the great escape - national council on problem gambling · the great escape: women and compulsive...

1

IIAR - All Rights Reserved

The Great Escape: Women and Compulsive Gambling

Coleen Moore, MA, LCPC, CSADC, CCGC,

MISA II, SAP Illinois Institute for Addiction Recovery


Goal of Today’s Training

Participants will:

Discuss the similarities and differences

between female and male gamblers

Become familiar with the many facets to consider in the treatment and recovery of female gamblers


History through the years...

“Many women are attracted to gambling

venues because they are clean,

attractively located, offer a feeling of

physical safety and they treat people

with respect. And besides that, most

people don’t imagine harm can come

from a game that only costs a quarter

to play.” Jeffrey Marotta, PhD, Oregon DHS

2


DSM - IV - TR Criteria

A. Persistent and recurrent mal-adaptive gambling

behavior as indicated by 5 or more of the

following:

1. Is Preoccupied with gambling

2. Needs to gamble with increasing amounts of $ in

order to achieve the desired excitement

3. Has repeated unsuccessful efforts to control, cut

back or stop gambling

4. Is restless or irritable when attempting to cut

down or stop gambling

5. Gambles as a way of escaping from problems or

of relieving a dysphoric mood



6. After losing $ gambling, often returns

another day to get even

7. Lies to family members, therapist or others

to conceal the extent of involvement with

gambling

8. Has committed illegal acts such as forgery,

fraud, theft, or embezzlement to finance

gambling



9. Has jeopardized or lost a significant

relationship, job, or educational or career

opportunity because of gambling

10. Relies on others to provide $ to relieve a

desperate financial situation caused by

gambling

B. The gambling behavior is not better accounted for

by a manic episode

3

Types of Gamblers

Casual Social

Gambler

Serious Social

gambler

Relief and Escape

Gambler

Professional

Anti-Social

Personality

Pathological

Gambler

IIAR -- All Rights Reserved



Types of Gamblers (Custer)

Compulsive Gambler

Gambling is the only thing in life

Ignores job, school, family and often

turns to crime to support habit

Cannot stop without treatment

Life is ruined unless help is obtained

4


Compulsive Gambler (Custer)

The Action Gambler

Predominately

male

Start young

Competitive

Gambling

“friends”

Grandiose /

Narcissistic

Criminal activity

- arrest record

Money is

principle relapse

issue

Can become

escape gamblers to

avoid consequence

of their behavior


Compulsive Gambler (Custer)

The Escape Gambler

Predominately female

Non-competitive

Short gambling career

Late onset

Relationship issues

Debts lower, no attempts to control

Emotions are primary relapse issue


What are Women Seeking?

Freedom from:

Chronic Pain / Health Problems

Loneliness / Isolation

Boredom / Lack of Leisure

Grief & Loss (people, places, things)

Abuse

5


What are Women Seeking?

Freedom from:

Domineering Spouse / Relationship

Issues

Emotional Issues ( Stress, Depression,

Empty Nest, Lack of Identity, Fear of

Death, Loss of Youth)


What do Women Get?

Safety / Controlled Atmosphere /

Rituals

Around people, but not “around” people

Power / Identity

Special treatment, prizes, freebies,

praise

Companionship

Machine / game provides comfort and

peace


Female Characteristics

“Closet Gamblers”, seldom brag

Usually stay with legal gambling

75% report “escape” while gambling

Family History of Addiction

The Council on Compulsive Gambling of New Jersey,

Inc.

6


Female Characteristics

Past history of a different addiction

(alcohol, drugs, spending, eating, sex)

Start gambling later in life than men

Low self-esteem

The Council on Compulsive Gambling of New Jersey,

Inc.


Putting it all together

Positive Screenings / DSM IV 312.31

Diagnosis

Medical and Psychiatric Evaluation

Financial Counselor


Putting it all together (con’t)

Biopsychosocial Assessment Family History, Educational History, Legal

History, Addictive Pattern History, Military

History, Leisure Assessment, Strengths and

Assets, Abuse History, Spiritual

Assessment, Emotional Assessment, Job

History, Peer Relationships, Sexual History,

Living Arrangements, Prior Treatments

7


Suicide


Medication

SSRI’s usually prescribed

Beware of addictive / mood altering

medications

MD / Psychiatrist must be aware of

Addiction Diagnosis


Medication

Mind and Body Concept / Self Awareness

What is in the mind, comes out on the body Non-medicinal alternatives to complaints:

Cool wash cloth

Milk

Stretching

Acknowledgement

Muscle relaxation/Biofeedback

8


Smooth transition to GA

Contact hotline and talk with female

gambler

Get a female contact to attend first

meeting with the client

Getting a meeting list

Give GA Combo Book prior 1st meeting

Possibility of answering 20 questions on

2nd meeting or round robin style to avoid

shaming


Focusing on YOU!

Co-dependency - M. Beattie defines: “A person who has let someone else’s behavior affect him or her and is obsessed with controlling peoples behavior”.

Rescue others

Unhealthy pattern of relating to others

Self-esteem depends on how the other person is doing emotionally

No boundaries or limit setting

Keeping things the way they are


Assignments for Co-Dependency

Identify and list your own feelings and

needs

Ask self twice before agreeing to

tasks - Learn to say NO!

Establish rules and follow-them

Letting go doesn’t mean not caring;

let others care for themselves

Children ages and needs

Find your balance

9


Female Roles - Where is the

balance?

Worker

Mother

Wife

Friend

Household Glue

Immediate Family Member


Coping Skills

Stress Management

Relaxation, Exercise, Redefine the needs for

now and let the rest go, Time Management and

Down Time/Self Care

Identify and Accept Feelings

Anger, guilt, shame, grief, loss, anxiety, fear,

disappointment, frustration, loneliness, etc.

Assertiveness

I feel ____ when you ____.

In the future...


Self-Esteem Building

Positive Daily Affirmations

Set goals and accomplish

If failed, learn and try again or move on

Connect with self

You are in control of you

10


Leisure and Fun

Set aside the time

Identify activities done in past or want

to learn

Hobbies, crafts, reading, movies, etc.

Be cautious about games and winning


New Rituals

Journaling

Sponsor contact

Meditation / Prayer

Daily Readings

Meeting Attendance


Journaling

Getting it down on paper to hold self

accountable and get it out of you

Every morning and every evening -

daily personal inventory and Step 10

11


Relationships / S.O.

Where do they stand? “Other wives shop till they drop. But Paula

plays a mean game of poker, and handicaps

the horses better than any man I know. I’m

proud as hell of her! So what when she

loses? I can afford it. Besides, it is all part of

the game.” Darren, lawyer, age 41

Gam-Anon

Participation in treatment and initial

conference not marital therapy


Relationships / Children

Education - how much is too much?

Where do they stand? She is the one that spent the money not on

food and clothes but gambling, she is the

one that forced dishonesty related to her

whereabouts.

Gam-Anon / Ala-teen


Relationships / Children

Establish boundaries, Honesty, and

Expectations

Participation in treatment and initial

conference not family therapy

12


Financial

Financial Counselor Contact

Inventory, bank statements, credit

reports, bills, account of savings and

investments

Budget

Designated lead in financial matters,

they participate but have no access to

funds

Repayment Plan

NO BAILOUTS / NO BANKRUPTCY


Legal

Acquire an attorney for any legal

charges pending

Fraud, domestic issues, child

endangerment and neglect, forgery,

deceptive practices

Accountability and Consequences vs.

Wiping the Slate Clean


Safety Nets

Banning from Gambling

Establishments

Closure of Brokerage Accounts / On-

line Investments

Internet Controls (Parental Guards)

No access to money

Provide receipts for pocket change

13


Assignments for Stepwork

Steps 1 - 5 usually completed in primary

treatment, 6 - 12 in continuing care

Written assignments

Step 4 - Defects of Character: Changing

the parameters

List of relapse triggers and warning signs

Calendar of “special” dates

Cross Addiction


Stages of Recovery (Custer)

Growth


Growth

Begin addressing core issues when

stability in sobriety according to client,

treatment specialist and MD /

Psychiatrist

ACOA Issues / CODA

Family Therapy

Marital Therapy

Individual Therapy

Abuse Issues

14


Growth and Relapse

Denial sneaking back in

Intense Feelings and Desire to Escape Hope is always present - even in the losing and

desperation phases. Hope rebounds stronger in

recovery, denial can surface, and the hope can

turn towards being able to win again.

Self-sabotage

Rationalize

Roadblocks for women


Signs of Relapse

Neglect of

Self care and needs

Emotions

Spiritually

Not showing for sessions

Not completing assignments

Lack of participation in group or GA

expectations

Gambling in their head


Relapse Management

Gut feelings and ask questions /

confront

State facts / caring manner / honesty

Identify detour / Get back to program

New list of goals and expectations to get

through the relapse

When do you say when?

When referrals are necessary

15


Stages of Recovery (Custer)

A New Way of Life (Rosenthal)


A New Way of Life

Continuing the process after

addiction treatment completed

Validate the reengagement of

treatment services

www.womenhelpingwomen.com


Wrap - Up

Questions

Closing Game

Completion of Evaluations

the great escape - national council on problem gambling · the great escape: women and compulsive...

Documents