Who is susceptible, supporting young people, signs and impact of gambling, barriers to seeking help, resources for self-help, organisations that can assist, strategies for families and friends, the brief intervention practice approach, child aware practice
This page has three sections:
Background Material that provides the context for the topic
A suggested Practice Approach
A list of Supporting Material / References
Who is susceptible to developing gambling problems?
Several authors concur that the following factors are clearly linked to higher rates of problem gambling: being young, being male, being part of a minority ethnic group, having a lower income, having a high consumption of drugs and/or alcohol and having had a parent who had a gambling problem (Rogers, 2013).
One of the strongest findings from prevalence surveys across the world in recent years is that rates of problem gambling are up to three times higher in adolescents than in adults. Sensation seeking and risk taking are linked to gambling behaviour in young people as are poor coping skills and parental gambling.
Those who experience unemployment, poor health, poverty, housing, and low-educational qualifications have significantly higher rates of problem gambling than the general population.
It is clear from several studies in a range of countries that individuals in ethnic minority groups display much higher levels of problem gambling than in the majority cultural group.
Whilst studies repeated suggest that the prevalence of gambling problems remains much higher among males, the level of gambling problems in females has increased. The reasons why women gamble may be significantly different from those which trigger gambling among men. For example, gambling can be used as a means of escaping problems in their home lives, or problems from their past.
Supporting young people
Some tips for practitioners working with young people with addiction issues (Butler, 2019):
Make connections with young people. Social workers cannot change behaviour without understanding the young people that they work with.
Understand the young person’s motivation to gamble and work with that. Find out why they want to do this and explore avenues that will allow them to get a similar buzz in a less harmful way.
Social workers can become fixed on abuse and neglect of the young person. If gambling is happening, don’t minimise the damage it may be doing.
Try and understand how the world of gaming is developing and how this can lead young people into addictive behaviours.
Signs of problem gambling
Regular playing of poker machines can lead to problem gambling, e.g. in 2010, three quarters of people with gambling problems played poker machines. The following are signs a person has or may be developing a problem with gambling (Australian Government, Department of Social Services, 2016):
Becoming secretive about money
Saying they must stay back at work
Tension at home, frequent arguments or even violence
Becoming withdrawn from family and friends
Becoming defensive when questioned
Absent for long periods or late home constantly
The Royal Society of Public Health - RSPH (2017) suggests the following are also signs someone is experiencing difficulties with gambling. RSPH add it is difficult to know if someone is struggling with gambling because if often has no physical effects and many people do not show their feelings, lie or get angry when questioned.
Finding it hard to manage or stop gambling.
Losing interest in usual hobbies.
Lying about gambling or hiding it.
Chasing losses or gambling to get out of financial trouble.
Gambling until all money is gone.
Borrowing money, selling possessions, or not paying bills to pay for gambling.
Needing to gamble with larger amounts of money or for longer to get the same buzz.
Neglecting work, school, family, or personal needs because of gambling.
Impact of problem gambling
(Australian Government, Department of Social Services, 2016; Rogers, 2013)
On the Person/Society Problem gambling is linked to many individual and social problems including depression, suicide, significant debt, bankruptcy, family conflict, domestic violence, neglect and maltreatment of children and offending.
On Relationships The impact of problem gambling may extend beyond financial problems. A person affected by problem gambling can cause harm to themselves and their family. They may suffer mental and physical health problems, find it difficult to hold down a job, and struggle to maintain relationships. There can be utter devastation when realising the magnitude of the financial loss. Many partners start to blame themselves. People affected by problem gambling are six times more likely to be divorced. Others, however, do manage to tackle the problem together, and as a result their relationship can grow stronger.
On Children Children growing up in a family where there is a gambling problem are at greater risk of developing emotional and social problems than other children. Children often know there is less money for food, clothing, family outings and school activities. The effects of poverty can hit hard. Often, children can experience feelings of guilt, and feel that they have in some way contributed to the problems of the parent and the family. Children may become reluctant to invite friends over, particularly if there is significant fighting and tension in the home. Children may stop trusting the parent affected by problem gambling because of promises being made and constantly broken, or through to finding out their parent has been stealing money from them.
Motivating factors to change/Barriers to seeking help
Most people presenting with gambling problems express control problems associated with electronic gaming machines. Recovery from problem gambling can manifest in multiple ways with abstinence not being a necessary condition of recovery. But control of the urges to gamble and a resistance to a return of the problematic behaviour are crucial. It is not appropriate to say recovery is “final” (Nuske & Hing, 2013).
Overseas and Australian reviews have concluded that the primary motivating factors to seek professional help are
psychological distress, and
financial and relationship breakdown,
while the main barriers are
unwillingness to admit the problem,
issues with treatment itself, and
false hope in regaining control or winning back losses (Nuske & Hing, 2013).
A Possible Pathway to Recovery
Through analysing their stories of the gambling experience and recovery process Nuske and Hing (2013) plotted the pathways followed by 10 recovered gamblers. They found there were five critical points along the pathway towards recovery. Based on their research the authors suggest social workers consider using storytelling as a therapeutic tool, combined with tools for self-help and other therapies. The critical points were:
A distaste for themselves (self-loathing) and a questioning of whom they really were (loss of identity) emerged. Gamblers built barriers around themselves and felt they had let others down.
Fear emerged, fear of failure (an unwillingness to accept they could not master gambling), of losing the gambling experience (a sense of comfort and security) and of being judged by others (non-judgemental attitudes of counsellors were important in recovery).
Fear stimulated a move towards taking control over their lives, albeit in different ways.
Self-help strategies were a common starting place (e.g. writing down all the reasons not to gamble and referring to these when tempted, reading personal development books, ‘‘self-talk’’, limiting the amount of money carried, and self-exclusion).
Seeking help from family and friends occurred if self-help failed. While these two strategies can work for some, relapse was common.
Meaningful change was achieved through a combination of professional help and utilising gambling support groups. For some professional help focused on one area (e.g. gaining insight into personal history or gaining control of thoughts and behaviours) but for most it involved a combination of different approaches.
The defining moment came when problem gamblers were able to share their narrative, i.e. lift their heads high and share their stories with other problem gamblers and the general community.
Overall problem gamblers used multiple forms of help on a journey of movement that began with self-help, moved through professional / nonprofessional help, and then relapse. After returning to self-help, professional help or both, sometimes with the nonprofessional support of family and friends, the help-seeking process culminated with retelling of stories and sharing narratives with others as the crucial point of recovery.
In Australia there are many ways to get help and information about gambling (Australian Gambling Research Centre, 2021; Australian Government, Department of Social Services, 2016):
Call the National Gambling Helpline on 1800 858 858 (24 hours/7 days), www.gamblinghelponline.org.au
Use online counselling (e.g. real time online chat, email, and forums) https://www.gamblinghelponline.org.au/take-a-step-forward/chat-counselling
Find information about help services in your state or territory https://www.gamblinghelponline.org.au/services-in-your-state
Get information and support for family and friends https://www.gamblinghelponline.org.au/helping-others
Get information about how to talk with someone about their gambling https://mhfa.com.au/resources/help-a-friend-family-member-or-co-worker-with-mental-health-illness-or-crisis
Contact Gamblers Anonymous https://gaaustralia.org.au/
Gambling Impact Society www.gisnsw.org.au
Beyondblue www.beyondblue.org.au Tel: 1300 22 4636
Lifeline www.lifeline.org.au Tel: 131 114
Relationships Australia www.relationshipsaustralia.org.au Tel: 1300 364 277
Financial Counselling Hotline Tel: 1800 007 00717
Canadian Problem Gambling Index www.problemgambling.ca/EN/Documents/ProblemGamblingSeverityIndex.pdf
State / Territory resources https://www.gamblinghelponline.org.au/services-in-your-state
Australian Government www.problemgambling.gov.au
Organisations in the United Kingdom include:
National Gambling Helpline 0808 8020 133
Money Advice Service http://www.moneyadviceservice.org.uk/
Addiction Recovery Agency https://www.recovery4all.co.uk/
Citizens Advice http://www.citizensadvice.org.uk/
National Gambling Treatment Service https://about.gambleaware.org/national-gambling-treatment-service/
National Debtline http://www.nationaldebtline.org/
Stepchange Debt Charity http://www.stepchange.org/
Beacon Counselling Trust https://beaconcounsellingtrust.co.uk/
Strategies to assist problem gamblers
Self help (GamCare, 2019; Gambling Help Online, 2021)
People who are affected by gambling often believe they can predict or control the outcome of a bet. For example:
Thinking the odds are in your favour
Playing on certain machines increases your odds
Think that certain machines are due for a payout
Wearing 'lucky' clothes or having 'lucky charms'
Thinking a win is due
Thinking you have a 'lucky' coloured jockey.
The best way to manage these thoughts is to challenge them:
What evidence do I have for this thought?
Where has gambling gotten me?
How often do I really win big?
What would my partner/loved one say and how would they feel about me gambling?
What is the potential impact of gambling, what will it cost me (both in money and emotionally)?
How does this fit with my goals? How will I feel if I gamble?
Take control: decide whether to quit or cut down on gambling. If you have tried to cut down before, quitting may be the best choice. Accept that the urge to gamble will become stronger as you try to resist. Urges to gamble do not usually last more than one hour. So have alternatives to distract you. Choose from the self-help points that follow.
Write down the advantages and disadvantages of (i) reducing or stopping gambling, and (ii) continuing to gamble. Keep the list handy and review it when you feel the urge to gamble.
Try to avoid places you associate with gambling. Organise self-exclusion for venues or products (information about self-exclusion is available at venues and Australian gambling websites). For online sites, you are able to download and complete a self-exclusion application form from the sites. In general search under Responsible Gambling or Self-Exclusion.
Plan ahead when you know an engagement is coming up that could be challenging. Think of potential exit strategies and identify someone you can ask for support if needed.
Being active can take the focus of gambling - structure your day, plan how you spend your time; make time for hobbies.
o Call a friend, catch up with friends, join a club
o Watch a movie, go to the gym, walk, clean the house
o Go to the gym, exercise, dance, swim, go fishing
o Do something physical to elevate your mood
o Express your frustration in a productive way, talk to someone about how you're feeling, run up a hill, yell at the sky.
Manage your money:
o Carry only enough cash on you to cover your daily expenses.
o Leave credit cards and EFTPOS cards at home.
o Lower the daily withdrawal limit on your bank account
o Take Banking Apps off your smart phone.
o Cancel cash withdrawals on your credit card.
o Have a debit card rather than a credit card.
o Organise wages to be paid into a separate account from which funds need to be transferred before you access them.
o Tell family and friends and ask them not to lend you money.
o Ask someone you trust to hold money for you. For example, ask a reliable friend or spouse to manage your wages or hold onto your credit cards.
o Pay bills by direct debit or ask someone to pay bills for you.
o Purchase supermarket and other appropriate gift cards when you are paid to ensure you have money for food, petrol and other necessities.
Be aware you may have to address other habits and addictions (drinking, smoking, drug-taking) to successfully combat gambling issues.
People with gambling problems often find that many of their social contacts and activities involve gambling. One of the most important aspects of maintaining change is finding ways to spend the time they used to spend on gambling. Organise your life, e.g. clean the house, exercise. Build a support network. Reconnect with family, friends, and colleagues. Use online help sites.
Sometimes acceptance is a big step - for many gamblers, accepting that they will not regain the money they have lost is a major issue.
It is important to acknowledge progress and celebrate your achievements. It is also important to be realistic and not expect a ‘perfect’ day or week.
Stay healthy: engage in regular exercise and eat a healthy balance diet.
Strategies to Assist Family and Friends
(Australian Government, Department of Social Services, 2016)
Look after your health.
Recognise you are not alone.
Learn more about problem gambling.
Don’t be too hard on yourself. Someone affected by problem gambling can become very good at lying, at covering up, and are usually in denial.
Your ongoing involvement in the treatment of the person affected by problem gambling can impact the outcome. It can be hard to support someone who has caused you so much pain and stress, so remember to also focus on the support you need for your own recovery.
Seek immediate help if the person affected by problem gambling expresses thoughts of suicide.
You will need to have some very difficult conversations with the person affected by problem gambling. While these are likely to be hurtful, emotional, and stressful, try to talk about the problem rationally and without it turning into a heated discussion. Carefully choose the timing of your conversations.
Take control of finances
Be careful about your mortgage being impacted—talk to the bank. Talk to the person affected by problem gambling about your desire to minimise their access to money. Even if they are not agreeable, you have every right to minimise the money supply, and monitor it closely.
Talk to your bank about protecting cheque and savings accounts, credit cards, lines of credit and other avenues.
The more debt a person affected by problem gambling accumulates, the more elaborate methods they will employ to access money. This may include selling family possessions.
People affected by problem gambling are often convinced their loss is only a temporary setback, and the next big win is around the corner. All that’s needed is some extra cash. Tell family, friends, and co-workers not to lend the person money.
If the person affected by problem gambling has made the decision to stop gambling, talk to them about granting you or another family member or friend power of attorney and control over finances.
Once a person affected by problem gambling is on the road to recovery, they often find there is a big gap in their lives that gambling used to fill. They have often lost the ability to socialise, and struggle to find balance. Supporting the person affected by problem gambling to slowly restore healthy routines and reconnect with other friends and family can help recovery.
Recovery from problem gambling requires persistence, hard work, encouragement, and commitment, and having the support of a family member or friend can result in a more successful recovery. Problem gambling is like an addiction, and there is a good chance the person affected by problem gambling will relapse. As a supporter, keep an eye out for relapse triggers such as anxiousness, anger, stress, or depression.
It is highly likely that many of the people (both children and adults) that social workers have dealings with are among those who are most susceptible to addictions generally and gambling problems specifically. Problem gamblers often experience unemployment, poor health, poverty, housing stress and low educational qualification. Ethnic minority groups often display much higher levels of problem gambling than the majority cultural group. Furthermore, social workers study a range of social science theories in their training, including some of the systems theories and psycho-social theories which may offer particularly useful frames for understanding addiction problems (Rogers, 2013).
Boyle et al. (2018) suggest social workers do not always have resources at their fingertips to explore potential gambling harm. They suggest the following questions may help start a conversation on gambling:
Do you or a family member gamble on the pokies or online, at the casino or the track?
Is this a problem for you?
Would you like to go to a specialist service?
The authors also suggest the Problem Gambling Severity Index (PGSI) can be used to categorise the level of risky gambling behaviour into one of four categories:
non-problem gambling (0)
low-risk gambling (1-2)
moderate-risk gambling (3-7)
problem gambling (8+).
The material that follows can be used by social workers if they wish to work with clients to address risky gambling. However, Boyle et al. (2018) provide a list of resources that clients (and their family and friends) themselves can access to seek self-help. These resources can be accessed via the original article with the link provided in the Supporting Material section that follows.
Cognitive behavioural therapy (CBT) and motivational interviewing fit very well with the values of social work and have been shown to be effective in assisting problem gamblers (Rogers, 2013). The motivational interviewing approach is outlined elsewhere on this site. You’ll find it at https://www.thesocialworkgraduate.com/post/practice-model-motivational-interviewing.
Crisp et al. (2001) suggest a brief course of therapy can be effective when problem gamblers are ready to explore changing their habits. This is reinforced by both the Royal Society of Public Health – RSPH (2017) which provides a short, online, and free course on brief intervention for problem gamblers, and Matua Raki, New Zealand who produced a Brief Intervention Guide to address risk and harm related to alcohol, tobacco, other drugs, and gambling in 2012. This guide has been used by GambleAware and provided the material for the RSPH online course. It is included in the Supporting Material below.
What follows is an outline of the brief intervention approach to supporting problem gamblers using material from the RSPH online course.
What is a brief intervention? (RSPH, 2017)
Brief intervention refers to: "A short, purposeful, non-confrontational, personalised conversation with a person about an issue related to addiction." Brief intervention is most effective for people whose behaviour is hazardous or harmful, in other words people who are at risk of developing or people who are experiencing harm from an addiction. After developing rapport and engagement with a person, the actual intervention may only take 15 minutes or less.
Brief interventions are not designed to treat people who are dependent or addicted to gambling, although they are useful to improve motivation to seek more intensive treatment. The role of the brief intervention worker is to refer this group of people to specialist treatment services for further assessment.
Providing a Brief Intervention
In moving through the following stages social workers should be prepared to exit at any stage if the person indicates that they do not wish to continue.
Step 1: Introduce the subject
This step will occur after rapport and engagement have been established. Developing trust through discussing confidentiality should be part of the engagement process.
Ask permission to talk about the behaviour
"While we're discussing what you like to do with your free time, could we talk about gambling?" "You sound a bit worried about how much you've been gambling lately. Could we talk a bit more about that?"
Explain your role in relation to the behaviour’s to be explored
"If you are interested, we can work through a few quick questions. We use a process called a gambling screen. The screen provides you with your personal result. What you do with that information is your choice."
Clarify confidentiality issues
"We have already discussed confidentiality, but I just want to restate that this discussion will be confidential, in the same way as any other information about you."
Reinforce and respect the person’s choice
“It’s up to you.”
“What do you think you might want to do next?”
Step 2: Screen
Administer the screening tool. You could use the Problem Gambling Severity Index available online, e.g. at https://learn.problemgambling.ca/PDF%20library/assessment-pgsi-en.pdf
“This is the screening tool / gambling questionnaire. It will give you an indication about whether gambling might be causing problems for you. Shall we work through the questions together?”
Ask screening questions
Score the screening tool
Step 3: Provide feedback and advice
Review the screening data in collaboration with the person
"The PGSI score shows that your gambling is unlikely to cause problems. If your circumstances change, say you are planning to buy a house, then it might be helpful to stop gambling."
Check for the level of risk or harm
“The screening test suggests that you are gambling at a harmful level. This means there are risks for your mental health, your finances, and potentially for your family relationships.”
Provide personalised, brief advice
“Given your result, there would be significant benefits if you were to cut down on gambling. I know it is not an easy thing to do, but there are a number of options that could support you to stop.”
Points to note:
Check in with the person about how they are finding the process. Make space for them to ask questions.
If the person becomes withdrawn, argumentative, or resistant take this as a sign to back up. Avoid arguing and/or persuading, avoiding presenting reasons for change, maintain rapport and simply reflect what the person is saying to you.
If there are indications of dependence or addiction, recommend and support referral for further assessment or more intensive assistance.
Step 4: Listen for readiness and confidence
Check how the person is responding
“What are your thoughts about the screening result?’
Explore readiness to make changes
“What are your thoughts at this point? Are there any concerns that you have?”
Does change seem to be worthwhile to the person? Are they confident about their ability to change?
“Can you think of any benefits if you were to stop gambling?
Try to elicit change talk
"On a scale of 1-10, if 1 is not ready at all and 10 is totally ready, how ready are you to make changes to your gambling?” “What are some of your reasons for giving this rating?” or "Why did you rate 5 instead of 3?"
Points to note:
If the person is not ready to change, thank him or her for checking their gambling, offer to speak with them again if they ever want to change.
If the person is ambivalent about changing, restate their reasons and ask if, on balance, whether it would be having a go.
If the person wants to change but lacks confidence, ask what would need to happen for the person to become more confident.
Step 5: Provide further information (utilise material in the ‘background information’ above around getting help, self-help and strategies for family and friends)
"Would you like more information? I have a leaflet here that you could take home. It might be interesting to read about some of the benefits other people have experienced after cutting back."
Facilitate goal setting
"Could you consider setting yourself a goal in relation to gambling?"
"What are some changes that you are interested in trying out?"
Explore menu options
"Would it be helpful to look at some options that have been helpful for other people? There are some effective strategies available to help people stop gambling, such as letting a loved one take care of your finances for a while or self-exclusion. It could be helpful to look at whether any of these are worth trying for you."
"There are lots of options for cutting down on gambling, you are the best judge of what is likely to work for you. Would it be helpful to talk about some ideas and then, if you want to, set a goal for yourself to try out?"
Child Aware Practice
Parents with mental health, addiction, homelessness and family violence issues can cause major difficulties for children. These can have life-long consequences, e.g. suicide, eating disorders, drug and alcohol abuse, high-risk sexual behaviour, violence and criminal offending, homelessness and abuse and neglect of one’s own children.
Therefore, it is important that those supporting adults also assess the impact of adults’ issues on children and take steps to support adults in their parenting role.
This is what Child Aware Practice is about. You will find this topic covered in more detail on the website at https://www.thesocialworkgraduate.com/post/child-aware-practice
(Available on request)
Australian Gambling Research Centre. (2020). Gambling help. Retrieved from https://aifs.gov.au/agrc/gambling-help
Australian Government, Department of Social Services. (2016). Problem gambling: Help for family and friends. Retrieved from https://www.dss.gov.au/sites/default/files/documents/12_2016/help-for-family-and-friends.pdf
Boyle, C. M., Joshi, A., & Jenkinson, R. (2021). Understanding gambling harm and ways to identify those at risk. CFCA short article. Retrieved from https://aifs.gov.au/cfca/topics/gambling
Butler, I. (2019). Gambling addiction in young people - an issue for social work. Professional Social Work Magazine, October 8, 2019. Retrieved from https://www.basw.co.uk/resources/psw-magazine/psw-online/gambling-addiction-young-people-issue-social-work
Crisp, B., Jackson A., Thomas, S., Thomason, N., Smith, S., Borell, J., Ho, W-Y., & Holt, T. (2001). Is more better? The relationship between outcomes achieved by problem gamblers and the number of counselling sessions attended. Australian Social Work, 54(3), 83-92. doi: 10.1080/03124070108414335
GambleAware. (2017). Brief intervention guide: Addressing risk and harm related to gambling. Retrieved from https://www.begambleaware.org/media/1605/gambleaware-intervention-guide.pdf
Gambling Help Online. (2021). Making a change. Retrieved from https://www.gamblinghelponline.org.au/making-a-change
GamCare. (2019). Changing your relationship with gambling. Retrieved from https://www.gamcare.org.uk/self-help/self-help-resources/
A workbook for anyone who has recognised that gambling may be an issue for them.
Nuske, E., & Hing, N. (2013). A narrative analysis of help-seeking behaviour and critical change points for recovering problem gamblers: The power of storytelling. Australian Social Work, 66(1), 39-55. https://doi.org/10.1080/0312407X.2012.715656
Rogers, J. (2013). Problem gambling: A suitable case for social work? Practice: Social Work in Action, 25(1), 41-60. http://dx.doi.org/10.1080/09503153.2013.775234
Rogers, J. (2019). Gambling related harm is no longer in the shadows. Interview with Lyn Romeo, 1 March 2019. Social work with adults. Retrieved from https://socialworkwithadults.blog.gov.uk/2019/03/01/gambling-related-harm/
This interview has links to a number of UK organisations that assist people experiencing problems with gambling.
RSPH: Royal Society of Public Health. (2017). Understanding and responding to gambling harms. Retrieved from https://www.rsph.org.uk/our-services/e-learning/courses/online-course-understanding-and-responding-to-gambling-related-harm.html