Self-Exclusion Program: A Longitudinal Evaluation Study

Few self-exclusion programs have been evaluated and their long-term impact remains unknown. This study has two main goals: (1) to assess changes in gambling behaviour and gambling problems for self-excluded patrons, and (2) to follow self-excluded gamblers for a two-year period (during and after the self-exclusion period). Individuals who excluded themselves (N = 161 at the initial stage) participated in telephone interviews after signing the self-exclusion agreement and were followed at 6, 12, 18 and 24-months. Results show that according to the DSM-IV, 73.1% of the participants were pathological gamblers. The self-exclusion program has many positive effects. During the follow-ups, the urge to gamble was significantly reduced while the perception of control increased significantly for all participants. The intensity of negative consequences for gambling was significantly reduced for daily activities, social life, work, and mood. The DSM score was significantly reduced over time. This reduction also took place between the baseline and the 6-month follow-up. The clinical implications of the results are discussed in relation to the effectiveness of the program. Suggestions are provided in order to increase compliance of self-excluded patrons.     

Improved Self-exclusion Program: Preliminary Results

The gambling industry has offered self-exclusion programs for quite a long time. Such measures are designed to limit access to gaming opportunities and provide problem gamblers with the help they need to cease or limit their gambling behaviour. However, few studies have empirically evaluated these programs. This study has three objectives: (1) to observe the participation in an improved self-exclusion program that includes an initial voluntary evaluation, phone support, and a mandatory meeting, (2) to evaluate satisfaction and usefulness of this service as perceived by self-excluders, (3) to measure the preliminary impact of this improved program. One hundred sixteen self-excluders completed a questionnaire about their satisfaction and their perception of the usefulness during the mandatory meeting. Among those participants, 39 attended an initial meeting. Comparisons between data collected at the initial meeting and data taken at the final meeting were made for those 39 participants. Data showed that gamblers chose the improved self-exclusion program 75% of the time; 25% preferred to sign a regular self-exclusion contract. Among those who chose the improved service, 40% wanted an initial voluntary evaluation and 37% of these individuals actually attended that meeting. Seventy percent of gamblers came to the mandatory meeting, which was a required condition to end their self-exclusion. The majority of participants were satisfied with the improved self-exclusion service and perceived it as useful. Major improvements were observed between the final and the initial evaluation on time and money spent, consequences of gambling, DSM-IV score, and psychological distress. The applicability of an improved self-exclusion program is discussed and, as shown in our study, the inclusion of a final mandatory meeting might not be so repulsive for self-excluders. Future research directives are also proposed.

Compulsive gambling: Structured family intervention

Family intervention has been an effective procedure for getting alcoholics into treatment for more than twenty years. Now this technique is being used with compulsive gamblers. Because the gambling disorder is so easy to hide, the patient seems to be further into the illness by the time the family seeks help. Furthermore, because the gambling offers intermittent rewards, the denial in both the patient and family appears to be stronger than found with most alcoholics.During the intervention it is important to tell the compulsive gambler why the help of a professional was sought; what changes have been observed by family members and friends as a result of his/her gambling; how family relationships have been affected; what is feared will happen if he/she doesn't get help; and what each family member hopes will happen once the gambler is in recovery.Most concerned persons enter family interventions with the sole purpose of getting the gambler into treatment. However, since this is a family disease, ethically the primary goal of family intervention needs to be to getsomeone into treatment, if not the individual suffering with the disease then one or more of those concerned persons suffering from it.     

State lotteries and compulsive gambling

The legalization of gambling, including state lotteries, has resulted in a dramatic increase of compulsive gambling. Not surprisingly, a new profile of compulsive gambler has emerged which differs significantly from the previous profile of white, middle aged, middle class male. This paper discusses public policy issues, lottery advertising, and legislative/lottery support given to address the problems of compulsive gambling.     

The Self-Exclusion Experience for Problem Gamblers in South Australia

Abstract

Increased prevalence of problem gambling has accompanied the spread of gaming venues in many parts of the world. One intervention to minimise the impact of harmful patterns of gambling behaviours is self-exclusion, where patrons can elect to ban themselves from a gaming venue or its gaming facilities for a specified time period. While self-exclusion programs are widely available, little research has been conducted into their operations and efficacy, particularly from the self-excluders’ perspective. This paper presents findings from 35 survey responses and 23 interviews with gamblers who had self-excluded through a centralised service in South Australia. They identified key program shortcomings as low publicity, limits on how many venues they could self-bar from, and inadequate venue monitoring for breaches of self-barring orders. Nevertheless, the centralised service, staffed by trained psychologists and located away from gaming venues, which allows multiple venue barring in one application, appeared advantageous over programs that require people to self-exclude directly from individual gaming venues. Most respondents (85%) had ceased or lessened their gambling in the 12 months following self-barring. Nevertheless, some continued to struggle to manage their gambling, reflected in breaches of their orders and gambling in venues from which they were not excluded.     

Clinical and behavioral evaluation of pathological gambling in Barcelona,Spain

This paper assesses both the clinical characteristics and gambling behavior of 45 pathological gamblers (40 male, 5 female, average age 41) in a psychiatric hospital in Barcelona, Spain. These pathological gamblers tend to have other addictions and psychiatric disorders in addition to their pathological gambling. Suicidal ideation and attempts were one of the most frequent complications with these patients. Slot and fruit machines were found to be the most preferred form of gambling. Loans and crime were frequently used by the gambler to finance his or her gambling. Nevertheless, the gambler is rarely aggessive, and legal problems resulting from serious crimes are the exception. The profile presentes is similar to that found among pathological gamblers in other countries.     

Review of Self-exclusion from Gambling Venues as an Intervention for Problem Gambling

Self-exclusion programs are required to be provided by gambling operators in many international jurisdictions in an attempt to provide an option for those who have gambling problems to avoid further gambling. However, minimal robust and comprehensive research has been conducted to evaluate the effectiveness of self-exclusion programs. There is much scope for reform and greater cohesion between jurisdictions, particularly neighbouring jurisdictions that would offer greater protection to individuals and industry bodies. This review outlines the evidence surrounding existing self-exclusion strategies, the benefits and limitations of such programs, and provides potential recommendations for an effective intervention program. Research suggests that self-exclusion programs are under-utilised by problem gamblers and are not completely effective in preventing individuals from gambling in venues from which they have excluded, or on other forms. Nonetheless, self-report indicates that self-excluders generally experience benefits from programs, including decreased gambling and increased psychological wellbeing and overall functioning. There are many areas in which existing programs could be improved, such as providing more resources for excluded individuals and reducing barriers to program entry, and more research is needed. However, self-exclusion programs are an important component of any public health strategy that aims to minimise gambling-related harms and these should be based as far as possible on empirical evidence for effective program components.     

Gambling Responsibly: Who Does It and To What End?

Numerous responsible gambling (RG) strategies are promoted to assist consumers to “gamble responsibly”. However, consumer adoption of RG strategies, how this varies by gambler risk group, and whether usage is associated with non-problematic gambling are largely unknown. This study aimed to (1) determine how use of RG-related strategies differs amongst regular gamblers by gambler risk group; and (2) identify RG-related strategies whose usage predicts non-problem/low risk gambling. Regular Australian gamblers on high-risk products (N = 860), recruited through gambling venues and an online wagering operator, were surveyed about their use of RG strategies promoted on the website of their jurisdiction’s main RG agency. Knowledge of RG strategies was reasonably high amongst all gambler risk groups, but lower-risk groups were more likely to use RG strategies. A logistic regression correctly predicted 82.1 % of lower-risk gamblers and 77.2 % of higher-risk gamblers. Predictors of lower-risk gambling included: greater confidence in their understanding of RG; endorsement of lower gambling expenditure and frequency limits; fewer erroneous gambling beliefs; being less likely to gamble to win money, challenge their skills/beat the odds, or forget about worries and stresses; and being more likely to gamble for pleasure/entertainment. Lower-risk gamblers were more likely to set a money limit in advance of gambling and to balance their gambling with other activities. These findings contribute to understanding which strategies are favoured by different risk groups, and which are associated with safer levels of gambling. They can guide consumer information aimed at enhancing RG consumption and future research on RG consumption.     

Significant Others and Gambling Treatment Outcomes

Aims This study investigates the effect of significant others on treatment outcomes among treated pathological gamblers. Design This is a cohort study of individuals who received gambling treatment. Setting Oregon Problem Gambling Services (OPGS) for gamblers and their family members. Participants 4,410 adult gamblers who were discharged from treatment between August, 2001 and April, 2007. Measurements OPGS enrollment forms provided gambler gender, age, ethnicity, education level, employment status, gambling-related debt, and whether the gambler had a significant other at the time of enrollment. Termination forms provided information on the type of discharge (successful/unsuccessful) and treatment length (in days). Participation of the gambler’s significant other in the family treatment program was identified. Findings Results showed that age, ethnicity, gambling debt, and having a significant other are associated with the odds of successful treatment. Education level moderates the effect of having a significant other on treatment success. Age, ethnicity, education, employment, and having a significant other participate in treatment significantly impacted gamblers’ length in treatment. Conclusions These findings indicate that there may be a benefit to integrating significant others in gambling treatment methods. Significant others may act as social supports for gamblers seeking treatment, and involving loved ones in gambling treatment models may positively affect gambler treatment outcomes.     

Association of Problem Gambling with Type of Gambling Among Italian General Population

The origin of gambling disorders is uncertain; however, research has shown a tendency to focus on specific types of games as a potential important risk factor. The principal aim of this study is to examine the relationships between types of gambling practices and gambling disorder. The data were extracted from IPSAD-Italia^® 2010–2011 (Italian Population Survey on Alcohol and other Drugs), a survey among the Italian general population which collects socio-cultural information, information about the use of drugs, legal substances and gambling habits. In order to identify the “problem gambler” we used the Problem Gambling Severity Index. Three groups are considered in this analysis: no-risk gamblers, low-risk gamblers, moderate-risk/problem gamblers. Type of gambling practice was considered among two types of gambler: one-game players and multi-games players. 1.9 % of multi-game players were considered problem gamblers, only 0.6 % of one-game players were problem gamblers (p < 0.001). The percentage of players who were low and moderate-risk gamblers was approximately double among multi-game players, with 14.4 % low-risk and 5.8 % moderate-risk; compared with 7.7 % low-risk and 2.5 % moderate risk among one-game players. Results of ordinal logistic regression analysis confirmed that higher level of gambling severity was associated with multi-game players (OR = 2.23, p < 0.0001). Video-poker/slot-machines show the highest association with gambling severity among both one-game players and multi-game players, with scores of OR equal to 4.3 and 4.5 respectively. These findings suggest a popular perception of risk associated with this type of gambling for the development of gambling problems.     

Gambling and Federal civil service employment law

Federal sector employment law concerning employee misconduct in which gambling is a factor has evolved significantly since the enactment of the Civil Service Reform Act of 1978, and is breaking new ground in this aspect of civil rights and employment law. Among other things, a debate is taking place in this sector as to whether compulsive gambling is a handicapping condition similar to alcoholism and drug addiction. Traditionally, disciplinary cases in the Federal Sector may be classified in two categories. The first involves misconduct related to compulsive gambling. The second concerns gambling on-the-job, either through promotion of gambling by, for example, running a numbers game, or by placing bets. While employees who promote gambling by running numbers games can be fired for just one instance of such misconduct, employees whose misconduct on or off the job is the result of compulsive or pathological gambling have a strong affirmative defense restricting the employer's attempts to fire for just cause. As defined by administrative agencies which have primary jurisdiction over Federal civil service law matters, compulsive gambling, generally, is not recognized as a handicapping condition. Developments in Federal sector, however, have required the federal manager to consider the existence of a condition of pathological gambling as a mitigating factor in deciding upon appropriate discipline. Other related developments indicate that compulsive gambling may, in fact, be reclassified as a handicapping condition.The author is an Assistant Professor (Adjunct) of Public Administration at John Jay College, C.U.N.Y., where he teaches Administrative Law and Regulation and Labor Relations in the Public Sector and Employment Discrimination Law in the Master of Public Administration Program. This article is adapted from remarks made at the Second Annual Conference on Gambling Behavior held at Philadelphia, PA, November 19–21 1986.     

Editorial comment

The special issue of theJournal of Gambling Behavior, dedicated to a discussion of compulsive gambling and the law, represents a first effort in addressing some of the many complicated issues on this topic. Articles by experts on compulsive gambling—written by legal authorities, a treatment provider, and victims of the disorder—are included to present the broadest possible forum to analyze the turmoil the idea of compulsive gambling is having on the American legal system. Included are an historical account of how changing laws affect compulsive gamblers, problems facing the expert witness, effects of civil service policies and military law, comparisons of U.S. and English legalization debates, lottery issues, concerns of a lawyer representing casinos, and personal accounts by those who are suffering from this disorder.I. Nelson Rose is an Associate Professor of Law at Whittier College School of Law as well as a licensed attorney. Professor Rose is recognized as the nation's leading authority on gambling and the law.Dr. Valerie C. Lorenz has specialized in research, education and treatment of compulsive gamblers since 1973. She has extensive experience in military, state and federal courts, having served as a qualified expert witness on compulsive gambling.     

The family exclusion order as a harm-minimisation measure for casino gambling: the case of Singapore

Singapore is one of the first jurisdictions in the world that has implemented a harm minimization model based on third party exclusion known as the Family Exclusion Order (FEO). Unlike other forms of third party exclusion practiced in other countries, family members in Singapore are able to apply for FEOs to prevent a gambler from entering the casinos, if the family has experienced harm caused by his/her gambling. In this study, 105 applicants for the FEO were sampled from all successful FEOs granted within a five-year period. Using a qualitative approach, this study attempts to illuminate the intricate issues experienced by family members that provided the impetus for them to apply for the FEO. While the extant literature posits self-exclusion as a superior tool of restraint as it involves the gambler’s personal motivation to curb gambling, this paper reports initial evidence of benefits resulting from family-imposed restraints from the perspective of family members. In particular, positive ratings of the FEO stemmed from a sense of relief experienced by mother and wife applicants. Possible reasons behind these positive outcomes are explicated using intrinsic motivation theory, with sensitivity to gender relations within the family.     

Characteristics and Gender Differences Among Self-Excluded Casino Problem Gamblers: Missouri Data

The present study explores gender-related differences in the demographic and gambling-related characteristics of 2670 problem gamblers participating in a state-administered (Missouri) casino self-exclusion program between 2001 and 2003. Female (n=1298, 48.4%) and male (n=1372, 51.1%) participants ranged in age from 21 to 84 years. Gender-related differences were noted among demographic variables, patterns of gambling behavior, reasons for self-exclusion, and involvement in self-help, counseling, and bankruptcy services. Female self-excluders were more likely than males to be older at time of application, African American, and either retired, unemployed or otherwise outside the traditional workforce. In addition, female self-excluders were more likely to report a later age of gambling onset, a shorter period between onset and self-exclusion, a preference for non-strategic forms of gambling and prior bankruptcy. The main predictors for female participation in self-exclusion included a desire to gain control and prevent suicide and referral by a counselor. The desire to save the marriage was a motivating factor for all participants. Findings suggest that the most efficacious treatment strategies with this group will include family systemic therapy and financial management in addition to pharmaco-treatment and culturally-sensitive individual therapy.     

“I Am Becoming More and More Like My Eldest Brother!”: The Relationship Between Older Siblings,Adolescent Gambling Severity,and the Attenuating Role of Parents in a Large-Scale Nationally Representative Survey Study

The present study examined the association between having older siblings who gamble and adolescent at-risk/problem gambling and how parents (i.e., parental knowledge of their whereabouts) and peers might moderate such effects. Data were drawn from the ESPAD^®Italia2012 survey (European School Survey Project on Alcohol and Other Drugs) comprising a nationally representative Italian sample of adolescents. The analysis was carried out on a subsample of 10,063 Italian students aged 15–19 years (average age = 17.10; 55 % girls) who had at least one older sibling and who had gambled at some point in their lives. Respondents’ problem gambling severity, older gambler sibling, gambler peers, parental knowledge, and socio-demographic characteristics were individually assessed. Multinomial logistic regression analyses including two- and three-way interactions were conducted. The odds of being an at-risk/problem gambler were higher among high school students with older siblings that gambled and those with peers who gambled. Higher parental knowledge (of who the adolescent was with and where they were in their leisure time) was associated with lower rates of at-risk/problem gambling. There was also an interaction between gamblers with older siblings and parental knowledge. The combination of having siblings who gambled and a greater level of parental knowledge was associated with lower levels of problem gambling. The present study confirmed the occurrence of social risk processes (older siblings and peers who gambled) and demonstrated that gambling among older siblings and peers represents an important contextual factor for increased at-risk/problem gambling. However, parental knowledge appears to be sufficient to counterbalance the influence of older siblings.     

Missouri Casino Self-Excluders: Distributions Across Time and Space

According to public health research, exposure to casinos is a risk factor for disordered gambling. Consequently, casino self-exclusion programs, which provide gamblers with the opportunity to voluntarily seek limits on their access to gambling venues, can serve as a barometer of the concentration of disordered gambling in an area. This study reports on the distribution, both temporally and geographically, of 6,599 people who applied to exclude themselves from Missouri casinos between November, 1996 and February, 2004. Analyses used Microsoft MapPoint to plot the location of casinos and self-excluders (SEs) across Missouri and its constituent counties. These regional exposure analyses showed that the Western region around Kansas City is an epicenter of disordered gambling as, to a lesser extent, is the Eastern region around St. Louis. The annual number of SE enrollments increased during the first few years of the Missouri self-exclusion program and then leveled off during the later years. These findings have important implications for public health and the development of public health interventions for disordered gamblers.     

The Medicalization of Deviance as an Interactive Achievement: The Construction of Compulsive Gambling

This article joins two lines of research from distinct areas in sociology to illuminate the mechanisms through which the meaning of “compulsive gambling” and what it means to be “a compulsive gambler” are cooperatively constructed in interaction at meetings of the fellowship group Gamblers Anonymous (GA). Combining Conrad's work on the medicalization of deviance with a social psychological focus on support group interaction, I demonstrate how individuals' experiences and identities come to be imbued with a medical vocabulary through the homogenization of the initial diversity among members. This analysis contributes to conceptualizations of the medicalization of deviance as well as to interactionist interests in the social construction of reality.     

Parents of male compulsive gamblers: Clinical issues/treatment approaches

This is a study of 126 parents (57 couples and 12 individual parents) of 69 inpatient pathological gamblers. The gamblers ranged in age from 17–37 years. All were males who dated their average age of onset of heavy gambling at 13–14 years. The parents ranged in age from 38–69 years. Treatment approaches specific to parents of compulsive gamblers are discussed. These approaches include education, family therapy, conjoint sessions, combined group, parent group, and aftercare. In addition, the value of self-help through GamAnon is stressed as a means of returning sanity to their lives and as a way of recognizing that these parents have the ability to change their feelings and their behaviors, thereby no longer making the gambler and his gambling the focus of their existence.     

Pathological gambling: A comparison of gambling at German-style slot machines and “Classical” gambling

German-style slot machines and related legal issues are described. On the basis of a survey on 437 members of self-help groups (Gamblers Anonymous) in Germany, slot machine gamblers were compared with casino gamblers on such variables as sociodemographic data, gambling behaviour, financial expenditure, emotional experience while gambling, symptoms of pathological gambling, psychosocial consequences and gambling related delinquency. The casino gamblers' gambling behaviour is financially more extensive. There were similarities regarding the emotional intensity of the gambling experience. However the casino gamblers show more pronounced symptoms of pathological gambling and the psychosocial consequences of their gambling behaviour are more severe. In spite of these differences, the data show that for young people slot machines can be as stimulating and therefore as dangerous as casino gambling. The young slot machine gambler runs a similar risk of acquiring a pathological gambling habit as the casino gambler.I would like to thank Dr. Gerhard Meyer for his support and his comments on the first draft of this article which is based on data from a research project led by him.     

Italian Adult Gambling Behavior: At Risk and Problem Gambler Profiles

The present study examined adult gambling behaviours from a local perspective in order to assess the adult at risk and problem gambler’s profile stratified by genre and by different forms of game. 4773 Italian adults from 18 to 94 years old were administered a survey to assess socio-cultural information related to gambling behaviour and the SOGS to evaluate gambling behaviour severity. Logistic regression evidenced that both at risk and problem gamblers are associated with male gender, players that use to play to more than one game, gambling with strategy-based games. People with a gambler father or both parents who used to gamble were significantly more associated with problem gambling behaviour than participants with non-gambler parents. These results present adult profiles of at risk and problem providing a more clear understanding about the relationships between gambling behavior severity and type of gambling.