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.
I’ll never forget the first time I realized there was hope for my compulsive gambling. I was at confession and the priest said, “I don’t normally do this, but I’m giving you the phone number of someone in gambling addiction recovery at Gamblers Anonymous (GA).”
I always had the desire to quit gambling, but didn’t feel like I had the tools or the power to do it. I went to weekly GA meeting, and although I had weekly relapses in the beginning, I kept going. I’ve been going for more than three years, and the meetings continue to sustain me in my recovery.
When I was young, my grandparents and family loved to play Thirty-one and other card games for nickels or quarters. When I won the ‘pot’ it was like a big win for me. When I lost, I remember my grandma saying, “If you can’t play, you gotta pay.” It was always very enjoyable and I was lucky with it most of the time.
In college, I went to casinos with my parents. I brought $20-40 to lose. I played normally and, at this point, didn’t think of myself as a gambler.
After that, I went on a tour of different states to visit different casinos and their different games. My first really big disaster occurred in Las Vegas, where I lost my entire paycheck. I remember walking two miles in the desert with no money and feeling despair for the first time. I continued to gamble and always played until I lost everything.
A few years later, I remember going to a casino and praying because I was feeling attacked by demons at the casino. The people to my right were arguing about money while the faces of the people leaving the casino were distraught. These images were in marked contrast to people just arriving, who were running in and joyful.
At this point, I realized that if I were to continue gambling, I would lose my life’s savings. I decided that I was going to quit gambling, which I did for 13 years.
Then about six years ago, I went to a casino as part of a Christmas party my employer had. I won a TV and split a large 50-50 jackpot, and decided that gambling wasn’t so bad. Within a few months, I had four big wins, ranging from about $1,000 to $6,000. I remember thinking, “This is fantastic. This is easy money.”
I was courted in the VIP program and invited to parties and special events. I went to the casino four to five times a week. I also learned how to get a cash advance on credit cards and how to link my player’s card to my bank so I could take money out in advance. In that year, I lost about $28,000.
Things turned dark for me. I suffered from anxiety and medical issues, including a visit to the ER for a racing heart. I worked overtime, but every cent went to the casino. This went on for three years.
I looked into the Vanguard Center for Gambling Recovery and was told that I could benefit from enrolling there. However, I worried whether going there would jeopardize my job. I felt like I had to choose between losing my job or losing my life.
Between the tools I’ve gained from (inpatient) treatment at Vanguard, outpatient treatment and my GA meetings, I’ve been able to sustain my recovery since May. I know that I can string days together with sobriety and take comfort in knowing I only have to make a decision for the day.
Given my history — and given the nature of this nasty addiction — I can’t say that I’ll never gamble again. But I do know that every day in recovery is a better day than every day spent gambling.
If I could reach out to someone in the grip of gambling — who probably feels that it could lead to some kind of insanity or even death — I would tell them how quickly things start to get better once you start your recovery. In Minnesota, we are lucky to have many great resources, but you have to reach out.
Minnesota’s Department of Human Services continues to follow the federal health emergency guidelines for providing telehealth services. The current three-month approval will end in November. As of mid-October, there was no indication from DHS — one way or the other — as to whether this will continue.
Given the success of telehealth counseling and Minnesota’s expansive geography and often-hazardous winter weather, MNAPG will continue to advocate for this service becoming a permanent tool for counselors and therapists. With only 18 certified problem gambling providers in the state of Minnesota, most located in the Twin Cities metro area, we believe telehealth counseling is an essential tool in helping those experiencing harm from gambling, whether a gambler or a family member. While in-person will always be the gold standard, we think the accessibility of telehealth counseling can be extremely helpful for those seeking to begin their recovery.
I’m hardly the person you’d expect to develop a gambling addiction. I wasn’t a video gamer, didn’t like football pools and didn’t play the stock market. I didn’t even start gambling until I was almost 50. And even then, I took a roll of quarters to the casino, spent it in 15 minutes, and that was the extent of it.
But within a year, I fell fast and hard. I had a big win at the casino when I bet $20 and won $2,000 in a video poker game. Then I thought maybe I could win $20,000.
I got money from wherever I could. I maxed my credit cards and used the overdraft protection from my bank as a loan. And since I managed the finances where I worked, I started juggling the books and accessing funds, convincing myself I would “borrow” the money, keep track of it and pay it back.
My job performance eventually suffered because I spent so much time at the casino. I remember falling asleep at my desk one day because I gambled for the majority of a weekend, getting very little sleep. I ended up getting fired from my job because of poor performance, tardiness and absenteeism.
I knew it was a matter of time before I got caught for what I did with the organization’s books. The fateful day came a month after I was fired when detectives knocked on my door and went through every corner of my house. After I was arraigned, bail was set at a whopping one million dollars because I had previously gone on a cruise to the Grand Cayman, a place where people are known to hide money. I ultimately received a 51-month sentence, spending 34 months in prison and 17 months on parole.
I know that today there are specialty gambling courts in some states where people can avoid prison time if their offenses are related to their gambling addiction. I don’t know that that would have served me well. I think I needed all the time I spent in prison to come up with a plan for the rest of my life. A wrist slap, at least in my case, may not have been enough.
Once I became resolute in my recovery, I was amazed at how many times the “system” wasn’t really in step with my addiction. Once on parole, I was told not to drink or do drugs, though that was never an issue for me. I was subjected to urinalysis to make sure that I wasn’t doing either, but the test somehow came back positive for ecstasy (later determined to be because of a medication I was taking). Another time, while on parole, I was suspected of stealing cash from my employer, but the theft was later traced to a coworker. It’s at these times — when I was getting healthier in my recovery — that I felt sort of framed as a felon or criminal. It’s at these times — when you feel knocked down — that it’s tempting to turn back to the addiction. The key is continuing to work your recovery program.
Now I focus on sharing my story with others at outpatient centers and conferences. I talk about what it was like to be an addict and how I was able to overcome my challenges. I want to give back.
I look back on the lies I told and can’t believe how intricate they were. I once told my employer that I was gone for three hours for lunch because I was at a gas station and someone’s car caught on fire — and that my phone was lost in my act of trying to help them get out.
I came from a middle-class Christian home. I was raised to not lie, cheat and steal. Yet that’s what I became. Everything takes a back seat to the gambling addiction, which is what’s truly driving the bus.
If somebody hears my story and they’re sitting on the fence, I hope they do some reflection and use whatever resources are available to them and not go as deep into the addiction as I did. I feel physical pain when I hear of people that suspect they have a gambling addiction but continue to plunge deeper.
The message I want to leave people with is not to think that it can’t happen to you. It can. No matter your background or how good a person you are, these things can happen to good people.
Read the original article on The Basis website Here.
Problem gambling occurs more frequently among men, but it is still present among women and is understudied in this population. Gambling Disorder (GD) refers to persistent and problematic gambling behavior leading to distress, and that causes financial, relationship, and psychological harm. The effectiveness of GD treatment has received limited attention in the scientific literature. Common factors that might influence treatment effectiveness include discontinuing treatment and relapse. This week, The WAGER reviews a study by Marta Baño and colleagues that examined the short-term therapy outcomes of group CBT among women with Gambling Disorder.
What were the research questions?
What is the short-term effectiveness of group standardized cognitive behavioral therapy (CBT) among women with GD? Also, what are the most important predictors of primary therapy outcomes (discontinuing treatment and relapse)?
What did the researchers do?
The researchers assigned 214 women seeking treatment for Gambling Disorder at the Pathological Gambling and Behavioral Addictions Unit at the Bellvitge University Hospital in Barcelona, Spain to a group CBT program. Participants attended weekly 90-minute sessions for 16 weeks and learned CBT strategies to recondition cognitive distortions and improve emotional regulation, with the ultimate goal of absolute and continued abstinence from all gambling behavior. These CBT strategies included education on vulnerability factors, ways to avoid possible triggers, and how to respond to urges with alternative healthier behaviors. The researchers used logistic regression, negative binomial regression, and survival analysis to assess predictors of discontinuing treatment and relapse.
What did they find?
During the course of treatment in the study, 90 women (42%) skipped three consecutive treatment sessions and 77 women (36%) had at least one relapse. Women with relatively less severe Gambling Disorder, and experiencing greater psychological distress, were more likely to discontinue treatment. On the other hand, relapse risk was higher among women with lower education levels, those without gambling-related debt, and divorced women. Drug use (other than smoking), placing more maximum bets per gambling-episode1, preferring gambling games that rely on chance alone such as bingo or slot machines2, and lower socioeconomic status were also associated with higher relapse rates during CBT (see Figure).
Figure. Statistically significant predictors of primary therapy outcomes—discontinuing treatment and relapses— among women in CBT treatment for Gambling Disorder (n = 214). Arrows indicate significant predictors of either discontinuing treatment or relapse. Click image to enlarge.
Why do these findings matter?
Learning more about female gambling behavior and identifying specific predictors of discontinuing treatment and relapse can help clinicians provide better GD treatment. For example, severe emotional distress may indicate a need for greater emphasis on emotional regulation techniques (e.g., through mindfulness meditation) or healthy coping mechanisms. CBT might also need to be adapted for those with lower education levels to be more engaging and comprehensible. These findings also demonstrate a clear need for future research on women with GD to understand their unique lived experiences.
Every study has limitations. What are the limitations of this study?
As a study with only female participants, the findings can not be generalized to men. Additionally, measures such as amount bet per gambling episode relied on self-reported data, in which participants may have over- or underestimated their actual 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.
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[1] In this context, “maximum bets per gambling-episode” refers to most bets placed during any single past gambling experience. [2] As opposed to games like poker, which include both chance and skill.
The first time I started to think I might have a gambling addiction was when it was suggested to me by my manager at work. She saw that I enjoyed talking to coworkers about my gambling — even laughing off my appreciable losses. Until then, I didn’t give it all that much thought.
I was taken a little off guard by my manager’s comment, in which she actually asked me to watch how much I talked about gambling in the workplace because coworkers might think I had an addiction. But the message hit home for me — she was telling me I should consider that I had an addiction.
At my very next therapy appointment after that conversation I used my therapist’s phone to call the gambling helpline. I knew it was time.
Although I was decisive in seeking help once my manager talked to me — and I took the initial homework assignments very seriously — I still had relapses in the first several years while going to Gambler’s Anonymous (GA). And while I know that others might not return to GA after relapsing, I was struck by the welcoming, nonjudgmental outlook they shared, and so I never missed a meeting.
Two things motivated me to become more steadfast in my recovery. When visiting my father for six weeks before he died of cancer, I had to drive right past the casino. But despite the stress of my father’s health and his proximity to the casino, I never gambled.
The second motivator was the lingering feeling I had the last time I gambled. I distinctly remember how I wanted to drive my care into a wall to kill myself. I didn’t wish to revisit that awful feeling, and I also knew that my father would not want me to do that.
Over the years, I’ve learned about the various situations with other problem gamblers. Our stories always have similarities and differences. Unlike a lot of others, I never lied, cheated or stole. I was always honest with people and confessed when I had relapses. I’m also lucky because I never dipped into retirement savings, though I can only wonder how much more I’d have saved had I not spent so much money gambling.
With the work I’ve done to overcome my gambling addiction along with various other addictions, I’m very familiar with many of the processes, including the 12 steps. In my work in the social services industry, I’m able to provide insights to people when I share my own story.
I encourage others to replace gambling with another activity. And if drinking is also an addiction for them, I tell them to replace alcohol with another beverage of choice that they always have on hand. I also encourage people to reward themselves with jewelry or something else as they reach clean milestones to keep them going.
In August, I will have ten years clean from gambling. I live what some might call a boring 12-step life, but I’ve never been happier and more optimistic about my future.
