Read the original article on The Basis website here.
By Kira Landauer, MPH
Many jurisdictions require online gambling operators to provide digital features that are intended to help players gamble more responsibly and minimize gambling-related harms. These consumer protection tools (CPTs) include setting limits on the amount of money one can deposit into their account (deposit limits), the ability to temporarily deactivate one’s account for a short period of time (timeouts), or the option to deactivate one’s account for a longer period of time (self-exclusion). But, do online gamblers actually use the CPTs available to them? This week, The WAGER reviews a study by Robert M. Heirene and colleagues that examined CPT use among customers of multiple online gambling operators in Australia in 2018 – 2019.
What were the research questions?
Which CPTs are used and how often are CPTs used by customers across six major Australian online gambling operators during a 12-month period? Does CPT use vary depending on customer demographics or wagering behavior?
What did the researchers do?
The researchers obtained de-identified account data for 39,853 customers across six online wagering operators in Australia. The records covered July 2018 to June 2019. All customers wagered at least once during this period. Customer data included demographics and (for the 12-month study period): the use of any CPTs (deposit limits, timeouts, and self-exclusion), transaction details (e.g., withdrawals and deposits), and all bets placed.
The researchers examined the overall prevalence of CPT use. They placed customers into quartiles based on their betting intensity (i.e., median number of bets per active betting day). CPT use was compared across customer betting intensity quartiles. The researchers also examined demographic characteristics and wagering behaviors among different groups of CPT users (non-uses, deposit limit setters, and timeout and/or self-exclusion users).
What did they find?
Only 16.8% of customers used at least one CPT during the 12-month study period. Deposit limits were the most frequently used CPT (15.8% of customers). Timeout and self-exclusion tools were used by less than 2% of customers (see Figure). CPT use increased linearly with gambling intensity. Rates of CPT use (timeouts and self-exclusion, in particular) were highest among customers who gambled more intensely. Customers most often used deposit limits first, or used deposit limits and a timeout in the same day. Many customers made changes to their deposit limits. Increasing the deposit limit (i.e., making it less restrictive) was the most frequent change. Customers who made the most changes to their deposit limits were more likely to increase or remove the limit.
Compared to non-CPT users and deposit limit setters, customers who used timeouts and/or self-exclusion were more likely to be younger, male, bet more times per active day, lost more money, deposited more money into their accounts, and had higher median stake amounts during the study period. Few differences were observed between the non-CPT users and the deposit limit setters.
Figure. The prevalence of use of different consumer protection tools among online gamblers from six Australian wagering operators (total n = 39,853). Click image to enlarge.
Why do these findings matter?
Low rates of CPT usage might be attributed to a general lack of awareness that these tools exist. Further, customers may not be engaging with these tools due to the misperception that CPTs are intended for customers with gambling problems. Operators should do a better job of promoting these tools and communicating their relevance and benefits to all customers. Gambling operators might also consider using an “opt-out” strategy for certain CPTs, like deposit limits. In this case, customers would be provided an opportunity when signing up to either set a deposit limit or actively opt-out of doing so, which might increase the use of this CPT. Finally, this study found that limits are often increased or removed by customers at risk of experiencing gambling problems, at least according to their gambling intensity. Operators might consider imposing greater restrictions on the ability to increase or remove limits, and could consider implementing strategies to help customers set and stick to appropriate limits.
Every study has limitations. What are the limitations of this study?
This study used customer data from Australian gambling operators, where online gambling is restricted to sports and race wagering. Findings might not be generalizable to other jurisdictions that offer other forms of online gambling, such as online poker or casino games.
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, visit our Addiction Resources page.
Read the original article on The Basis website HERE
By Caitlyn Fong, MPH
The Professional and Amateur Sports Protection Act (PASPA), which previously outlawed sports betting in most of the United States, was repealed in 2018 by the Supreme Court. Since then, legalized sports betting has grown rapidly, with the majority of states having active legal sports betting or pending legislation to legalize sports betting. Some studies have suggested a link between sports betting and gambling harm. For sports bettors experiencing gambling-related harms, online communities can be a source of self-help information and mutual support. This week, The WAGER reviews a study by Mark van der Maas and colleagues that analyzed how posts in an online mutual support community for problem gambling have changed with the expansion of legalized sports betting.
What was the research question?
How did the volume and content of an online mutual support community for problem gambling change after the repeal of PASPA and subsequent expansion of legalized sports betting?
What did the researchers do?
The researchers collected posts from the r/problemgambling subreddit (a message board on reddit.com) from January 1, 2016 to December 31, 2020. Using interrupted time series analysis, they compared the number of posts per week before, during, and after June 1, 2018 (the first day that states other than Nevada were able to initiate legal sports betting programs).
The researchers also analyzed 558 original posts from 75 unique, randomly-selected days and all 17,041 post titles from the study period. They used thematic analysis to examine the content of the selected posts and the post titles for common themes.
What did they find?
From January 1, 2016 to June 1, 2018, message board activity grew at an average of 0.14 posts per week (see Figure). During the weeks immediately following June 1, 2018, there was an average increase of 24.2 posts per week. Following that jump in posts, message board activity sustained an increase of 0.79 posts per week, which is more than five times the pre-June 1 activity rate.
After June 1, 2018, it also became more common for posts to mention American major league sports, such as Major League Baseball (MLB), National Basketball Association (NBA), and especially the National Football League (NFL). During 2019 and 2020, posts were more likely to encourage sobriety or express worry about abstinence from gambling as the start of the NFL season approached and as the Super Bowl date neared.
Figure. Average increase in posts per week on the r/problemgambling subreddit from January 1, 2016 through December 31, 2020. Click image to enlarge.
Why do these findings matter?
The rise in number of posts and references to American major league sports indicate an increased need for treatment and support of people experiencing gambling harm, especially during the NFL season. Online mutual support communities might also be an effective way to encourage formal treatment as an option and provide relapse prevention strategies. However, people who are concerned about their gambling should also consider seeking professional help from clinicians or using evidence-based self-help resources, as some research has identified potential risks of help seeking in online communities, such as misinformation or triggering content.
Every study has limitations. What are the limitations in this study?
Most posts did not mention a specific form of gambling, so it cannot be determined whether the increase in post activity was due to greater exposure to or experience with sports betting. Reddit users tend to be younger and predominantly male, and only about half of them are based in the United States, so the study might not be representative of the United States population. As a result, the findings may also not be generalizable to people outside of the Reddit online community.
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.
As seen on The Phoenix Spirit. Read the original article Here.
By Bill Stein
There is great power in learning from someone who has “been there before.” People with similar lived experience may be able to listen and provide hope and guidance in a way that is uniquely received.
So-called “mental health peer support” has existed for decades. Since the 1990s, the concept of “consumers as providers” has become a larger component in mental health service settings.
Perhaps there is no more powerful example of the power of peer support than when a recovering compulsive gambler shares their story with someone still in the throes of addiction. Indeed, programs such as Gamblers Anonymous are built largely on the idea that others with similar challenges can lead the way to recovery.
Peer support specialists are people who have been successful in the recovery process and can help others experiencing similar situations. Peer support specialists have a proven place as a key component of integrated care for recovery.
What is a Peer Support Specialist?
A peer support specialist is someone with lived experience who is able to share that perspective with another person who has not yet achieved recovery from addiction. They provide a link between clinical services and “outside” supports and can help someone navigate the behavioral health system and find appropriate community resources. A peer provides an example of empowerment and success and can be a trusted role model. It’s often easier for a person seeking to begin recovery to talk with a peer support specialist than it is to talk to a counselor or attend a Gamblers Anonymous meeting. Peer support specialists can also foster trust in a healthcare system that has often disenfranchised many of those whom it serves.
The value of lived experience is helpful throughout the time a peer support specialist spends with a client but can be particularly helpful when the gambler is vulnerable to relapsing. Some peers are available 24/7 so that a gambler in distress can reach them at any time.
Benefits of Gambling Peer Recovery Support
Recovery from any addiction is a long process. Most people need support at various points throughout the difficult journey. While everyone’s struggle to achieve recovery is different, what each person has in common is the need to receive support in one form or another. Although the faces of addiction are many, all persons on the road to recovery need the support of others, who need to be familiar with what it means to be an addict.
There are four key elements to the support provided by the peer support specialists:
Emotional support. The peer support specialist provides emotional support by encouraging the individual through empathy, concern or caring, and helping to strengthen confidence and self-esteem.
Information source. The peer support specialist shares their knowledge about resources available to guide individuals to success, including access to treatment, which is often available at no cost.
At a practical level, a peer support specialist can help people complete tasks necessary for successful recovery, such as helping with transportation and housing.
A peer support specialist helps individuals gain a sense of belonging and being with others.
Peer support specialists may get involved in a range of activities, including:
Being a voice in individual, family, and group counseling.
Providing support to family members of problem gamblers.
Helping someone through financial counseling.
Being available by phone (including after hours).
Giving presentations, teaching, and providing training.
Being the voice of recovery providing input into program planning.
Serving as a connection to the “recovery community.”
Providing support in negotiations with the criminal justice system.
Many who work in recovery are in recovery themselves
Many people believe that individuals without shared experience cannot help those with addictions or fully understand what they’ve gone through. Studies provide considerable support for this contention. A review of existing studies found that the percentage of substance use disorder treatment providers who were in recovery was 33-50 percent. Those in recovery who are involved in client care have an ability to introduce their clients and patients to 12-step and other self-help supports in ways that those not in recovery are unable to do.
Provider Benefits
Peer support specialists that work within a treatment delivery system can provide an important benefit to providers. They can offer assistance with resources for those identified with a gambling problem and/or their family members.
Trained Professionals
While specifics vary by state, there is a formal process for becoming certified as a peer support specialist. In Minnesota, peer specialists must have 30 hours of continuing education every two years in areas of mental health recovery, mental health rehabilitative services and peer support.
The Need for Gambling Peer Support Specialists in Minnesota
Unfortunately, peer support specialists are not currently approved as part of gambling treatment programs in Minnesota. However, a number of other states, including Maryland and Connecticut, recognize them as vital parts of treatment and recovery. In each of these state programs, gambling peer support specialists engage with an individual as soon as they call the state gambling helpline. While not everyone seeking help may be ready to sit down with a counselor, they may be receptive to having a conversation, or a series of conversations, with a trained peer before seeking formal counseling. In fact, each of these states have seen an increase in those seeking treatment since the inclusion of the peer support specialist, crediting the importance of those early conversations.
In Connecticut and Maryland, the gambling peer support specialist is an integral component to an individual’s recovery treatment plan, working in conjunction with the counselor as added support. Peer support specialists are also available post-treatment, maintaining connections as the person in their early recovery begins to negotiate their new way of being.
The Minnesota Alliance on Problem Gambling is working with the Minnesota Department of Human Services to bring peer support professionals into the treatment mix given their clear value in helping those with gambling addiction in their recovery journeys.
Responsible gambling guidelines often dictate that gamblers set personal gambling limits to avoid gambling-related harm to themselves and others. While there are now more tools available to help gamblers to set limits, the limit-setting advice is typically general and non-quantitative, in contrast to other public health areas, such as drinking alcohol or food. A common responsible gambling slogan is: “set a limit and stick within it.”
To help provide gamblers and those who seek to establish responsible gambling programs, the Canadian Centre on Substance Use and Addiction developed lower-risk gambling guidelines based on scientific evidence. The guidelines are appropriate for those who implement programs aimed at reducing gambling-related harms or promoting public health. They provide consistent, evidence-informed advice and messaging about how to gamble in a lower-risk manner.
The guidelines, detailed on gamblingguidelines.ca, specifically address three aspects of gambling: how much, how often and how many?
How much The guidelines suggest that gamblers not bet more than 1% of their pre-tax household income.
How often It’s recommended that gamblers not gamble more than four times per month, which is roughly once a week.
How many Those who gamble on a regular basis should not play more than two types of games.
However, the guidelines caution that special risk populations and contextual factors play a role. The limits may not be appropriate for individuals experiencing problems from alcohol, cannabis or other drug use, those with anxiety or depression, and those with a personal family history of gambling problems or substance use disorders.
Other considerations
The type of gambling games one plays makes a difference. Fast-paced games that involve frequent betting can more quickly lead to problems. With slot machines, electronic gaming machines, poker and many online forms of gambling, people can spend a lot of money in a short time.
It’s also important to consider why someone gambles. Is it for fun? Those gambling to escape life problems are more likely to experience harm from gambling and might find it difficult to gamble within the suggested guidelines.
The source for information in this article was gamblingguidelines.ca.
While the impact of the COVID-19 pandemic on mental health is undoubtedly significant, how traumatic has it been and how does it compare to other traumatic events? This was among the topics discussed in “Understanding and Addressing Post-Pandemic Trauma,” a presentation by Ken Roberts, chief clinical officer for NUWAY, at the Minnesota Conference on Problem Gambling in November.
The term “trauma” can apply to a broad range of experiences that impact each individual differently. However, there are well-established data patterns that offer useful learning applicable to current pandemic circumstances.
Two relatively recent community-based traumas include the Sept. 11 terrorist attacks in 2001 and Hurricane Katrina in 2005. These large-scale traumatic events were shown to have a significant negative impact on substance use disorder and mental health patterns. In both events, the trends identified at year one actually continued to increase for another two to three years, a pattern consistent for a range of community traumas. Data has shown there are similar outcomes from other events, such as wildfires and mass shootings.
The scope and duration of the pandemic suggests a long-term impact. Although there are some potentially positive signs for dissipation of the latest pandemic wave, it is an experience that has had a global impact for two years without a foreseeable definitive resolution.
Since the early months of 2020, we’ve been on a roller coaster ride that has included the promise of vaccine relief and lessening restrictions, all too rapidly undercut by new waves of variants. Both our personal and professional worlds have been turned upside down in what is likely to be a generational event. As we consider the potential long-term impact of the pandemic, we must recognize that versions of the individual challenges each of us have faced are occupying the consciousness of billions of people around the world.
It’s important to recognize the paradox of the pandemic trauma experience. On one hand, there are the common experiences we all relate to that have become the themes of our daily conversation. Yet, on the other hand, there are myriad unique and intensely personal stories often borne in silence and solitude.
Part of the enduring strain of the pandemic has been the uncertainly of its actual end, leading to chronic stress and erosion of even our most healthy coping strategies. This prolonged period of instability has set the stage for potential behavioral health service needs over the next several years that mirror the patterns of Sept. 11 and Katrina, but are almost incomprehensible in possible magnitude.
Notable increases in anxiety, depression, trauma/stressor disorders, substance use, self-harm, and overdose that have occurred since the pandemic began are all grim indicators reflecting the needs and deficits seen by mental health professionals. If we are unable to expand access and improve outcomes, we will continue to add many “deaths of despair” to our numerous COVID-19 fatalities.
Whether we are considering the traditional clinical trauma disorders or the new conceptualization of Pandemic Trauma and Stress Experience (PTSE), the individual experience is always the key consideration in considering subsequent effects and impact on functionality, as well as what trauma-focused interventions might be best for those individuals. Similarly, just as one person’s experience after a car crash might different from another’s, the same is true for how each of us is experiencing the current pandemic.
Thankfully, the majority of individuals who experience trauma events and effects also possess sufficient protective factors that allow for adaptions and resiliency to overcome traumatic circumstances through what is frequently termed a “natural recovery.” The concepts of enhancing protective factors and empowering resilience will be an important focus as mental health professionals consider trauma intervention strategies.
The American Psychoanalytic Association is seeking to distinguish between PTSE and Post Traumatic Stress Disorder (PTSD). Understanding the difference is important to both educating and normalizing clients while avoiding the potential stigma of unwarranted diagnosis and targeting effective interventions. More information about PTSE can be found at https://apsa.org/PTSE.
It’s also important for providers to cultivate resilience, altruism and creativity in ourselves, our teams and our agencies in order to best serve those in need.
In summary, our extended experience of the COVID-19 pandemic is currently and will continue to drive the need for co-occurring services. Understanding the additional layers of pandemic trauma and stress as a potentially new concern and an amplifier of existing conditions allows us to be strategic in conceptualizing and evolving client care while maintaining professional resiliency. These steps will drive the direction of our industry in years ahead.
