Redefining Recovery From Gambling Disorders: The Iowa Gambling Treatment Program

In the public health and recovery arena, there has been a shift in how mental health professionals understand how to best help those who want treatment for gambling disorders. As a guiding principal of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services, the principles of “recovery-oriented systems of care” are redefining treatment methods for behavioral health agencies. Thanks to Mark Vander Linden, executive officer for the Iowa Gambling Treatment Program, and his team at the Iowa Department of Public Health, this new definition of recovery is providing a new framework to help those with gambling disorders across the state. Their collective efforts serve as a model for public health officials about how to collaborate with key stakeholders to make sure the needs of a community are met in terms of problem and pathological gambling recovery services.

According to Vander Linden, a recovery-oriented system of care is “not a brand new concept, but is a rethinking of how to organize services that the state provides to problem and pathological gamblers.” This approach to treatment is person-centered and self-directed, allowing the individualto rely on their strengths and build on the resilience of their family, community and other support systems.

“In recovery-oriented systems of care, patients are encouraged to take responsibility for their own health,” said Vander Linden. “It also helps eliminate the obstacles that stand in their way, some being very tangible problems.”
Research shows that only 12 – 15 percent of those diagnosed with pathological gambling seek formal treatment. Common barriers to following through with treatment include the inability to afford treatment due to a lack of money or health insurance, a lack of access toresources and ambivalence about changing problematic behavior.

After a comprehensive evaluation of their services in 2011, the Iowa Gambling Treatment Program determined that implementing a recovery-oriented system of care required them to increase the tools and resources for clinicians and the general public. “We wanted to expand the view of what ‘treatment’ looks like for these individuals,” said Vander Linden.

One way that Iowa is accomplishing this goal is through their recovery support services program, which includes a broad array of community-based resources designed to enhance the client’s recovery. For example, some who struggle with pathological gambling also experience unmanageable debt. Iowa’s recovery support services menu includes housing assistance so a patient can keep utilities running at their residence and gas cards to help them travel to counseling appointments. The Iowa Gambling Treatment Program also offers Electronic Recovery Support Messaging, which sends encouraging and informative emails to the person in recovery to help improve their health, life quality and wellness.

Iowa’s shift to a recovery-oriented system of care required the collaboration of key players throughout the state. In 2011, the Iowa Department of Public Health released a survey of adult Iowan’s gambling behaviors and attitudes. This report illustrated that the state’s public health leaders needed to engage key stakeholders in cooperative efforts, including convening these groups for education and prevention programs.

“The work doesn’t start and end with the treatment providers who are only focused on clients with a gambling disorder. It also includes treatment providers who have patients with substance use disorders, Department of Justice personnel and other community mental and public health organizations who see this issue played out among their clients,” Vander Linden said.

The 2011 report also emphasized the need to highlight resources for those who want to learn how to gamble responsibly. The Iowa Gambling Treatment Program’s website, www.1800betsoff.org, houses information about tips for responsible gaming and includes a budget calculator to understand how much a person can potentially lose when gambling, based on the odds of a particular game. Website visitors also can find a guideline of what to expect if someone should call the 1-800- BETS-OFF helpline. In addition to its website, the Iowa Gambling Treatment Program created a YouTube channel with short videos explaining the many resources it offers.

For more information, visit the Iowa Gambling Treatment Program’s website or YouTube channel at www.youtube.com/1800betsoffiowa. Vander Linden also will present at the 13th annual NCRG Conference on Gambling and Addiction about the Iowa Department of Public Health’s efforts to implement recovery-oriented systems of care. For more informationon that event, please visitwww.ncrg.org/conference.

This profile of Mark Vander Linden and the Iowa Gambling Treatment Program was originally published in the summer 2012 edition of Responsible Gaming Quarterly. To read or download a full copy of this issue, you can visit theNCRG website.

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Guest Post: NCRG Conference Update: Using Research To Educate About Online Gambling

Simo Dragicevic, BetBuddy

Today’s Gambling Disorders 360˚ post comes from Simo Dragicevic, president and CEO of Bet Buddy. Dragicevic will present findings from his latest research on gambling disorders and responsible gaming for those who gamble online at the13thAnnual NCRG Conference on Gambling and Addiction. Dragicevic’s plenary session, titled “New Research: Educating Online Players about the Risks Associated with Gambling,” will take place on Monday, October 1 from 3:15 – 4:15 p.m. PST, and the NCRG’s social media team will be sharing the highlights of his talk in real-time onTwitter(@theNCRG, #NCRGConference). For more information on the NCRG Conference or to register, visit theNCRG Conference website. To learn more about Bet Buddy, you can visit their website or watch Dragicevic’sinterview with Cass Business School.

Today is an exciting time for the gaming industry regarding Internet gambling. Cumulative investment in technology research and development over the last decade has created powerful technology platforms, analytical capabilities and skilled resources. In parallel, the research and academic community’s understanding of gambling disorders is also growing. Combining this rich pool of research together with technology and analytical capabilities is allowing us to gain deeper insights into players’ behaviors and help those players to make more informed decisions about their health and behaviors. Ultimately, this knowledge helps to make regulated gambling markets safer environments for vulnerable players.

I am very excited to have been invited to speak at the13thNCRG Conference on Gambling and Addiction.The above trends have been at the heart of what my colleagues and I have been working on passionately. My plenary session will focus on the following areas:

  • Examining new research using large internet casino and poker player data sets
  • Demonstrating how new software applications are applying insights from peer-reviewed research to identify problematic gambling behaviors and educate gaming operators and players.

Our session will look at three studies that Bet Buddy and GTECH G2 have been collaborating on since 2010. The first study, which was published inInternational Gambling Studiesin 2011, builds on the work undertaken at the Division on Addiction, Cambridge Health Alliance, a division of Harvard Medical School. Specifically, this work replicated Braverman and Shaffer’s (2010) clustering analysis of Internet sports player data using data from online gamblers playing casino games.

The second study is focused on describing Internet casino and poker self-excluders’ gambling behavior. The participants included more than 240,000 GTECH G2 Internet casino and poker players from the regulated European markets. For example, we compared the demographics and player behaviors (e.g. betting patterns such as amount of time spent gaming, games played, losses, etc) of those who self-excluded from Internet gambling and compared them to the control group.

The third study explains how we have used the insights from the previous studies to build models to predict self-exclusion events for Internet gamblers using statistical classification algorithms.

During the plenary session, we also will discuss the evolution of responsible gaming software in the gambling industry as well as how the innovation curve drives new product development in gaming, drawing on UK-based research undertaken by GamCare, Salford University and Bet Buddy that was recently presented at the Responsible Gambling Council’s Discovery 2012 conference in Toronto. We will also explain how Bet Buddy and GTECH G2 are using insights from peer-reviewed research to build new data-driven analytics software products (a type of ‘big data’ solution, to use a current technology buzz word) that can analyze large quantities of personal and machine generated data to track and predict player behaviors. This analytics software also allows us to interpret these insights to educate both gambling operators and gamblers about the risks associated with gambling. The demonstration will be of interest to the regulatory, academic, clinical, treatment and gaming industry communities, and also to those interested in how to execute data-driven research and who want to understand the challenges and opportunities associated with productizing such research. I look forward to seeing you there!

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Register Today For The Next NCRG Webinar On September 19

Save the date and register today for the latest NCRG Webinar Series session on September 19! Wendy S. Slutske, Ph.D., 2011NCRG Scientific Achievement Award winnerand professor at the University of Missouri – Columbia, is leading the upcoming training, titled “Path to Recovery: Is Controlled Gambling Possible for Pathological Gamblers?” The webinar will be held on Wednesday, September 19, 2012 from 2 to 3 p.m. EST. The session is free to attend, participants will earn one CEU and registration is now open on the NCRG’s website.

Abstinence from gambling has been the only acknowledged treatment goal in most pathological gambling interventions. However, a new study from Australia challenges the notion that abstaining from gambling is the only path to recovery. Dr. Wendy Slutske will discuss research that found 90 percent of those in the recovery group participated in some form of gambling in the past year. She will explore the implications of this finding for treatment and interventions.

Christine Reilly, senior research director for the NCRG, will be moderating the discussion. If you are unable to attend on the day of the webinar but would like to submit questions for Dr. Slutske, you can leave them in the comments section below or email Amy Kugler atakugler@ncrg.org.

This session has been approved forone hour of continuing educationby:

  • NAADAC, the Association for Addiction Professionals (provider # 737)
  • The California Foundation for Advancement of Addiction Professionals (provider # OS-02-26-1111)
  • The National Board for Certified Counselors (Provider 6474)
  • The NCRG is also approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. The NCRG maintains responsibility for this program and its contents.

As last year’s NCRG Scientific Achievement Award winner, Dr. Slutske brings a wealth of knowledge and expertise to this session. She is regarded as one of the world’s leading experts on behavioral genetics of gambling disorders, and her current work is a groundbreaking project on recovery from gambling disorders. A recent finding is that a large number of people who recover from gambling problem are able to continue to gamble without symptoms of a gambling disorder. These findings and more will be presented on September 19, so make sure to register today!

Have a comment or question about the upcoming session of the 2012 NCRG Webinar Series? Leave it in the comments below.

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Nationally Renowned Speakers Will Address New Trends In Addiction Research And Treatment At The NCRG Conference

The13thannual NCRG Conference on Gambling and Addictionis a month away, and many engaging speakers are set to present on emerging research and applications for addictions, gambling disorders and responsible gaming from September 30 to October 2 at the Sands Expo and Convention Center in Las Vegas. Make sure to register by September 10 to receive the discounted rate of $295 for the main sessions and $45 for pre-conference workshops! You can visitwww.ncrg.org/conferenceand click on the registration page for more details.

Here are a few of the speakers you won’t want to miss:

  • H. Westley Clark, M.D., J.D., M.P.H., CAS, FASAM, is director of the Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services, where he leads the agency’s national effort to provide effective and accessible treatment to all Americans with addictive disorders. Dr. Clark will offer a national perspective on recovery-oriented systems of care based on his efforts to implement this model in his position at SAMHSA.
  • Alexandre B. Laudet, Ph.D.,is a nationally recognized expert in addiction recovery. Her federally funded research over the past 15 years has focused on understanding what helps people with drug and/or alcohol problems quit drinking or getting high and how they stay in recovery. She leads the Center for the Study of Addictions and Recovery at the National Development and Research Institutes, Inc. In her plenary session, Dr. Laudet will explain the science of recovery and the research that examines the components, patterns, paths and predictors of long-term recovery from addiction.
  • A. Thomas McLellan, Ph.D.,is the CEO and co-founder of the Treatment Research Institute (TRI) and an experienced substance abuse researcher. From 2009 to 2010, he served as science advisor and deputy director of the White House Office of National Drug Control Policy (ONDCP), a congressionally confirmed presidential appointment to help shape the nation’s public policy approach to illicit drug use. With more than 35 years of experience in addiction treatment research, Dr. McLellan will report on the experience of taking an evidence-based treatment and adapting it to actually fit and self-sustain in a medical and a school environment.
  • Robert Ladouceur, Ph.D.,is professor emeritus of psychology at Université Laval. He is one of the leading international authorities on gambling disorders, publishing more than 200 articles on topics such as cognitive therapy, the effectiveness of responsible gaming programs, youth and adult population studies and other aspects of gambling addiction. Dr. Ladouceur will explain the latest research on a pre-commitment strategy that gamblers can use to reduce excessive gambling.
  • Mark A. Lipparelliis chairman of the Nevada Gaming Control Board, to which he was appointed in January 2009. Lipparelli will bring his experience in the gaming industry to a panel discussion of the best practices in, newest technologies for and relative necessity of regulating responsible gaming in the online environment.

For a full list of NCRG Conference speakers and their biographies, visit theNCRG Conference speaker page. To register, visit theNCRG Conference registration page. We look forward to seeing you in Las Vegas!

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“21 Is A Must” – Colorado Youth Educate Peers About Responsible Gaming

This March, the Problem Gambling Council of Colorado (PGCC) and the Colorado Lottery joined forces to help students showcase their creativity and educate the community about gambling disorders and responsible gaming through the first “21 is a Must” scholarship contest. High school and college students from across the state were invited to create a poster educating youth about the age requirement for gambling and the warning signs of problem gambling. Entrants competed for two scholarships: the first-place winner received a $2,000 award and the runner-up was awarded $1,000.

“The creativity, originality, content and style of the entries exceeded our expectations, as did the educational value of the submissions,” said Lois Rice, PGCC board member and executive director of the Colorado Gaming Association. “The excellence of these entries made it extremely difficult to select a winner.”

While only in its first year, 14 students entered the contest, and the first-place scholarship went to Hannah Byerly from Trinidad State Junior College; Kelly Carter from Colorado State University received the second place scholarship. Byerly’s entry included a student who was standing on the side of the road, with a sign stating “Don’t Bet Your Future.” “When adolescents are making the choice to gamble underage, they are betting more than they think,” Byerly said.

The winning posters were reproduced and distributed in educational marketing materials throughout Colorado during the American Gaming Association’s (AGA) Responsible Gaming Education Week (RGEW) from July 30 – Aug. 3. This annual event was created by the AGA to promote the industry’s ongoing efforts to educate employees, patrons and the public about responsible gaming. It also provides gaming companies and problem gambling associations across the country with an opportunity to expand their existing efforts to address the issues of underage and problem gaming.

‘We work diligently with our partners in the gaming community to constantly reinforce the age requirements for participating in gaming activities and to educate the public about problem gambling,” said Matt Robbins, Community Relations Specialist for the Colorado Lottery and PGCC Board member. “The poster contest is a great way to engage young people in this effort, and we’re proud to be involved. Given the success of this year’s program, we look forward to next year’s contest.”

This article was originally published in the summer 2012 edition of Responsible Gaming Quarterly. To read or download a full copy of this issue, you can visit theNCRG website.

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Research Update: The Social Network Of Pathological Gambling

Adam Goodie, Ph.D.

What is a “social network analysis” of gambling disorders and responsible gaming? The phrase might evoke images of Mark Zuckerberg in a hooded sweatshirt, or the Oscar-winning film about the creation of Facebook. In reality, a social network analysis (SNA) is a method that researchers use to study how social connections effect behaviors, such as problem or pathological gambling.

“It’s important to realize that this research relates to the naturally occurring social networks that we all have with people we actually know, and not in particular to social technologies like Facebook or Twitter,” said Dr. Adam Goodie, an associate professor at the University of Georgia and director of the Georgia Decisions Lab.

Dr. Goodie and his team recently received a $172,000 grant from the NCRG to study how social connections may impact an individual’s gambling behavior. How do researchers in this field study something as intangible as social connections? “There are two basic approaches,” said Dr. Goodie. “In an ‘egocentric’ type of study, each participant reports on his or her own personalnetwork, and there is no assumption that any two participants know each other.”

The other type is a “sociocentric” analysis, which studies all members of an existing social structure and examines the many relationships and bonds that influence the members’ perspectives and behaviors. The team at University of Georgia will take an “egocentric” approach to learning about the lives and gambling behaviors of nearly 250 frequent gamblers and their 30 closest social connections, a project that will produce information on more than 7,000 people.

Dr. Goodie’s team will evaluate a gambler’s social networks on two major characteristics: “density” and “centrality.” Density is the degree to which members of your network know other members. In this case, the more that people in a network know each other, the “denser” the network. “Centrality” describes the degree to which a person in a given network has connections with others in that same social circle, often becoming a person of influence. (e.g., a spouse who knows almost all of your social contacts would have high centrality).

By using these metrics, the researchers will measure how problematic gambling behavior impacts the relationships of those surrounding the individual who has been diagnosed with pathological gambling. For relatively simple relationships between the gambling behavior of an individual and their peers, the social network analysis may show something completely different than more complex relationships, depending on how close or “dense” the social network of a pathological gambler is when compared with non-gambling situations. The researchers also will be looking at how an individual’s problematic gambling behavior correlates with other potential disorders, such as substance abuse. “We know that problem gamblers tend to have these traits themselves,” said Dr. Goodie, “and we are exploring whether their entire networks might possess these traits to a greater degree than nonproblem gamblers.”

Once Dr. Goodie and his team have more insight into the relationships between social networks and gambling behavior, those findings will allow them to ask additional questions about how these research findings translate to realworld relationships. Though the proposed research hopes to shed light on how social factors contribute to gambling behavior, there is still plenty of research to be done on individual factors such as personality traits and brain chemistry. “As is so often the case in the real world, finding that one factor has a causal role usually doesn’t rule out the possibility that other factors also play roles.” Dr. Goodie said.

This profile of NCRG-funded researcher Dr. Adam Goodie, associate professor at the University of Georgia, was originally published in the summer 2012 edition of Responsible Gaming Quarterly. To read or download a full copy of this issue, you can visit theNCRG website.

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Responsible Gaming Quarterly’s Summer Issue Is Now Online

Responsible Gaming Education Week isn’t the only time of year that the National Center for Responsible Gaming (NCRG) and the American Gaming Association (AGA) work together to help educate community members on some of the latest research and information about how to gamble responsibly. They also produceResponsible Gaming Quarterly,a free publication that provides a broad range of coverage on recent research results, regulatory efforts, studies and developments in the treatment field and best practices for programs that encourage responsible gaming.

In its ninth year of publication, the NCRG and AGA relaunchedResponsible Gaming Quarterlyas a fully online publication for the summer 2012 issue. You can visit the AGA or the NCRG’s website to see the full issue and flip through the pages!

The summer 2012 issue includes articles that highlight:

  • Events such as Responsible Gaming Education Week and the 13thannual NCRG Conference on Gambling and Addiction
  • International responsible gaming programs, including a new mobile app in Canada and online initiatives in Singapore.
  • Back-to-school programs from both the NCRG and the Problem Gambling Council of Colorado that are educating students about gambling problems and the legal age to play.
  • NCRG-funded research that examines the social networks of those with gambling disorders.
  • And more!

Do you have a story idea for the nextResponsible Gaming Quarterly? Please let us know in the comments below.

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The NCRG And Aga Are “All In For Responsible Gaming”

Even though Responsible Gaming Education Week only happens once a year, the American Gaming Association (AGA) and the National Center for Responsible Gaming (NCRG) focuses on responsible gaming year-round through programs and education initiatives. As in past years, the NCRG is joining with the AGA to encourage casinos and their patrons to understand how to gamble responsibly for Responsible Gaming Education Week, July 30 to August 3. During this year’s Responsible Gaming Education Week, we’ll use Gambling Disorders 360 to highlight some of the NCRG’s responsible gaming resources, as well as successful tools from other groups.

The NCRG believes that education is an essential component of increasing awareness of gambling disorders and promoting responsible gaming. There are two key NCRG programs that are used to develop and enhance responsible gaming programs in the gaming industry. ThePartnership for Excellence in Education and Responsible Gaming (PEER)program is a dynamic, one-of-a-kind program created by the NCRG to provide the tools and resources needed to develop a comprehensive and world-class responsible gaming program.EMERGE,which stands fortheExecutive, Management and Employee Responsible Gaming Educationprogram, is a science-based online training program for gaming industry employees, but can be used by everyone.

PEERwas created to help gaming organizations create a comprehensive responsible gaming education program rooted in sound science but practical and understandable for all employees and patrons. A codified approach to responsible gaming is vital for success, but not everyone has the necessary resources to implement a comprehensive program. This is wherePEERcomes into play. The program was based on theNCRG’s Code of Conduct for Responsible Gamingand membership inPEERprovides organizations full access to thePEERResource Guide, a blueprint for developing and implementing a world-class gaming education program, regardless of the size of the gaming facility.

A key component ofPEERisEMERGE,the NCRG’s web-based training program developed by addiction specialists at Harvard Medical School.EMERGEis customizable to any gaming facility and translates the most current scientific research on gambling disorders into a practical tool for casino employees at all member casinos. Current casinos who are usingEMERGEinclude San Manuel Band of Mission Indians in California and Dooley’s Club of Australia. In fact, in the spring of 2010,Tribal Government Gamingmagazine featured an article about the responsible gaming measures already in place at tribal casinos and how some of these operations, including San Manuel Band of Mission Indians, have expanded their efforts to include science-based technological innovations, such asEMERGE.

You can view the introductory video forEMERGEbelow to learn more about how the program works. For more information onPEERorEMERGE, contact Amy Martin at (202) 552-2689 or visit www.ncrg.org/peerprogram. Please feel free to let us know your thoughts in the comments section below.

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The NCRG Launches New Series Of Resources To Educate About Gambling Disorders And Responsible Gaming

Gambling disorders and responsible gaming aren’t just casino issues – they’re community issues. From local companies and nonprofit organizations to government officials and civic leaders, everyone in the community has a role to play in getting educated and helping to spread the word about available resources. To help educate various stakeholders about this community issue, the National Center for Responsible Gaming (NCRG) developed theGambling and Healthseries, including guidebooks and factsheets that are designed to explain more about pathological gambling, provide resources available to refer to those who may need help and encourage responsible decisions when gambling.

During this year’sResponsible Gaming Education Week, the NCRG is launching the first edition of theGambling and Healthseries, titled “Gambling and Health in the Workplace.” Human resources (HR) and employee assistance (EA) professionals are often trained to help employees with addiction and other mental health issues, but are not always equipped with the knowledge and resources when it comes to pathological gambling. To help address this issue, the NCRG created this educational resource to help HR and EA managers learn about gambling disorders, encourage responsible decisions when gambling and understand practical ways to assist and refer individuals with gambling problems.

The guide provides the latest research on gambling disorders, frequently asked questions that HR and EA professionals might face in the workplace, characteristics of pathological gambling that they may see in an employee’s behavior and ways to help educate employees about responsible gaming. Additionally, there is a one-page flyer for employees that outlines facts about the issue and resources to learn more about gambling addiction. The guide and one-pager are available as free downloads atwww.ncrg.org/gamblingandhealth.

‘Gambling and Health in the Workplace’ was developed under the guidance of an advisory committee of leaders in the HR and EA fields, drawing experience from government, the commercial gaming industry and mental health clinicians. It is being released in conjunction with Responsible Gaming Education Week, an annual program coordinated by the American Gaming Association and the National Center for Responsible Gaming designed to provide gaming companies and affiliated national organizations with an opportunity to expand on work they do every day to educate employees and patrons about gambling disorders and how to gamble responsibly.

For more information or to download a free copy of the guidebook, visitwww.ncrg.org/gamblingandhealth. Stay tuned to Gambling Disorders 360˚ for more information on Responsible Gaming Education Week activities, newly available resources and successful responsible gaming programs.

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Deadline For NCRG Conference Scholarships Is Friday, July 20

Deadline to apply: Friday, July 20

The NCRG is thrilled to announce that need-based scholarships are now available to help offset the cost of attending the13th annual NCRG Conference on Gambling and Addiction. This year, based on response and availability, the NCRG will provide up to 30 individual sponsorships to attend the NCRG Conference. A portion of these scholarships may also include travel assistance up to $250. Scholarships are available to all interested attendees, especially those in the clinical and public health sectors.

Click here to download the application form.

To Apply:

–Click hereto download the NCRG Need-based Scholarship Program form

– Provide answers to the application questions by number on the application, a separate document or in the body of your email

– Submissions can be made by email tocreilly@ncrg.orgor faxed to 978-552-8452 by Friday, July 20

– In return for their scholarship, recipients will be asked to submit a (minimum one-page) letter to the NCRG following the conference describing their experience at the event.

For more information, contact Christine Reilly, senior research director for the NCRG, atcreilly@ncrg.org, or 978-338-6610. Applicants will be notified of a scholarship no later than Wednesday, August 1. All of the materials are also available on theNCRG Conference scholarship webpage. You can find more information about the 13thAnnual NCRG Conference on Gambling and Addiction visitwww.ncrg.org/conference.

Make sure you apply today so that you can attend the 13th annual NCRG Confernece! Did you receive a scholarship last year? Let us know in the comments below!

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