Apr 24, 2020 | HELP, PROBLEM GAMBLING, PROFESSIONALS, RECOVERY
The COVID-19 pandemic has affected virtually all aspects of life. Gambling counseling is no exception.
Given the drastic reduction in social contact, we asked several gambling counselors about the state of gambling therapy and the changes they’ve observed.
Lisa Vig, Gamblers Choice
More of our clients are keeping appointments than we anticipated. It tells me that staying connected to recovery support is very important at this time. They have also been initiating and requesting additional individual support as well.
We use a variety of platforms, including Teams, Zoom and the phone. One accommodation we’ve had to make using these platforms is reducing the size of groups. It’s more difficult to manage attention spans, allowances for everyone to talk and receive the attention they need with eight or nine in one group. We’ve adapted by offering shorter groups, more often, with fewer attendees.
As a counselor, I find that takes a different level of energy to conduct telehealth counseling. When you’re not in the same room sharing the same space, you have to pay more attention to their voice, inflections, participation and engagement since the ability to watch body language or other expressions is compromised. The clients we have worked with have expressed gratitude at every opportunity to stay connected.
I think telehealth counseling has a very valuable place, especially in this part of the country where we are dealing with rural living and limited availability of counselors. At least 50 percent of our clients would benefit from the option of telecounseling. Being able to utilize a combination of in person and telecounseling to customize delivery of treatment services would be ideal.
Craig Johnson, Club Recovery
Once all of my clients became used to the change and requirements of the stay-at-home orders, my group attendance has been good. Most clients are participating and “showing” up for group.
Except for rare occasions, we are completely virtual. We use phone or a Telehealth platform to conduct interactions with all clients at every level of service we provide.
While counseling is not a “one size fits all” process, I think that at some level and some circumstances all clients can benefit from using a Telehealth platform. We need to adapt and move forward with as many innovations in reaching out to clients that we can. Since the beginning of the COVID-19 crisis, the treatment community has been advocating vigorously for the use of Telehealth platforms and CMS and DHS recently approved that all services we provide can be done with Telehealth. Telehealth is a capability that we must keep as an option to use when a client may not be able to access services via traditional means.
There is a great need for gambling disorder providers outside of the Twin Cities, Duluth and near Fargo. Without Telehealth, potential clients in those areas would not be able to get services. As a community of providers we must promote this capability wherever and whenever possible to reach all those who need help. This will be the main topic of discussion at the next meeting of the DHS Advisory Committee on Gambling Disorder on May 14.
Paul Mladnick, Solo Practice/Bridges & Pathways
I don’t think Telehealth counseling is ideal but I don’t think that much is lost. About half of my clients prefer to cancel appointments until we have the all clear. I’d say about 30 percent are coming to my office while about 20 percent are receiving counseling over the phone.
From a practical perspective, I am keeping my office sanitized prior to each session and I do practice social distancing in my office. I have noticed that the number of referrals is down since March 17, so I have considerable availability for those with a gambling problem or those concerned for family and friends.
Feb 24, 2020 | HELP, PROBLEM GAMBLING, PROFESSIONALS, RECOVERY
We asked some of Minnesota’s certified problem gambling counselors for their thoughts on the barriers for Minnesotans receiving problem gambling treatment. Here is what they said:
Cheryl Minx, Director, Freedom Center, Inc.
I think people may not realize help is free to those who need it. Many people think if they’re broke and in trouble financially that there is no way to pay for help. I also think that the helplines are not very visible so that people don’t know how to find help.
Christina Pristash, MS, LMFT
There can be many contributing factors that interfere with a person reaching out for help or accessing treatment for problem gambling. I know that personal fears get in the way as well as individuals/families not knowing what resources are available and/or what makes a person qualify for help. We are fortunate to have an inpatient option in our state as well as outpatient treatment options, but many people aren’t aware of these resources or the differences between the two. Continued education and information sharing will continue to create fewer barriers for people, but choosing change is still always going to be hard.
Dawn Cronin, LSW NCGC Gamblers Choice, Lutheran Social Services of ND
I think a significant barrier is the nonpayment to phone counseling providers. While most providers recognize phone sessions are not the preferred method for counseling, they are necessary at times. I believe the many rural areas of Minnesota and the frequent poor winter driving conditions are putting severe limitations and interruptions in treatment participation for clients. I have three clients over the age of 62 traveling over 50 miles one way for treatment who have had to interrupt treatment because of travel conditions. We also have limited numbers of Gamblers Anonymous meetings in these rural areas so we are unable to encourage participation at these meetings for the same reasons.
Craig Johnson, LADC, Club Recovery
One of the greatest barriers is the lack of understanding by insurance companies, or just plain recognition, that gambling disorder is the exact same as any other psychological disorder as described in the DSM 5. I also think that clients are often told that gambling disorder is not covered and so they stop right there.
I have heard that a large hospital program discourages clients who do not have private pay insurance from seeking services because the reimbursement rate from the state gambling fund is significantly lower than what a given provider might pay.
There is a distinct lack of providers in outstate Minnesota, where access to treatment can be a challenge. We need to push telehealth as a way to reach individuals who either don’t have the means or the access to a provider near their home. I think that prevention programs need to include education on gambling disorder.
Programs aimed at young adults mention the opioid crisis, the vaping crisis, legalizing marijuana and so on, but often do not even mention gambling.
Lisa Vig, LAC, NCGC, Gamblers Choice
I’m concerned about those who live in rural Minnesota who may not have access to a trained counselor, access to a GA meeting and may not have reliable transportation or funds to travel the necessary distance to receive treatment and support. We need to explore other options to reach these individuals, such as phone counseling, telehealth treatment and/or online resources. The challenge to find appropriate, reputable financial management services for this population in conjunction with treatment is also a concern.
Paul Mladnick, LADC, NCGC, LMFT, Bridges and Pathways Counseling Services
One barrier that I see is a lack of awareness of gambling treatment services and that financial help is available for Minnesota residents, so I think we need to do more to advertise gambling treatment resources.
Also, there is still much ignorance over problem gambling and many people still think this is more of a moral problem or a lack of common sense. An educational campaign to alert people that this, too, is an addiction that can happen to anyone would be helpful.
Do you have a thought on barriers to treatment that you’d like to share? If so, please send your comment to sstucker@mnapg.org.
Feb 24, 2020 | CONCERNED OTHERS, HELP, RECOVERY, STORIES
I was five months pregnant with our second daughter in August 2014 when I received a call from my husband that would forever change my life. He told me he had won $20,000 at a casino — $10,000 in cash and $10,000 in a check. I figured we’d use the money towards paying off debt and giving generously to our church.
I was surprised by this news because I wasn’t aware that he was going to the casino. When I asked him about it, he told me he’d been going for a few months. All the while he seemed tired, but I knew that something was not right with him. I later learned that he’d been gambling a lot longer than a few months when I noticed gambling activity started to show up in our credit union accounts. I also discovered that he was using money he’d put away for our daughter and started dipping into his bill money. When I confronted him about it all, he always told me he could stop whenever he wanted.
He continued to gamble after our daughter was born. He eventually made a bad personal decision and lost the job he’d held for eight years in May 2015. I was working part-time and he was the primary breadwinner. Without his $45,000 income, we were in trouble. He continued a downward spiral into depression, anxiety, cross addiction with drinking, scratch off lottery tickets, candy crush and deeper into gambling.
The stress created by my husband’s addiction took a toll on me. My blood pressure spiked and I developed alopecia in the front of my hairline. That was a wakeup call!
By August, I sought help and learned about Gamblers Anonymous (GA) for my husband and Gam-Anon for myself. He went to GA once and refused to go again. But for me, going to Gam-Anon turned out to be the next big thing that would change my life.
On numerous occasions my husband admitted to me that he had a problem, but refused to seek treatment. After being separated for a few years I filed for divorce, which was finalized in June 2019 so I could chart my own path. I am now the primary breadwinner and speak at the annual GA/Gam-Anon conference. I have focused on my career as well as learning about addiction and recovery and how to better support people that come after me, because there will always be more addicts and families affected by addiction.
I was asked what advice I might give to other spouses and families who are going through the same thing that I went through. I would tell them that addiction is a time sucker, a hell of a roller coaster ride and that even in the midst of the storm they need to realize the importance of self-care — choosing joy and finding their own purpose.
It’s easy to become so co-dependent on the addict that you stop living your life. There are things spouses and family members can do to protect themselves if the problem gambler isn’t willing to get help. Some of these things include:
- Knowledge is power — learn as much as you can about addiction and how it’s an actual mental illness.
- Control your financial assets and don’t allow the gambler’s behavior to damage your credit or your mortgage.
- Don’t enable and bail out the gambler by helping with gambling-related debts.
- Get the support you need from people who understand your situation, such as what Gam-Anon offers.
These were hard lessons to learn. It’s unfortunate that I had to go through this but if I didn’t, I wouldn’t have a story to tell and be able to influence others. The ability to speak at an annual conference, for example, is a door that never would have been opened if I didn’t have a spouse that’s an addict.
One day, my ex-husband will realize what he has thrown away and will choose recovery for himself. For me, I am excited for new beginnings. To create new traditions and memories for my daughters. I’m in control of my future and looking forward to writing the next chapter.
The state of Minnesota offers 12 sessions of family therapy (per year) through the state problem gambling program when visiting an approved provider. An approved provider list can be found here.
