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Yesterday, the14th annual NCRG Conference on Gambling and Addictionheld an informative session on using a scientific approach to evaluating responsible gambling programs thatDebi LaPlante, Ph.D., an assistant professor of psychiatry at Harvard Medical School and the director of academic affairs at the Division on Addiction, Cambridge Health Alliance, a teaching affiliate of Harvard Medical School.

Dr. LaPlante began the session by explaining that gambling disorders can cause a ripple effect—impacting the individual, his or family, acquaintances and the broader society; therefore, safeguards are often needed for some populations. One way to do this is by through regulating responsible gaming initiatives.

Some of the most common responsible gaming regulations include employee education, resources (e.g., self-exclusion programs, signage and helplines), advertising and marketing restrictions, alcohol services, credit restrictions, loss and stake limitations and mitigation efforts (e.g., treatment funding).

Dr. LaPlante noted that scientific evaluation can help guide regulator programs and provided a flow chart to show how the process works:

1. Develop and utilize regulation
2. Build regulation outcome monitoring system
3. Assess regulation penetration among targets
4. Analyze and identify best practices activities
5. Summarize regulation outcomes among targets
6. Conduct feedback and reporting

These steps form a circular loop. Once the feedback and reporting has been done, the process should begin again.

Dr. LaPlante added that regulations can either decrease or increase gambling-related problems, have no effect on a person’s gambling behavior or influence gambling-related problems indirectly through other factors. One example she provided was baseball’s regulation to stop selling alcohol after the seventh-inning stretch. The intention of this regulation is to limit the amount of alcohol consumed during the game, but often, spectators will purchase several alcoholic beverages before sales conclude (she referred to this as the seventh-inning binge).

Dr. LaPlante stated that regulatory evaluation might be especially important for gambling due to the limited amount of high quality information we have available, adding that what we think we know about gambling is long on anecdote and short on evidence. She provided three different examples and the most recent research on these topics to illustrate this: gambling expansion, Internet gambling and game effects.

After presenting the research, key findings and take-aways from these three examples, Dr. LaPlante posed the question: What do we know about regulations for gambling?

“Not much,” she answered. She added that often, regulations go into play with very little research to support or evaluate them. She also advised that using conventional wisdom to guide regulatory development could send us down the wrong path.

But, she noted that there are ways to know about which regulations work. First, it is important to conduct research that follows gamblers pre-and post-harm minimization effort, as well as test which behaviors and activities of problem gamblers and gambling opportunities influence their problems versus which reflect their problems. This will help inform future harm minimization strategies. She also said that there needs to be less of a reliance on self-reporting and more randomized trials, which coordination with regulators for testing.

However, she said, there are things that science can’t tell us. Sciencecantell us the costs and benefits of a given regulation, how a gambling problem develops and how regulations might intervene in that process. But, sciencecannottell us how much weight to give to individual liberty versus governmental prevention of harm.

She concluded that in an ideal world:

• We need science to tell us whether regulations and interventions do what we think they do
• Good intentions do not ensure anticipated benefits or prevented unanticipated harms.
• Evidence-based regulations will preclude the development of policy based on individual whim and advocate lobbying
• A science of regulations will ensure that legislation provides targeted influence in the intended direction

While gambling creates opportunities to improve and complicate day-to-day life, the challenges that we face are: (1) to be aware of the changes gambling might create, (2) to navigate the changing opportunities safely and (3) to get ahead of naturally-occurring adaptation, and facilitate the dissolution of novelty effects among those most at-risk.

Did you attend this session? What else did you take away from Dr. LaPlante’s presentation?

NCRG staffConference on Gambling and AddictionDr. Debi LaPlanteNCRG ConferenceRegulatorsresponsible gaming

The first day of the14th annual NCRG Conference on Gambling and Addictionconcluded with a few breakout sessions, including one that took a close look at building partnerships with Native American populations.

The session began with a short presentation fromKate Spilde, chair of the Sycuan Institute on Tribal Gaming and associate professor at San Diego State University. Ms. Spilde provided two key resources on building successful research partnerships with tribal communities: the National Congress of American Indians (NCAI) report,“Walk Softly and Listen Carefully,”and the Betty Ford Institute’s “Seme7 (Non-Native) Counselor in a First Nations: A Story of Professional/Personal Growth and Transformation.”

She noted that the tribal gaming industry has brought income and employment benefits to both tribal and non-tribal communities. The economic and social indicators reveal improvements in education attendance and individual/family income, and poverty and unemployment often decreases. However, these good points often mask the long-term problems of tribal gaming and make it more difficult to uncover them.

Ms. Spilde emphasized that research is a key tool of tribal sovereignty, adding that efforts to address longstanding issues, such as health disparities for American Indians and Alaska Natives, have increasingly used research partnerships.

She also noted several tribal community concerns when conducting research in their communities, including:

• Research needs vary by community.
• An inability for researchers to identify the pressing needs of community members
• Recovery needs within tribal communities may not mirror mainstream public policy questions
• Non-Natives bring intervention frameworks and tools that may not be appropriate or meaningful to tribal members
• Key qualities to look, listen and learn

While it is important for researchers to look, listen and learn, Ms. Spilde also suggested investigators should keep various challenges in mind:

• Tribal leaders are community members; many of them also struggle with addiction both personally and within their families.
• There is strong political pressure to maintain a positive image of the tribe
• Poor understanding among clinicians and researchers of addiction syndrome in Indian Country; are recovering alcoholics more vulnerable to gambling than active ones?
• Tribal community-level factors often not included in public health model in Indian Country (i.e. rate of unemployment, presence/absence of community resources/social agencies, lack of recreational outlets)
• Difficult to capture impacts of the stress of reservation life, including grief from residential/boarding schools.

Following her presentation, Ms. Spilde also introducedMiriam Jorgenson, Ph.D., research director for the Native Nations Institute for Leadership, Management and Policy at the University of Arizona; research director for the Harvard Project on American Indian Economic Development at Harvard University; and a member of the NCRG’s Scientific Advisory Board.

Dr. Jorgenson started by pointing out that there is far too much research “on” and not enough research “with” or “for” tribal communities. She emphasized that relationships matter, and that is why it is important to conduct researchwiththese communities.

To reiterate point, Dr. Jorgenson shared a quote from the NCAI report:

“Trust takes time. You need to prove—as a researcher or as an outsider—that you can actually function as a positive member of that community; and there’s no way to do that without becoming a part of that community. That takes time.”

Finally, Dr. Jorgenson noted that often, both universities and tribal communities have protocols already in place to help establish and continue the partnership, and if those protocols don’t exist, it is important to establish them prior to facilitating the partnership. She also provided some of the tangible elements of a successful research partnership, including money and resources, in-community partnerships, advocacy for the tribe with funders, products for the community and pro-bono work for the community.

Following Dr. Jorgenson, John Iyott, a counselor with theIndian Health Service, shared some key elements for engaging in successful partnerships. First, he noted that as with any other culture, it is understand the historical trauma that the tribal community has endured before entering into a partnership. He also noted that all tribes are different, and it is important to understand their culture when entering into a partnership.

The session concluded with an engaging question and answer session that left participants interested in connecting with each other for future partnerships and endeavors.

NCRG staffConference on Gambling and AddictionNative American PopulationsNCRG Conference on Gambling and Addictionpartnerships

Before the14th annual NCRG Conference on Gambling and Addictionofficially kicked off yesterday, the NCRG held three pre-conference workshops for conference attendees. One workshop featuredShirley Beckett Mikell, NCAC II, CAC II, SAP, director of certification and education, and National Certification Commission for Addiction Professionals (NCC AP) staff liaison forNAADAC, the Association for Addiction Professionals, who spoke about a partnership between the NCRG and her organization to develop a new, evidence-based endorsement for counselors interested in specializing in gambling disorders.

This workshop drew attendees from across the United States—and even from Mexico and Canada—who specialize in many different treatment areas, including mental health, alcohol and drug abuse, family, marriage, substance abuse, addiction and more.

Ms. Mikell began the workshop by providing background on NAADAC and its certification arm, theNCC AP. NCC AP operates as an independent body from all matters involving the association’s alcohol and drug abuse counselor certification and specialty endorsement opportunities at the national and international levels.

After describing NCC AP’s current accreditations and endorsements, Ms. Mikell announced that the organization is partnering with the NCRG to develop a gambling endorsement. Ms. Mikell noted that the gambling endorsement has many benefits, including:

• Offers the ability to capitalize on specialized training and education obtained in specialty areas
• Allows one who holds a current nationally recognized credential or license identity in a specialty area
• Does not cost as much or as long to obtain as a credential
• Does not have to be renewed as often as a credential
• Identity as a specialist in a specific area of practice

The gambling endorsement will focus on best practices, highlight current theories and approaches, engage experts in the profession and build an educational and training foundation. It will focus on several domain areas, including definitions, the etiology of gambling disorders, population studies, counseling practices and recovery.

Before concluding the session with a question and answer session, Ms. Mikell stated that the gambling endorsement should be ready in 2014.

Are you interested in learning more about this new gambling endorsement? Stay tuned toGambling Disorders 360°for future updates!

NCRG staffConference on Gambling and AddictionGambling EndorsementNAADACNCRG Conference on Gambling and AddictionPre-Conference Workshop

This weekend, the14th annual NCRG Conference on Gambling and Addictionwill kick off at The Sands Expo and Convention Center at the Venetian Las Vegas. The 2013 Conference will offer attendees more than 14 sessions in total and the chance to earn up to 11continuing education (CE) hours.

But did you know that the NCRG is offering three pre-conference workshops and a chance to earn up to two additional CE hours before the conference opens Sunday afternoon? This year, the NCRG is offeringthree pre-conference workshopson Sunday, Sept. 22 from 9:30 – 11:30 a.m., and spots are still available! The NCRG pre-conference workshops include:

Using the DSM-5 in Clinical Practice (2 CE hours)

Leader: Jon Grant, J.D., M.D., M.P.H., The University of Chicago

Are you prepared for the changes in the DSM-5? Revisions in the diagnostic codes for gambling and substance use disordersmean that health care providers specializing in addiction need to consider the implications for their clinical practice. Dr. Grant, co-author of the supplemental guidebook forthe DSM-5, will lead an exploration of the clinical issues posed by these changes.(This pre-conference workshop requires an additional fee.)

New Gambling Credential for Counselors through NAADAC (2 CE hours)

Leader: Shirley Beckett Mikell, NCAC II, CAC II, SAP, NAADAC, the Association for Addiction Professionals

NAADAC, the Association for Addiction Professionals, and the NCRG have partnered to develop a new, evidence-based credential for counselors interested in specializing in gambling disorders. Long-time NAADAC education expert and trainer Ms. Mikell will lead workshop participants in a review of the new credential, including the exam questions as well as educational and supervision requirements.

Trends in Research Methodology: A Workshop for Early Stage Investigators

Leaders: Bethany Bray, Ph.D., Penn State University; Clayton Neighbors, Ph.D., University of Houston

In order to produce the most innovative research, scientists need to draw upon collaborations and suggestions from other researchers in the field. Drs. Bray and Neighbors will examine how to efficiently assess an analytic method’s potential for your research. This session will cover how to evaluate what research questions can be addressed by a specific approach and ways to incorporate innovative methods in your grant proposals. Drs. Bray and Neighbors will specifically examine techniques and research questions that are covered by latent class analysis (LCA), causal analysis and a new methodology for analyzing intensive longitudinal data.

Registrationis required for all of the pre-conference workshops, and you can register on-site for the NAADAC and Research Methodology workshops!

If you can’t attend this year’s NCRG Conference, make sure you subscribe toGambling Disorders 360°for recaps from conferences session and interviews with leading experts. You can also follow the action onTwitter(#NCRGConference) orFacebook!

NCRG staffConference on Gambling and AddictionDSM-5Early Stage InvestigatorsNAADACNCRG ConferencePre-Conference Workshops

Don’t miss your chance to gain access to the latest information about gambling disorders and responsible gaming at the14th annual NCRG Conference on Gambling and Addiction, taking place September 22-24, 2013 at the Sands Expo and Convention Center in Las Vegas.

For more than a decade, the NCRG Conference has provided a unique forum where all stakeholders in the field of gambling disorders and responsible gaming come together to discuss the latest research, share best practices and explore real-world applications for new scientific findings.

This three-day conference is designed to enhance your professional development—whether you’re in the health care sector, the gaming industry, government or academia—by providing the following benefits:

• Network with more than 300 conference attendees and industry leaders
• Talk with the world’s leading addictions experts
• Earn up to 13 hours of continuing education credit
• Gain a critical perspective to develop and evaluate policies that address gambling disorders
• See the latest research at the annual poster session
• Attend interactive pre-conference workshops
• And more!

Click herefor more information and to register for the 14th annual NCRG Conference on Gambling and Addiction!

NCRG staffConference on Gambling and AddictionEarly Bird RegistrationNCRG Conference on Gambling and Addiction