Factors influencing treatment-seeking behavior in female ... Stigmatization and Gender...

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    Factors influencing

    treatment-seeking behavior

    in female pathological gamblers

    Universität Hohenheim, Gambling Research Center

    Andrea Wöhr M.A.

  • Use of Treatment

    “Only 7%–12% of those with a history of DSM-IV pathological gambling had sought either formal treatment or attended meetings of Gamblers Anonymous …”

    (Slutske 2006: 300)

    2 Email: andrea.woehr@uni-hohenheim.de

    Universität Hohenheim

    Forschungsstelle Glücksspiel

    Prof. Dr. Tilman Becker

    Michael Loeper / pixelio.de

  • Shame and Fear of Stigmatization

    “Stigma and shame have been identified as major barriers to help-seeking for problem gambling“

    (Hing et al. 2016b: 32)

    3 Email: andrea.woehr@uni-hohenheim.de

    Universität Hohenheim

    Forschungsstelle Glücksspiel

    Prof. Dr. Tilman Becker

    Lucie Gerhardt / pixelio.de

  • Stigmatization of Gamblers

    • Addictions attract high level of stigma

    → Individuals are perceived blameworthy for their behavior

    →Problem gambling perceived as weakness of character or lack of self-control

    (Hing et al. 2016b: 36-37)

    4 Email: andrea.woehr@uni-hohenheim.de

    Universität Hohenheim

    Forschungsstelle Glücksspiel

    Prof. Dr. Tilman Becker

  • Stigmatization and Gender

    Concepts of gender:

    • Risky behavior more likely to be tolerated in (young) men

    (Hing et al. 2016a: 264)

    5 Email: andrea.woehr@uni-hohenheim.de

    Universität Hohenheim

    Forschungsstelle Glücksspiel

    Prof. Dr. Tilman Becker

    Daniel Stricker / pixelio.de

  • Stigmatization and Gender

    • Women seen in dependent role: “Because of historically defined gender roles for women as caregivers, nurturers, mothers, partners and homemakers, women risk being judged as irresponsible, unrespectable, incompetent and selfish if they display problem-gambling behaviours…” (Hing et al. 2014: 72-73)

    6 Email: andrea.woehr@uni-hohenheim.de

    Universität Hohenheim

    Forschungsstelle Glücksspiel

    Prof. Dr. Tilman Becker

  • Internalization of Stigmatizing Beliefs

    • Self-stigmatization

    “…participants described feeling ‘weak’, ‘stupid’, ‘worthless’, ‘bad’, ‘ashamed’ and ‘embarrassed.”

    → Self-esteem

    → Self-efficacy

    → Perceived social worth

    → Health problems

    → Problem is kept secret

    (Hing et al. 2014: 73-74, Hing et al. 2016a: 264)

    7 Email: andrea.woehr@uni-hohenheim.de

    Universität Hohenheim

    Forschungsstelle Glücksspiel

    Prof. Dr. Tilman Becker

  • Gambling Motivation

    • Gambling as strategy to cope with problems and/or stress

    • High stress level

    – Multiple disorders/(psychic) comorbidities

    – Quality of life (e. g. problematic childhood, traumas)

    (Vogelgesang 2011: 117)

     “Married female problem gamblers often have poor relationships.”

    (Boughton 2003: 5)

    → “…women [feared] that treatment would ’require me to give up all gambling when I don't want to’” (Boughton 2003: 4)

    8 Email: andrea.woehr@uni-hohenheim.de

    Universität Hohenheim

    Forschungsstelle Glücksspiel

    Prof. Dr. Tilman Becker

  • Life Situation

    9 Email: andrea.woehr@uni-hohenheim.de

    Universität Hohenheim

    Forschungsstelle Glücksspiel

    Prof. Dr. Tilman Becker

    Source: Deutsche Suchthilfestatistik 2014 (German statistics of addiction aid)

    Persons with main diagnosis pathological gambling (in %)

    3,3

    34,3

    62,4

    3,3

    33,3

    63,5

    0 50 100

    unknown

    living alone

    not living alone

    females (n=1.344)

    males (n=9.654)

    8,6

    7,7

    29,4

    30,2

    55,7

    6,1

    5,9

    9,2

    48,7

    59,4

    0 10 20 30 40 50 60 70

    other person(s)

    other relative(s)

    parent(s)

    child(ren)

    partner

    females (n=853) males (n=6.028)

  • Perception of Treatment Programmes

    • Do treatment programmes address and appeal to women and their needs?

    → Sensitive topics (e.g. experience of violence) need protected environment

    → Different age group

    → Child care

    10 Email: andrea.woehr@uni-hohenheim.de

    Universität Hohenheim

    Forschungsstelle Glücksspiel

    Prof. Dr. Tilman Becker

  • Factors Influencing Treatment Seeking

    • Stigmatization (gender role)

    • Stress (comorbidities, biography, actual living conditions)

    • Appropriateness of treatment services

    11 Email: andrea.woehr@uni-hohenheim.de

    Universität Hohenheim

    Forschungsstelle Glücksspiel

    Prof. Dr. Tilman Becker

    Ingrid Ruthke / pixelio.de

  • List of Sources

     Bellringer, M. et al. (2008). Problem gambling - barriers to help seeking behaviour, Final report, 1-188.

     Boughton, R. (2003). A feminist slant on counselling the female gambler: Key issues and tasks. Electronic Journal of Gambling Issues 8, 1-23.

     Hing, N. et al. (2016a). How does the stigma of problem gambling influence helpseeking, treatment and recovery? a view from the counselling sector, International Gambling Studies, 16:2, 263-280.

     Hing, N. et al. (2016b). Perceived stigma and self-stigma of problem gambling: perspectives of people with gambling problems, International Gambling Studies, 16:1, 31-48.

     Hing, N. et al. (2014). Stigma and problem gambling: current knowledge and future research directions. International Gambling Studies, 14:1, 64-81.

     Holdsworth, L. et al. (2013): All Mixed Up Together: Women's Experiences of Problem Gambling, Comorbidity and Co-occurring Complex Needs. International Journal of Mental Health and Addiction, 11(3), 315-328.

     Rodda, S. N. et al. (2014). Improved outcomes following contact with a gambling helpline: the impact of gender on barriers and facilitators. International Gambling Studies, 14:2, 318-329.

     Slutske, W. S. (2006). Natural recovery and treatment-seeking in pathological gambling: Results of two U.S. national surveys. American Journal of Psychiatry, 163(2), 297-302.

     Suurvali, H. et al. (2009). Barriers to Seeking Help for Gambling Problems: A Review of the Empirical Literature. Journal of Gambling Studies 25, 407-424.

     Vogelgesang, M. (2011): Gender. In Petry, J. et al., Pathologisches Glücksspielen, Suchtmedizinische Reihe Band 6, 114-121.

    12 Email: andrea.woehr@uni-hohenheim.de

    Universität Hohenheim

    Forschungsstelle Glücksspiel

    Prof. Dr. Tilman Becker