Problem Gambling Experts Focus on Unique Treatment Needs of Women

As those involved in the field of problem gambling find there is no effective "one size fits all" treatment approach, they are beginning to focus on the specific needs of various populations. Two recent initiatives brought together various sectors of the industry, clinicians, researchers and policy-makers to determine how best to address issues in this field that are unique to women.

THINK TANK AIMS FOR INTEGRATION OF CLINICAL, RESEARCH COMPONENTS TO ADDRESS WOMEN'S ISSUES

When 11 problem gambling professionals gathered in Rehoboth Beach, Del., last October, the result was one of the most comprehensive examinations of the emerging issue of women and disordered gambling ever conducted as well as the launch of some of the most exciting new developments in the problem gambling treatment field.

The concept for the three-day retreat, dubbed the Think Tank on Women's Healing and Problem Gambling, was developed by Lori Rugle, Ph.D., president of the Ohio Council on Problem Gambling.

According to Rugle, the idea for the meeting stemmed from a conversation with Joanna Franklin, director of training and network development at Trimeridian, Inc. and president of the Maryland Council on Compulsive Gambling, regarding the current needs in the problem gambling field. They noted a large gap in research on women and problem gambling, mainly due to the fact that women have just recently begun to enroll in treatment programs in many areas of the country. 

"The goal of the retreat," Rugle said, "was to bring together a variety of female perspectives from the field to review each other's work and discuss how to integrate the clinical and research domains to develop more effective approaches to treating female problem gamblers."

Participants in the retreat included leading researchers, clinicians and public policy experts from across the country. Sessions included scientific presentations to determine the current state of research in the field, as well as discussions by treatment providers on what techniques had proven to be particularly successful among women.

"We wanted to collect information from actual women in the field," said Franklin. "There are significant differences between men and women in the problem gambling arena, as men and women respond very differently to specific treatment techniques. We wanted to focus on the application 
oof research and experience to the treatment setting, to find out what impact the existing research and public policy has on clinical work, education and training."

Sponsors of the meeting included the Delaware Council on Gambling Problems; International Game Technology (IGT); Harrah's Entertainment, Inc.; Maryland Council on Compulsive Gambling; Mohegan Sun; Ohio Council on Problem Gambling; and Trimeridian, Inc.

According to Rugle, a report of findings from the retreat will be released in June at the annual conference of the National Council for Problem Gambling (NCPG), which is scheduled to focus on women and problem gambling. The report will include a summary of research presented, including source data, as well as integrated discussion of the ideas presented at the meeting. Rugle plans to post the report on the NCPG Web site following the event, and a second, expanded retreat is scheduled to take place in spring 2005. 

"The report and our meeting really just scratch the surface of this issue," Franklin said. "We want to move forward and are very curious about how to learn more. At our next meeting, we want to focus on how to conduct successful outreach to women to get them into treatment, discuss treatment advances and determine what methods work better for women, and continue exploration of how to deal with existing barriers to treatment for women."

The group will also work to develop a plan to allow for coordinated data collection on the women currently enrolled in state-funded problem gambling treatment centers across the country, she said.

"We want to take a look at all the women involved in state-funded treatment programs across the country," Franklin said. "Right now, we don't know how many there are, their common characteristics, how they got into treatment or what are their specific problems with gambling. No one has ever looked at this data before. We know that women's health issues are different from men's, and that behavioral health care for women is different than for men. If we can take a closer look at this data and make inroads to understanding this fastest-growing population of problem gamblers, we can begin to develop much more effective treatment and education strategies."

CONNECTICUT PROJECT AIMS AT EDUCATING STATE TREATMENT PROVIDERS

Problem gambling professionals in Connecticut also have taken steps to address the specific needs of female problem gamblers.

When Susan McLaughlin was named primary prevention services coordinator for the Connecticut Department of Mental Health and Addiction Services (DMHAS) Problem Gambling Services in 1997, she noted that while it had long been generally accepted that women in substance abuse recovery programs have complex and differing needs from their male counterparts, the case for gender competent treatment for women seeking help for disordered gambling had yet to be made in Connecticut or other parts of the country.

To address that need, McLaughlin worked together with the University of Connecticut Gambling Research and Treatment Center and the Connecticut Lottery Corporation to launch The Connecticut Women's Problem Gambling Project in 1998. The group's mission is to raise awareness of and increase the capacity of service providers in advocacy, prevention, intervention and treatment of women experiencing gambling problems and those impacted by them. It accomplishes those goals through increased and improved screening, training for service providers in assessment and referral, and the facilitation of more research to understand gender differences that may assist in the development of more effective treatment strategies for women.

The project recently partnered with DMHAS Problem Gambling Services to sponsor a competency-building symposium for mental health, addictions and prevention professionals in the state. Held in March, Women and Problem Gambling: Issues Across the Ages was designed to create awareness of problem gambling as a women's issue among mental health and addictions personnel. Originally planned for 80 to 100 treatment service providers, more than 370 mental health and addictions professionals throughout Connecticut registered to attend. Organizers changed the venue to accommodate approximately 260 participants, McLaughlin said.

The symposium reviewed the latest research on problem gambling among women as well as clinical advances and gender-specific treatment strategies. The event also served to launch the Women's Project Action Plan, which centers on the distribution of materials on disordered gambling throughout Connecticut communities. The materials, developed by the lottery, include a brochure for treatment providers to help them recognize symptoms of disordered gambling as well as a disordered gambling awareness pocket guide for women that will be available in a variety of venues across the state. More than 90 symposium participants signed on to assist in the distribution of materials.

The group's first project was the initiation of a comparative study to differentiate between male and female problem gamblers. From 1999 to 2001, researchers at the University of Connecticut collected and analyzed data on 150 male and female problem gamblers who had presented for treatment in the United States and Canada. Researchers examined data on the gambling history of each patient, as well as childhood and life history information.

The goal of the study, McLaughlin said, was to find out what in these women's backgrounds contributed to their being a problem gambler. Results are scheduled to be published inPsychology of Addictive Behaviors later this year or in early 2005.

"Since problem gambling is often a co-occurring disorder, our aim was to develop a way to educate and train people who already work with women in recognizing and testing for the symptoms of disordered gambling," McLaughlin said. "There was a high level of awareness among this group that they needed more information on this issue, and this event was designed to give them the tools to address problem gambling with their patients."

According to McLaughlin, the project is committed to building on the success of these initial efforts. She indicated the next step in the program will most likely include advanced training for symposium participants focused on how to conduct clinical interventions with problem gamblers and how to treat problem gamblers and assist their family members.