🤑 Center of Excellence on Problem Gambling – CBS Baltimore

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Research indicates counselors benefit form the specialized knowledge of gambling treatment, so they learn how to help with complicated financial restitution.


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Maryland Center of Excellence on Problem Gambling On-Line Training. Sign Up! Maryland CEPG Online Training Parts I and II trains counselors, educators.


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During this current health crisis, the Maryland Center of Excellence on Problem Gambling (the Center) remains open and committed to providing real-time.


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Developmentally, impulsive behavior that underlies pathological gambling tends to start during late adolescence or early adulthood. Consequently, the center's.


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Maryland Center of Excellence on Problem Gambling

One counsellor mentioned that their own education was also an obstacle to clients receiving help for their problem gambling. Counsellor 2. One counsellor defined it more specifically as a loss of control or a loss of focus on priorities. Keywords: problem gambling, gambling disorder, methadone maintenance treatment, gambling treatment. Problem gambling to me is when you had twenty thousand dollars and it be gone in a year. Among MMTP patients, the combined prevalence rates of problem gambling and disordered gambling ranged from In contrast, the rate of gambling disorder among the general population ranges from 0. Grounded theory strategies allowed researchers to use inductive processes to obtain data and develop theories on this underexplored topic Byrne, Researchers used a constant comparison, opening coding approach. Previous studies have used qualitative methods to discuss perceptions of problem gambling among college students, homeless individuals, and clients in substance abuse treatment and have provided information on the development of treatment interventions for each of those populations Guilcher et al. All participants met the DSM-5 criteria for gambling disorder in the previous study. Even among problem gambling helpline callers who initiated treatment, treatment unavailability was reported to be the foremost barrier Additional barriers that have been reported are participants wanting to solve the problem on their own, difficulty admitting gambling was a problem, concerns about the cost of treatment, and concerns or uncertainties about the treatment itself Gainsbury et al. I think education about finances would probably help to raise a little bit more awareness about gambling. Counsellor 4. Counsellor 8. This approach allows researchers to gain invaluable information about the perceptions of gambling and gambling treatment and allows for the development of effective intervention approaches that can be used to improve treatment for problem gambling in methadone maintenance clinics. With this addition to the treatment program, clients may be able to better engage in treatment and to stay in treatment longer than occurred previously, therefore continuing to lessen their risk. This coding process allowed researchers to develop a grounded theory of the perceptions of problem gambling and barriers to problem gambling treatment in the clinic. Counsellor 6. Given that the overwhelming majority of clients defined problem gambling solely as overspending, clients seemed to be able to acknowledge gambling as an issue only if it was having an impact on their financial situation. Client interviews took place at an off-site administrative building and counsellor interviews at the university-affiliated MMTP. The findings revealed important differences between clients and counsellors: Opinions differed on the definition of problem gambling, obstacles to treatment, and optimal treatment settings. Client 3. In addition, the findings have important clinical implications, including a need for more effective screening and treatment in MMTPs and to provide substance use counsellors with training related to problem gambling. You still go through the same array of symptoms as if you were going to buy drugs. In addition, clients were asked about types of gambling and their own personal gambling behaviours. The majority of clients agreed that gambling can be used as a substitute for drug use and acknowledged that problem gambling has many similarities to a drug addiction. Participants provided informed consent prior to beginning the interviews. Interviews produced three additional emerging themes in which clients and counsellors expressed differing perspectives: definition of problem gambling, obstacles to treatment, and treatment setting. In the current investigation, we sought to do the following:. Petry, Rash, and Alessi reported that, in contrast to the results of previous studies, offering gambling intervention programs did not significantly affect SUD treatment outcomes. Maybe we need to have a counsellor here who is really versed on the questions that we can answer.{/INSERTKEYS}{/PARAGRAPH} Counsellor 1. The present study was reviewed and approved by the institutional review board at the University of Maryland Baltimore. For this study, the term gambling disorder is used to refer to those who meet four or more criteria from the Diagnostic and Statistical Manual of Mental Disorders 5th ed. {PARAGRAPH}{INSERTKEYS}Problem gambling is highly prevalent and rarely treated among clients who attend methadone maintenance treatment programs MMTPs. After open coding was finished, researchers constructed focused codes and created a finalized database of codes and supporting text. Codes and emerging themes established by each investigator were discussed during coding meetings. The client interview guide is provided in Appendix A and the counsellor interview guide in Appendix B. This examination of responses of counsellors and client feedback provides a useful mechanism to better understand problem gambling in MMTPs. Counsellors and clients shared perspectives on three of these themes: gambling as a substitute for drug addiction, gambling as a trigger for relapse, and finances as a motivator for change. Client 2. Client 5. Our study aims were to a develop a clearer understanding of the gambling experience of clients and counsellors at a methadone clinic and b gain insight into the current treatment options and obstacles to treatment in the clinic. In-depth interviews with clients and counsellors yielded six emerging themes. It has a crossover to it. Problem gambling, it comes to a problem when it affects you paying your bills. A qualitative research method was used for the present study, as it allows researchers to gain a deeper and more nuanced understanding of gambling in the clinic. Gambling treatment may be an important addition to MMTPs to complement other treatment strategies. I think every time I think of a problem, I think of loss of control. All interviews were audio-taped and professionally transcribed verbatim with permission from client and counsellor participants. Studies have also reported increased rates of drug use and illegal activities in clients under treatment for substance use disorder SUD who also meet the criteria for problem gambling. Data were coded by 4 investigators by using a constant comparison, open coding approach. Semi-structured interviews were conducted by trained members of the research team. If investigators agreed on codes, the code was finalized. Client 6. Several counsellors mentioned that they use a money chart when discussing gambling with their clients in order to help them recognize that their gambling may be a problem. Investigators initially categorized data by interview questions, and then coded the data for each interview question. Counsellors specified that clients may be likely to use drugs both when they experience a sizable loss while gambling and when they experience a sizable win while gambling. Initially, each investigator had individual databases with codes and supporting text. Despite the negative effects that ongoing problem gambling appear to have on recovery, previous research showed a low percentage of treatment for gambling disorder during SUD treatment Leavens and colleagues found that These findings clearly indicate a need among SUD clients for treatment that focuses on problem gambling behaviours. In addition, several counsellors indicated that their conversations about gambling with clients revolve around financial planning Table 4. Semi-structured interviews focusing on gambling issues were conducted with 8 clients and 8 counsellors at an MMTP located in an urban area. Given the limited research available about gambling interventions in substance use treatment clinics, it is unclear whether gambling interventions will have an impact on SUD treatment outcomes. You gamble on the odds. Researchers ended data collection when saturation was reached. Four investigators took part in coding and analysing interview data; each interview was coded independently by two investigators. Counsellors stated various obstacles that interfere with clients seeking treatment for problem gambling, including lack of awareness, legality of gambling, lack of counsellor education, denial, and issue avoidance. Counsellors are trained in substance use treatment and stated they did not have the resources or education to help clients with their problem gambling. If investigators found any discrepancies in codes, the discrepancies were discussed by all four investigators and codes were reconsidered. While counsellors acknowledge that a lack of money or overspending might be signs of a gambling addiction, it is not the only indicator of gambling addiction. Investigators met a final time to discuss the themes that had been created, reconcile any differences in codes of themes between investigators, and create a final list of emerging themes. As we were specifically interested in including clients with an identified problem gambling disorder as assessed by a score of 4 or higher on the DSM-5 problem gambling questionnaire, participants were recruited from a previous study 5th ed. Each interview lasted approximately 1 hr. Counsellors were contacted for an interview if they expressed interest in participation and provided contact information during the meeting. Participants were asked questions to gain an understanding about their perspectives on, treatment options for, and treatment barriers to problem gambling in the clinic. Clients and counsellors expressed agreement that gambling is often used as a substitute for drug use. Counsellors at the same MMTP were approached during a staff meeting and informed about the study by research assistants. Gambling treatment programs are scarce among the MMTP population; therefore, there is more to be learned about the effects of gambling interventions on substance abuse treatment. Individuals were contacted for the present study if they had participated in the previous study, which examined the rates of gambling disorder in MMTPs, and provided written permission to be contacted for future studies. Clients agreed with counsellors and stated that they would only recognize that their gambling has become a problem when they can no longer pay their bills. Unlike other substance use treatment clinics, MMTPs follow a harm reduction approach. In contrast, when clients were asked to define problem gambling, all but one client defined problem gambling as overspending, or not being able to pay bills Table 6. Client 1. Clients and counsellors also agreed on some elements, including the negative impact that problem gambling can have on recovery from substance use. Instead of getting my money order for my rent, first I go to the next window at the check cashing place where I get my money order and get scratch-offs and sit there and play them. Participants did not report a lack of interest in treatment as a significant barrier in any of these studies. Counsellors mentioned that the thrill associated with gambling can be similar to the thrill clients achieved through drug use. However, considering the high rates of problem gambling among MMTP patients compared with those of the general population, treatment for problem gambling within MMTPs is still advantageous. Given that rates of gambling disorder are approximately times higher among those receiving methadone maintenance treatment than among the general population, treatment for this disorder should be addressed in MMTPs. Vice versa. Compared with those of the general population, rates of gambling disorder have been found to be elevated among individuals receiving methadone maintenance treatment. As noted in Tables 1 and 2, counsellors and clients also reported that problem gambling behaviours not only mimic behaviours associated with drug addiction, but that problem gambling could also lead to a relapse to drug addiction. The coding process began with each researcher entering codes and corresponding supporting text in a database. Two additional counsellors reported that a monetary incentive, such as a paid research study, would trigger change in clients. Clients tended to not recognize gambling as a problem if it was not causing financial struggle.