What’s In a Name: Might the Renaming of Massachusetts’ Council Be the Way of the Future?

What’s In a Name: Might the Renaming of Massachusetts’ Council Be the Way of the Future?

In September, after nearly 40 years, the Massachusetts Council on Compulsive Gambling (MCCG) changed its name to the Massachusetts Council on Gaming and Health (MACGH). Northern Light discussed this change and its implications with Marlene Warner, executive director of MAGH.

Q: Why was the organization renamed?


Marlene Warner

A: We started talking about this around four years ago. For starters, the term “compulsive gambling” was antiquated. We also became involved with GameSense, which meant we were more focused on the full spectrum from prevention to recovery rather than just intervention. We also heard increasingly from people at casinos and on social media, helplines, etc., about the blurring of lines between gaming and gambling. Since iGaming takes place on the casino floor it made sense to talk about “gaming,” which is more of an all-encompassing term. The “health” aspect of our name reflects that we do more than just intervention — we also want to look at the larger public health implications. The intention of the name is to not only expand our mission but also to designate what we’re truly doing as an organization.


Q: Was there a tipping point in the decision to change the name?


A: It was a gradual thing but in the last two years as we’ve realized the blurred lines between gaming and gambling, so have gaming commissions. Congress has even held hearings on gaming. It became clear to us that this was the next wave and we didn’t want to miss it.


Q: What has the response been to the name change?


A: For the most part, everyone has been incredibly supportive. They thought it was appropriate and future-focused.


Q: Have you made any changes to your training since the name change?


A: The very first thing we did was to work on a certificate program and clinical training program to broaden counselor and clinician knowledge of video gaming in a clinical setting. We want to make sure they’ve been prepared so that when someone presents with a gaming problem, they know how to respond.


Q: How is Massachusetts handing gaming disorder? Are counselors encouraged to take the INTENTA training? (INTENTA is the first approved training provider for the new International Gaming Disorder Certificate (IGDC) by the International Gambling Counselor Certification Board).


A: The training that we’re putting together is sort of a competitor to INTENTA. It’s another option that is a little shorter and less expensive. We are collaborating with the Evergreen Council on Problem Gambling and the course is called Foundations in Gaming Disorder. As with INTENTA, it will qualify for international board certification.


Q: Do you plan to measure the impact of the name change, whether through changed attitudes or diminished stigma around gambling disorder?


A: For now, we’re just collecting anecdotal feedback. But a year from now, we’ll want to know we’ve done the right thing. I think we’re gaining a lot of traction. We’re also in the process of putting together a major national study with gambling and gaming stakeholders with major universities. That, alone, has been well received.


Q: Do you think other state councils will make similar name changes?


A: Several fellow state councils have asked us how to do it. Many of us were trained on the idea of calling it “gambling” rather than “gaming” so it takes some fresh thinking. It’s not a change to be done lightly.

NCPG Conference Roundup

NCPG Conference Roundup

I (virtually) attended the annual conference of the National Council on Problem Gambling in July. Here is a recap of some of the presentations. – Susan Sheridan Tucker

Industry Trends

The conference featured a considerable focus on responsible gambling, particularly in light of the expansion of gambling. This includes sports betting and igaming, along with esports and the continued blurring of lines between gambling and video gaming.

Operators, regulators and players are all part of the multichannel platform growth. Technology and an apparent pent-up demand for wagering have hastened the need for increased legalization and regulatory rules that address the desire for operators to make a profit, for states to collect revenue and, most importantly, to protect consumers with comprehensive responsible gambling tools. In Minnesota, no new legislation has passed yet, but it’s just a matter of time. It will be critically important to ensure the legislative language provides for funds to cover prevention, treatment and research, and to insist on best regulatory practices and sharing the aggregate data with the state.

COVID-19 has presented financial challenges to operators and states, who have already seen profits and tax revenues plummet due to brick and mortar closings and the tanking of other sectors of the economy. For the few states that had already passed online gambling legislation, the transition from land-based to online sites was fairly smooth. Early indications show that existing customers and new ones found and used the online alternatives. However, in states without legalized online gambling, players were lured to offshore, unregulated sites which present a myriad of unethical practices; this is one of the arguments for legalizing more forms of gambling. Several states are not only jumping to pass sports betting, but also igaming so they can create an omni-channel market for consumers. If land-based casinos need to shut down for a pandemic or natural disaster, operators can continue to offer their products to customers online, reducing the hit on profits and state tax revenue.

Another trend that’s emerging internationally and creeping into the U.S. is a move to go cashless. The industry prefers this because it minimizes the amount of cash they need to secure on the premises, more consumers are accustomed to using less cash and, with COVID-19, eliminating handling of cash is more sanitary. Cashless systems present opportunities to closely monitor customers’ playing habits and to build in responsible gambling tools during play that may deter players from taking too much risk. However, there are also disadvantages with cashless systems. The availability of on-demand access to digital payments means consumers may increase their spending beyond their means. These new systems also shift more risk to the player and remove protective factors, such as the need to pause the game to replenish cash. If cashless systems are to be adopted, specific consumer protections must be part of the plan.

Some operators are beginning to realize they have a greater responsibility to identify problem gamblers and to talk with them when gambling patterns indicate troubling behavior. In some European casinos, operators are using data to have conversations with players about the risks they’re taking and recommending they take a break, discussing self-exclusion or suggesting they seek help from a professional. The NCPG has developed Guidelines for Payment Processing as a guide to the industry as they begin to adopt these tools and minimize the incidence of gambling addiction.

Generation Z

Those working to prevent gambling disorder need to be aware of the generational characteristics of Generation Z, which consists of people born between 1997 and 2017. This is the first genuine digital generation and is redefining what “winning” means. For this generation, a win equates to a good experience, engagement and bragging rights, but not necessarily winning money. They enjoy games of skill, not chance. It’s expected that esports will explode with this generation because it’s popular with both males and females.

The exposure to online gaming and apparent attraction to “trying out” a game — plus the strategic use of game bonuses — are considered a priming of the pump for gambling once these players are in a position to spend money.

This is a generation that creates and follows influencers – not necessarily the traditional influencers, such as sports figures or Hollywood personalities. Innovative social media (not Facebook) apps rule the way they communicate and, like most generations, they have created their own style of communication that is vastly different than past generations.

Relevant responsible gambling materials/prevention need to reflect this rising generation, educating them early on about potential risks in gaming/gambling.

Why Responsible Gambling Programs Are Essential

Ultimately, responsible gambling programs make good business sense. While the gambling industry seeks to provide an entertaining experience for all who partake, some are clearly unable to do so without causing significant harm to themselves and their loved ones. By adopting robust responsible gambling programs, the industry plays its role in keeping all players healthy, helping to flag issues before customers crash.

Properly designed, a responsible gambling program extends to the regulator, operator, its staff and the player. This shared responsibility helps combat the stigma of gambling disorder that blames the player and leaves them struggling in isolation.

Responsible gambling programs:

  1. acknowledge the risks up front,
  2. provide the rules and odds of each game,
  3. incorporate intervention tools that enable a player to pause and reset, and
  4. create a mutually beneficial and nonjudgmental relationship to ensure a player’s experience is positive.

The purpose of responsible gambling programs is to create opportunities for safer sustained play. This requires a multi-pronged approach involving understanding the needs of players (from new players to serious players to those who appear in trouble), producing positive messages that invite open discussion of prevention, making materials readily available and knowing when to deliver messaging and/or other resources to a troubled player. A robust responsible gambling program also helps gaming staff enjoy their jobs because it offers them more tools to assist and it builds empathy for their customers.

Ultimately, a responsible gambling program requires a commitment from top leadership with an understanding of the long-term benefit. It also requires regulatory bodies be willing to insist on best practices and enforcement when needed.

Racism in Gambling Disorder/Healthcare

Each day of the conference, a small segment was dedicated to reminding attendees that systemic racism exists in the problem gambling arena, as it does in so many other aspects of our healthcare and economic systems.

Some statistics:

  • Black, indigenous and people of color (BIPOC) experience gambling disorder at twice the rate of whites.
  • Generational trauma is real, and quite apparent in the African American community.
  • Blacks represent 13.4% of the U.S. population, but very few are seeking treatment due to roadblocks, such as mistrust of the system, shame, privacy issues, lack of information and financial concerns.
  • COVID-19 has clearly shown that BIPOC are more vulnerable and experience more serious symptoms due to the lack of access to good healthcare throughout their lives.

NCPG has formed a Diversity Equity and Inclusion Committee that advises on issues affecting the Black community, additional communities of color and other marginalized groups. We expect there will be recommendations made in time.

(As a side note, NPGA is reexamining all of its collateral material to ensure it reflects Minnesota’s diversity. In the past year, we have made a concerted effort to portray that diversity in our public service announcements.)

Call For One National Problem Gambling Helpline

NCPG is appealing to states to join its national gambling helpline. Twenty-two states have separate problem gambling helplines, in addition to the national number used by NCPG. These helplines were established over the decades for various reasons. The question is whether it makes sense for each of these states to have separate numbers. Minnesota has its own helpline, which is managed by the Minnesota Department of Human Services and operated through a contractor. While there would be costs with transitioning to a national number — including changing printed and online materials —there are advantages to having one number. A single helpline provides centralized data collection and the assurance that training is consistent and meets best practices.

Oregon Core Competencies For Treatment Providers

In Oregon, a public health authority teamed up with researchers at Lewis & Clark College to develop new guidelines for gambling counselors. The publication, A Guide to Core Competencies for Problem Gambling Treatment Counselors, was created over the course of a year through surveys conducted across the country and the world to compile best practices in treatment counseling.

After consultation with advanced problem gambling counselors, a total of 166 core competencies were identified. These competencies were organized around five primary domains:

  1. knowledge of problem gambling
  2. psychoeducation
  3. basic problem gambling treatment skills
  4. case management and ethical practice and
  5. sociocultural awareness and competence.

The full report can be found on our website at NorthstarPG.org under Professional Resources. The state of Oregon intends to use this document as a way to improve the training it provides to gambling counselors.

Minnesota Gambling Control Board Plays Critical Role in State Gambling

Minnesota Gambling Control Board Plays Critical Role in State Gambling

The Minnesota Gambling Control Board plays a critical role in regulating gambling activity in Minnesota. Northern Light conducted the following Q&A with Matt Gettman, the agency’s executive director.

Q: What is the primary role of the Minnesota Gambling Control Board (MGCB)?
A: Our role is to regulate the lawful (charitable) gambling industry to ensure the integrity of operations (games) and provide for the lawful use of net profits (where the dollars go). There are a lot of moving parts with a lot of different stakeholders with potentially conflicting interests.

Q: Who are MGCB’s stakeholders?
A: Our stakeholders haven’t changed much over time. Licensees, the organizations that purchase gambling licenses, make up a large number of the stakeholders. Licensees include the manufacturer and distributor as well as the organizations. Other stakeholders include those we don’t license, such as the owners and managers of the premise permit locations (where the gambling activity takes place). Other stakeholders include bookkeepers and the accounting firms who assist licensees in determining where the dollars go.

State agencies are also stakeholders, such as the Minnesota Department of Revenue and the Minnesota Department of Public Safety. There are also local agencies, such as city councils, city clerks, city financial officers and planning commissions. We also deal with the associations that represent those groups, such as the League of Minnesota Cities. Stakeholders also include the targeted beneficiaries of the net profits from the lawful charitable gambling.

The last group of stakeholders includes the players, the public and even the non-players who are affected by the gambling taking place. This includes NPGA. We’re all part of the community in which this activity is occurring.

Q: What work are you doing related to COVID-19?
A: With mandates and protections for social distancing, there’s been a need to figure out how businesses can conduct their businesses without exposing or further exacerbating the virus issues. That includes not having bar service. So people who order drinks sometimes aren’t actually going to the bar counter. They may be seated in a parking lot that might not be owned by the establishment.
Beyond the immediate COVID issues, we’re always looking to improve the safeguards, flags and controls — all of which ensure integrity of playing games and use of the proceeds. We’re also involved in outreach and education so that all of our stakeholders, such as Northstar, are educated.

Q: What changes might take place because of the prolonged COVID-19 closings or reduced capacity in bars and taverns?
A: The impact has been as these establishments — these licensees —have restarted lawful gambling each deals with its own unique impact and, in some cases, additional local restrictions imposed by local municipalities.
For our part, we used the time of closures to take the initiative to do additional checks and audits we could never have done in the past. This has allowed us to identify organizations that were not properly accounting for funds or otherwise not supporting the integrity of lawful gambling.

Q: We’ve heard that sales for electronic pull tabs are going through the roof, but paper pull tabs are not. Do you have any idea why this is the case? Is there a perception that they’re somehow cleaner?
A: Social interaction and the desire to support local community causes has historically driven the paper games. The restricted number of people has, most likely, in turn impacted total sales. However, at this time, we have no data to support any conclusion.

Q: It seems that there’s a move in the U.S. toward cashless casinos. Do you foresee a time when credit cards will be allowed to purchase pull tabs? If not, why?
A: We don’t have the authority to allow the use of credit cards. That would require a statutory change by the state legislature. I don’t see this changing any time soon. However, when we reach that point of allowing the use of electronic means for gambling purchases, we will also have the ability to support self-imposed limits on those electronic accounts for problem gamblers.

Q: Do you foresee electronic pull tabs replacing paper altogether?
A: No, I don’t. They cater to two different game players. The ones historically playing paper see it as part of their social activities – collectively opening a pool of paper pull tabs in one social setting. However, because of the nature of electronic pull tabs, which are played by only one person at a time even when part of the same social circle, there’s a different social dynamic. Both forms of lawful gambling appear to be staging a strong recovery after the COVID pause, and neither appears to be replacing the other.

Q: Once the debt service is paid off for the Vikings stadium through electronic pull tabs, does the portion set aside for problem gambling services go away as well? Is there a specific sunset built into the legislation?
A: The MGCB has no stake in where dollars raised from charitable gambling go. Those directives are made by legislative mandate. There is no sunset provision for the funding of problem gambling services and it is not tied to the debt service for the Vikings stadium.

Q: Is there anything else you’d like to share about MGCB?
A: We’re trying to find more opportunities to engage with various shareholders. We’re happy to hear from anyone with ideas on how we can help educate folks in their respective circles and help them reach their respective objective. At the end of day we are one community.

COVID Mental Health Trends from EAP (Employee Assistance Program) Callers

COVID Mental Health Trends from EAP (Employee Assistance Program) Callers

The following are some trends that have emerged from people calling in to employee assistance programs.

  •  Loneliness is causing increased mental health issues. This seems to be an underlying theme if clients are far from their support systems or have spent a lot of time alone. Issues from the past, including previous trauma or unresolved mental health issues, appear to be resurfacing in a major way.
  • There is considerable grief and loss, particularly around COVID-19. There have been calls for grief counseling related to the difficulty of coping with not being able to hold memorial services and funerals.
  • There is significant work stress, both for essential workers going to the workplace (usually medical personnel concerned about if there is sufficient PPE or having to work forced overtime) as well as staff not deemed essential but currently working at home and feeling anxious about how things will be different as they transition back to the workplace.
  • Relationship problems. EAP has seen a lot of interpersonal conflict leading to requests for couples counseling or one partner calling in wanting to explore legal services for separation/divorce. Counselors are screening for domestic violence concerns, and occasionally clients confirm domestic violence.
  • Increased substance use calls. Clients have identified increased substance use, with alcohol use in particular.
  • Parenting stress. Calls usually involve young children at home and discuss uncertainty of how parents can support childrens’ anxieties about the pandemic. There are also new obstacles, such as parents concerned about whether their older children will be able to proceed with attending college in person as planned in the fall.
The Problem Gambling Landscape in Wisconsin

The Problem Gambling Landscape in Wisconsin

Northern Light sat down (virtually) with Rose Blozinski, executive director at the Wisconsin Council on Problem Gambling, to gain some insights about the problem gambling landscape of our eastern neighbor.

Here are some highlights of that conversation.

Q: How is the Wisconsin Council on Problem Gambling funded?

A: We have a grant from Wisconsin’s Department of Social Services for a public awareness campaign and also receive funding from casinos and private donations. Our budget is approximately $475,000.

Q: How does Wisconsin train gambling counselors?

A: We have two types of training. The first is a 60-hour phased program that consists of four phases of 15 hours each. We also have an intro training that’s six hours long. The goal is to provide people with more awareness of gambling disorder and to get them interested in continuing the four-phase program. The training is provided by three certified gambling counselors.

Q: Does Wisconsin have licensure for problem gambling counselors?

A: We do not have a state certification, though we encourage people to get the national or international certification. We have approximately 80 counselors who have gone through the four-phase program and who are listed as referral sources on our helpline. We also have an additional approximately 20 counselors who are nationally/internationally certified. And several more are in process.

Q: Is video gaming addiction incorporated in the state’s training?

A: We have started doing that. One of our trainers has done some research in that area. We are adding that into our programming for teenagers in school.

Q: Within Wisconsin masters counseling programs, how much time is dedicated to teaching about problem gambling specifically vs. addictions in general?

A: This is purely a guess, but I think that any problem gambling education that takes place is through addictions training.

Q: What types of professionals attend training — social workers, addiction counselors, psychologists, etc?

A: We don’t seem to have as many addiction counselors attending as we used to. We see a lot of social workers and other kinds of counselors who take the training as part of their masters programs.

Q: Does the Wisconsin council have any kind of relationship with schools?

A: We have a relationship with several schools and a few technical colleges to provide an alternative class. While one technical college has put that class on their schedule for three years, nobody has taken it because of other classes they are required to take. We are trying to get a jumpstart on that. We do a program with high school classes as requested.

Q: What’s the likelihood of sports betting becoming legal in Wisconsin?

A: At the present time it is not legal, though some people are trying to work on that. I don’t think it’s going to go anywhere too quickly. However, I think if surrounding states legalize sports betting, Wisconsin will look at it more seriously.

Q: How has the pandemic impacted your services?

A: We at the council are working remotely, so the helpline, which we operate, has continued. We’ve seen less calls than we expected as we thought people would be panicking because casinos were closed. Regarding treatment, one counselor told us they weren’t seeing a lot with gambling but were seeing people with other addictions. And a lot of this counseling is taking place by phone, which is different.

Q: Is Wisconsin allowing telecounseling during the pandemic?

A: It seems so. A lot of counselors are doing it, but I’m not sure if they are part of private or state agencies.

Q: Does Wisconsin provide money for treatment?

A: No. In Wisconsin, there are zero dollars set aside for treatment. As you might imagine, this is very difficult because gamblers seeking help usually have no money. We encourage them to go to GA, but there aren’t many GA groups in rural areas so, unfortunately, the cycle tends to continue.

Q: How many casinos are there in Wisconsin?

A: We have 26, with one in Hudson being the closest to Minnesota. All casinos are owned and operated by 11 tribes, but several tribes have several casinos each.

Q: Does Wisconsin have self-exclusion programs for gamblers?

A: The casinos do, but each one is different in how they administer the program.

Q: What are the challenges you see in Wisconsin?

A: The biggest issue is getting people the help they need. We can refer them all over but if the financial resources aren’t there it doesn’t do that much good. Affordable treatment is one of the biggest issues. Another issue from our perspective is the challenge to get a public awareness effort going all over the state. It’s a battle to reach people in an efficient way.

Q: What are some exciting things as you look ahead?

A: In the short term, we’re hoping that our state conference that’s been rescheduled to August will happen. Beyond that, we have more webinars and more trainings online. We’ve also talked to technical colleges that could do an intro course online. And, of course, we continue to find ways to reach out to people with gambling problems.

A Review of Sports Wagering & Gambling Addiction Studies — Executive Summary

A Review of Sports Wagering & Gambling Addiction Studies — Executive Summary

The following is taken from the National Council on Problem Gambling:

This report on recent research suggests that gambling problems may increase as sports gambling grows explosively at the same time that mobile and online technologies evolve to create seemingly unlimited types of wagering opportunities. Here are important highlights from a special review of more than 140 studies and reports on the connections between sports betting and gambling addiction.

Sports Betting and Online Gambling: A Potentially Volatile Mix

The rate of gambling problems among sports bettors is at least twice as high as among gamblers in general. When sports gambling is conducted online, the rate of problems is even higher, with one study of online sports gamblers indicating that 16% met clinical criteria for gambling disorder and another 13% showed some signs of gambling problems.

Concerns About Modern Sports Gambling

Nearly half of American adults have bet on a sporting event. More and more are betting online, with 45% of sports wagering now taking place on the internet. Today’s online sports betting is particularly concerning for several reasons:

  • Access: internet gambling is available virtually all the time.
    – It’s more convenient and provides more privacy.
    – Early research shows that those who bet using mobile devices have higher rates of problem gambling.
  • Live “In-Play” Betting: today’s sports gamblers can bet on much more than just the winner of a game.
    – Sports gamblers can bet — during the game — on hundreds and potentially thousands of discrete events. Any aspect of a team or player’s performance or activity that can be measured is now a potential wager.
    – This shortens the lag between bet and reward, increasing the speed and frequency of gambling, which increases the risk of problematic behavior.
Professional Athletes Frequently Gamble on Sports

Sports gambling is widespread among professional athletes. While no study of gambling among U.S. professional athletes is publicly available, such studies have been conducted elsewhere. One recent European report showed that 57% of professional athletes surveyed gambled on sports in the previous year, with 8% exhibiting problem gambling behavior, roughly three times greater than the general population.

Youth are at Higher Risk

Data from 2018 shows that more than 75% of students gambled. This is a big concern given the risk-taking behavior that takes place in adolescence and young adulthood, along with gambling being more socially acceptable and glamorized. More than 13% of adolescents wagered money on sports teams according to a study in 2017. Students most often bet on professional football and college basketball. Youth gamblers have higher rates of gambling problems than adults. Males are far more likely than females to both gamble on sports and to experience gambling problems.

Popularity and Growth of Fantasy Sports Gambling

From 2004 to 2018, participation in fantasy sports gambling quadrupled — from 14 million to 57 million. Higher fantasy game participation is associated with significant increases in problem gambling severity.

The Profile of a Sports Bettor

Heavy sports bettors who meet the criteria for clinical gambling disorder are typically male, young (up to age 35), single, fully employed, and have a high level of education. They think sports gambling is more skill than luck, suggesting they’re prone to distortions in thinking. They affiliate with others who favor sports betting, frequently taking advantage of different types of promotions, and are generally highly impulsive.

Marketing Inhibits Ability to Stop Gambling

Aggressive promotions in all forms of marketing and advertising make it more difficult for sports bettors who are trying to curtail their gambling. Ads that emphasize ‘free play,’ tout the ease of placing a bet, or offer risk-free bonuses are particularly problematic.

Looking Ahead

Sports gambling is growing rapidly with significant potential to create or worsen gambling problems. Twenty-three states to date have legalized sports betting. Moreover, it’s clear that substantial prevention and treatment efforts need to be developed and targeted to those most vulnerable to developing an addiction through sports gambling.

The review was conducted by Jeffrey Derevensky, PhD, and Ken Winters, PhD in the autumn of 2018. The full report, A Comprehensive Review of Sports Wagering and Gambling Addiction, is available here.

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