Read the original article on The Basis website HERE.
By Kira Landauer, MPH
Recovery capital refers to the internal and external resources that an individual can access to start and sustain recovery from an addictive disorder. Existing along a continuum, recovery capital can be negative and impede an individual from enacting change and overcoming their addiction, or positive and help to enhance the recovery experience. This week, The WAGER reviews a study by Belle Gavriel-Fried and Niva Lev-el that identified and modeled elements of negative recovery capital (NRC) that might impede recovery from Gambling Disorder.
What was the research question?
What are the NRC elements that impede recovery from Gambling Disorder?
What did the researchers do?
The researchers conducted semi-structured interviews with 133 individuals with a self-reported lifetime history of Gambling Disorder. Participants were currently in treatment or had recently been treated in five gambling treatment centers in Israel and reported no co-occurring substance use disorder within the past year. The authors asked the research participants to describe factors that impeded or made their recovery process from Gambling Disorder more challenging. Next, the researchers analyzed the interviews using deductive and inductive qualitative content analyses. They categorized factors that impeded recovery into the four domains of recovery capital and then assessed their frequencies: (1) Human Capital (skills, personal traits, and knowledge); (2) Social Capital (family and friends, social networks); (3) Financial Capital (financial assets, such as money); and (4) Community Capital (community resources that promote social norms of a recovery lifestyle).
What did they find?
Fourteen elements of NRC were identified and categorized across the four domains of recovery capital. The majority of participants (82%) reported at least one NRC element in the domain of Negative Human Capital as a barrier to their recovery. This domain included negative emotional, cognitive, and behavioral states and negative life circumstances, including cognitive distortions, which were cited by 36% of participants (see Figure). Of the 14 NRC elements, the most frequently cited obstacle to recovery was conflictual or dangerous social networks, cited by 56% of participants. This NRC element is within the Negative Social Capital domain, which includes lack of support from family and friends. Sixty-three percent of participants cited at least one element in this domain as an obstacle to their recovery. An environment that encourages gambling and financial distress and debts were frequently cited NRC elements, and belong to the Negative Community Capital and Negative Financial Capital domains, respectively.
Figure. Frequencies for negative recovery capital elements that impede recovery from Gambling Disorder across the four domains of negative recovery capital (n = 133). Adapted from Gavriel-Fried & Lev-el (2022). Click image to enlarge.
Why do these findings matter?
These findings illustrate the many challenges and obstacles that might impede or hinder an individual’s recovery from Gambling Disorder, and this study is the first effort to map these elements across various domains pertinent to the recovery process. This study found that many elements that challenge the recovery process fall within the Human Capital domain, suggesting a focus be placed on addressing factors within this domain during recovery (e.g., addressing cognitive distortions through cognitive behavioral therapy or motivational interviewing). Findings from this study reinforce the importance of social networks in the recovery process, and highlight that unsupportive or conflictual relationships can hinder the recovery process. Clinicians should consider including family members into the treatment process and help clients manage relationships within their social networks. While it may be beneficial to prioritize these more common NRC elements, these results suggest that a holistic approach be taken to treatment and recovery. A tailored approach should address the full range of obstacles or challenges that might impede recovery across social, financial, personal, and community domains.
Every study has limitations. What are the limitations of this study?
This study used data from individuals without an active substance use disorder who sought help for their gambling. Findings might not be generalizable to individuals with an active substance use disorder, individuals who have not sought treatment for their Gambling Disorder, or to those residing in other countries.
For more information:
Do you think you or someone you know has a gambling problem? Visit the National Council on Problem Gambling for screening tools and resources.
Read the original article on The Basis website HERE.
By Caitlyn Matykiewicz, MPH
Social casino games have become very popular during the past decade. Typically played on mobile devices, these online games are connected to social networking sites, allowing players to see their scores on leaderboards and share results with their friends. Social casino games resemble gambling activities like slot machines (aka electronic gambling machines [EGMs]), even including similar sounds and offering in-game purchases or microtransactions with rewards of virtual points. Because they are free to play and the player cannot win any real money from the outcome, social casino games are not currently considered gambling. However, people who play simulated gambling games, such as social casino gamers, might be more likely to experience gambling problems. This week, The WAGER reviews a study by Hyoun S. Kim and colleagues that investigated motives for playing social casino games and transitioning between social casino games and gambling.
What were the research questions?
Why do people who gamble play social casino games? Why do people transition from social casino games to gambling? Why do people transition from gambling to social casino games?
What did the researchers do?
The researchers recruited 269 United States residents who both gambled and played social casino games. Through an online survey, participants provided their top three reasons for playing social casino games, transitioning to gambling after playing social casino games, and transitioning to social casino gaming after gambling. Participants also completed the Problem Gambling Severity Index (PGSI). The researchers conducted a thematic analysis of participant responses and identified key motives for each of the three research questions.
What did they find?
For all three research questions, the most frequently mentioned motive was playing for enhancement–in other words, to experience fun, entertainment, excitement, or thrill (see Figure). Participants also played social casino games to alleviate boredom (46%) and for social reasons (29%). Among participants who started with social casino games and transitioned to gambling, 70% reported the opportunity to win real money as a motive for doing so. Availability (42%) and affordability (31%) were common reasons for switching from gambling to social casino games. Gambling-harm minimization was another motive for playing social casino games, among all participants (17%) and among those who transitioned from gambling (28%). Motives for playing social casino games did not differ by PGSI score category.
Figure. Top two reported motives for why people (a) play social casino games, (b) transition from social casino games to gambling, and (c) transition from gambling to social casino games. Click image to enlarge.
Why do these findings matter?
Social casino games can be a potential precursor to gambling and gambling problems. A majority of participants reported that they began gambling as a way to win real money, which is concerning because social casino games have inflated payout rates that could give players a false perception of skill. Players should be informed that their odds of winning in social casino games do not necessarily reflect the odds of winning in gambling.
On the other hand, many participants reported playing social casino games to reduce the chance of gambling harm, as it can satisfy their urge to gamble without them risking any real money. Social casino games may be a potential harm reduction strategy to help people with gambling problems cut down on their gambling behavior, though more research is needed to determine its effectiveness and the harm that results from spending too much time on social casino gaming.
Every study has limitations. What are the limitations in this study?
Participants were limited to United States residents who both gambled and played social casino games, so the results might not be generalizable to people who live in other countries or to people who currently play social casino games but have not yet transitioned to gambling. Because this study was cross-sectional, we also cannot determine whether any of these motives actually caused changes in social casino gaming or gambling behavior.
For more information:
Do you think you or someone you know has a gambling problem? Visit the National Council on Problem Gambling for screening tools and resources. For additional resources, including gambling and self-help tools, please visit our Addiction Resources page.
Susan Sheridan Tucker provides a breakdown of the pre-conference sessions provided by the National Council on Problem Gambling on June 8-9.
One of the unanticipated benefits of the COVID pandemic is the variety of excellent content available on virtual platforms. NCPG has pivoted to providing conference content via Zoom for the past two years. This year, while committed to meeting in person in Boston in July, two half-day virtual sessions were added for those seeking CEUs who might not be able to travel and for those seeking supplemental information to the in-person conference.
This year, 30-minute sessions were offered on an array of topics. The first day’s sessions included:
Updates on this year’s past legislation.
The not-to-be ignored rise in women sports betting.
Black women sharing their recovery stories and how they carved out recovery paths that met their cultural needs.
The ability to track markers of harm for online gamblers and what some operators are doing to communicate with players with problematic gambling.
The promotion of International Gambling Counselor Certification Board (IGCCB)-approved gaming disorder training.
A provider’s ruminating over lessons learned in creating a problem gambling treatment program from scratch and living to tell the tale.
An awareness alert about gambling activites in the expanding metaverse – the creation of casinos and other gambling venues within virtual worlds in which one’s aviator is actually engaged in gambling activities.
The second day did not disappoint. The sessions included:
The Massachusetts Council explained how it has instituted remote self-exclusion applications in conjunction with its successful Game Sense program.
Descriptions of the emotional rollercoaster a family experiences when living with a person with problem gambling.
Learning what a public health response to sports betting looks like in the state of Maryland.
A summary of the wildly diverse and disjointed implementation of sports betting and regulations in 25-plus states.
Building and implementing diversity, equity and inclusion into community outreach practices in the state of Massachusetts.
The announcement of the new national helpline number, 1-800-GAMBLER, and the NCPG modernization project that will improve services for states without their own helplines and improve transitions to ensure anyone who calls is directed to their appropriate state helpline. (See separate article on 1-800-GAMBLER.)
The programs were stimulating, always leaving me to ponder how we can do better in Minnesota. It also left me a bit envious of some of my colleagues in other states who are provided appropriate funding for their problem gambling programs, integrating care, services, research and, above all, are able to acknowledge and respond to gambling disorder as a public health issue.
As the pandemic turns endemic, MNAPG has had more opportunity to do in-person outreach. Here’s a look at some of the recent efforts undertaken by Sonja Mertz, MNAPG’s community educator, and Susan Sheridan Tucker, MNAPG’s executive director.
Presentations ºFebruary 2022: A virtual presentation for 20 staff members of the University of Minnesota Duluth Health Services, which included nursing, mental health and administrative staff members.
ºMarch 2022: Susan was excited to present to Kevin Spading’s class on Problem Gambling. Kevin has been on the forefront of presenting at least some content on problem gambling to his students for years. This year marks his first full semester offering problem gambling.
ºApril 2022: A presentation at the Metro State University Recovery Conference that focused on gambling and college students. The presentation was well received.
Exhibits With conferences beginning to return to their normal formats, we had the opportunity to exhibit at the Minnesota Social Services Association and the Minnesota Psychological Association conferences this spring. In an effort to reach less traditional audiences, MNAPG has also been exhibiting at more community-based events, including senior citizen health expos, the Minnesota Parent Teacher Association Conference, the Military Mental Health Conference at Camp Ripley, and the Minneapolis Community Connections Conference.
A Seat at the Table In April, Sonja had the opportunity to join the Minnesota Suicide Prevention Taskforce, housed under the Department of Health. This will be our opportunity to bring awareness about the impact that suicide plays in problem gambling and to ensure that language about problem gambling and gambling disorder is included in strategic planning for the
2023-2027 Minnesota State Suicide Prevention Plan.
Susan was recently appointed to the Hennepin County Local Advisory Council on Adult Mental Health. This group has been meeting for over two decades and has provided the county with significant feedback and input on its mental health services. As Hennepin County continues to identify where the gaps are in mental health services, Susan is advocating for awareness about the prevalence of co-morbidity of gambling disorder and mental health issues.
MNAPG will continue to explore opportunities in which we can be a voice at the table and increase awareness of gambling disorder.
If you’d like to have MNAPG provide a presentation to a group or at a conference, pleasecontactSonja Mertzatsmertz@mnapg.org.
I was exposed to a variety of games early in my life. Our family played Pokeno — which is how I learned to play cards — and spun dreidels, which was the first game I played that involved money. I won my first big pot at the age of five years old.
As I got a little older, I played poker and pinochle. I remember losing all my money in poker to my neighbors but then watching my father bail me out by winning it all back. I enjoyed the thrill of being a part of that.
I went to a casino for the first time at 21. I enjoyed it. Then, at about age 30, I met a man who also enjoyed gambling. We started playing Bingo a lot and pull tabs. I remember finding Bingo to be slow, so I played multiple cards and also pull tabs between games.
It was about this time when I started to become preoccupied with gambling. I began lying to myself and others about money. I lost a job directly because of errors in my work due to my gambling, which I sometimes did for 24-36 hours before work.
Eventually, I started attending GA meetings with my husband, but mainly to support him. I looked at the others and thought they had more problems than I did. There was a part of me that wanted to stop, but my desire to continue gambling was greater than my desire to not gamble.
I rationalized that gambling helped me when I was feeling depressed, as I would otherwise just stay home and sleep. I became suicidal, but since I only felt that way when I wasn’t gambling, I convinced myself that I should keep gambling.
Eventually, I realized that my gambling was a symptom of a deeper problem. Gambling was a part of keeping feelings down — guilt, shame, remorse, etc. I was doing things that were against my core principles, such as lying to dear friends, writing bad checks, losing jobs, more drinking and depression. I rationalized some of my behavior by thinking that I hadn’t gone to prison or killed anyone.
While I stopped gambling for periods of time, I couldn’t stop completely. My finances were in ruin and I was full of anger toward myself and my out-of-control behavior.Thanks to my fellow GA members, I was eventually hospitalized for a second time for depression and then went on to treatment for my gambling. The last time I gambled was on February 19, 2011.
I learned that you can find hope and meaning from the most unlikely of sources. In my gambling fog, I had neglected so many things, including my dog and my plants. While I was away, a friend cared for my house, including my plants. When I returned home, I saw that my tomato plant had somehow survived and was even sprouting new life; I refer to it as Lazarus the Tomato Plant. I took that as a sign that I was going to grow a new life as well.
I can’t believe all the positive things about my life. I’m proud of who I am today and the work I do with the GA program. In the past, I thought only of myself. Now I think of others and volunteer my talents whenever possible. I’ve grown personally. I challenge myself to do things that make me uncomfortable. I enjoy trying new things and taking new approaches in my life of recovery.
If people reading this are on the fence about whether to seek help, I would tell them to keep coming back. Although I was initially not working the GA program when I attended the meetings, they still helped me — the seeds eventually took. I would encourage others to hang on to the desire to stop gambling. It doesn’t have to be an armload of desire; it can be a smidgeon. The desire to stop gambling just has to be greater than the desire to gamble.
