acts of self-harm,and suicidal ideation,in online gamblers

Gambling problems have been linked to suicidal ideation and enhanced risk of suicide attempts. However, we know very little about the factors associated with either thoughts or acts of self-harm amongst people who gamble. A web-based study of 4125 online gamblers (79% males; mean age 35.5 years), analysed using hierarchical multiple regression, revealed that self-reported non-gambling-related self-harm was negatively related to age and marital status, and positively related to problematic alcohol use. Self-reported acts of self-harm both related and unrelated to gambling were associated with drug misuse. Thoughts and acts of gambling-related self-harm were associated with problem gambling, gambling involvement and parental problem gambling. All types of self-harm were associated with mood disorder symptoms, unemployment and certain gambling motivations. When tailoring assessment and interventions for individuals at risk for gambling-related deliberate self-harm, it is important to recognize that contributory factors may include some that differ from those for deliberate self-harm in general, and that there is potential value in evaluating gambling involvement and motivations, and history of parental gambling.     

GPs and Problem Gambling: Can they Help with Identification and Early Intervention?

General Practitioners (GPs) are well placed to identify problem gamblers and provide early intervention. To date there is no evidence to suggest that GP’s are routinely screening patients for potential gambling problems. This paper discusses the prevalence of problem gambling, the links with other health problems and ways that GPs can assist. Results from a pilot project that provided educational resources to GPS are also discussed. Suitable screening tools are available that could easily be used by GPs to assess the possibility of gambling problems in patients who may be at increased risk but do not seek help. Early identification and intervention may help prevent a gambling habit escalating to a serious problem. More work needs to be done to increase awareness with GPs of the extent of problem gambling in our community and to alert patients to the fact that gambling can affect their health and that GPs can help.     

Improved Outcomes Following a Single Session Web-Based Intervention for Problem Gambling

Research suggests online interventions can have instant impact, however this is yet to be tested with help-seeking adults and in particular those with problem gambling. This study seeks to determine the immediate impact of a single session web-based intervention for problem gambling, and to examine whether sessions evaluated positively by clients are associated with greater improvement. The current study involved 229 participants classified as problem gamblers who agreed to participate after accessing Gambling Help Online between November 2010 and February 2012. Almost half were aged under 35 years of age (45 %), male (57 %) as well as first time treatment seekers (62 %). Participants completed measures of readiness to change and distress both prior to and post-counselling. Following the provision of a single-session of counselling, participants completed ratings of the character of the session (i.e., degree of depth and smoothness) post-counselling. A significant increase in confidence to resist and urge to gamble and a significant decrease in distress (moderate effect size; d = .56 and .63 respectively) was observed after receiving online counselling. A hierarchical regression indicated the character of the session was a significant predictor of change in confidence, however only the sub-scale smoothness was a significant predictor of change in distress. This was the case even after controlling for pre-session distress, session word count and client characteristics (gender, age, preferred gambling activity, preferred mode of gambling, gambling severity, and preferred mode of help-seeking). These findings suggest that single session web-based counselling for problem gambling can have immediate benefits, although further research is required to examine the impact on longer-term outcomes.     

The Dark Side of Authenticity: Feeling “Real” While Gambling Interacts with Enhancement Motives to Predict Problematic Gambling Behavior

Engaging in activities that make people feel authentic or real is typically associated with a host of positive psychological and physiological outcomes (i.e., being authentic serves to increase well-being). In the current study, we tested the idea that authenticity might have a dark side among people engaged in an addictive or risky behavior (gambling). To test this possibility, we assessed gamblers (N = 61) who were betting on the National Hockey League playoff games at a sports bar. As predicted, people who felt authentic when gambling reported behavior associated with problem gambling (high frequency of betting) as well as problematic play (a big monetary loss and a big monetary win). Moreover, such behavior and gambling outcomes were particularly high among people who were motivated to gamble for the purpose of enhancement. The interaction of feeling authentic when betting and gambling for purposes of enhancing positive emotions proved especially troublesome for problematic forms of play. Implications of authenticity as a potential vulnerability factor for sports betting and other types of gambling are discussed.     

Effectiveness of a Self Help Cognitive Behavioural Treatment Program for Problem Gamblers: A Randomised Controlled Trial

The study aimed to strengthen the scarce literature on self-help treatments for Problem Gambling (PG) by comparing the effectiveness of a Self-Help Cognitive Behavioral Treatment (SHCBT) program (n = 23) with a 6-week Waitlist condition (n = 32) in problem gamblers. Participants were community volunteers with gambling problems and were randomly allocated to the Waitlist and treatment conditions. Results showed significant improvements at post-treatment in gambling behaviors including frequency of gambling, average amount gambled per day and PG symptoms as well as a number of gambling correlates including psychological states (e.g., depression, anxiety and stress), gambling cognitions, gambling urges, gambling related self-efficacy, satisfaction with life, and quality of life among those who completed the SHCBT program, when compared with the waitlist condition. The effect size (partial η ²) ranged from .25 to .57 for all assessed outcomes that showed significant improvement from pre- to post-treatment. It was concluded that a self-help CBT program can be beneficial for treating community problem gamblers.