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Transcript of July 11, 2012 National Conference on Problem Gambling Presenter: Jennifer Clegg, LSW, MSW, NCGC-II,...
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July 11, 2012National Conference on Problem Gambling
Presenter:Jennifer Clegg, LSW, MSW, NCGC-II, OCPS-II
Recovery Resources3950 Chester Ave.
Cleveland, OH 44114216-923-4021
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Prevention is an ordered set of steps along a continuum to promote individual, family and community health, prevent mental and behavioral disorders, support resilience and recovery and prevent relapse.
Prevention is prevention is prevention!
Common risk and protective factors exist for many addictions and mental health problems. Good prevention focuses on these common risk factors that can be altered
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Resilience is built be developing assets in individual, families and communities through evidenced based health promotion and prevention strategies
Systems of prevention services work better than service silos
Baseline data, common assessment tools and outcomes are shared across service systems can promote accountability and effectiveness of prevention efforts
(The Guiding Principals of the Strategic Prevention Framework, SAMHSA)
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1950’s- early 1960’sScare tactics
Mock crashes Recovery speakers Graphic pictures
Research indicated that these strategies are not effective
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Late 1960’s to early 1970’s Information
Factual information “medicine show’s” Teaching what drugs are used and how they are
used
This strategies was found to be counter productive and actually glamorized drug use
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1970’s- mid1980’sDevelop curricula providing effective
education and alternative activities and trainings Just Say No MADD
Mid 1980’s - mid 1990’sResearch based curricula and peer
prevention programs SADD DARE
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Mid 1990’s - TodayThe gap between research and application
are gradually bridgedEvidences based curricula developed
Utilizing environmental approaches Comprehensive programming targeting many
domains, strategies evaluation of prevention programs, media campaigns and culturally sensitive programs
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Adolescents today are the first generation of youth exposed to accessible and various types of gaming.
Gambling has become a new rite of passage
Typically 50-80% of teens reports gambling for money during their lifetime
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Cards Cards
Sports BetsSports Bets Games of Skill Games of Skill (like (like betting each other in betting each other in hoops, pool)hoops, pool)
Video/Arcade Video/Arcade GamesGames
LotteryLottery
InternetInternet BingoBingo
Common Types Common Types of Gambling of Gambling
Among TeensAmong Teens
Source: Carlson & Moore, 1998
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TardinessMissing school
StealingMood swings
Criminal activityTheft/RobberyEmbezzlement
Drug dealingShoplifting
Secrecy/withdrawalUnexplained debts/cashMissing moneyIncreased anxietySubstance use
FAMILYFAMILY COMMUNITYCOMMUNITY WorkWork
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Can’t think of anything else but doing drugs
Need more and more to maintain a high
Will do drugs at any cost
Can’t stop even if they want to Lying and stealing to keep
using drugs Drugs help to escape life’s
problem, allows to forget Consequences:
Failing School Problems with
friends/family Risk of ending up in jail
• Can’t think of anything else but doing gambling
• Need to gamble more and more to maintain a high
• Will gamble at any cost• Can’t stop even if they want
to• Lying and stealing to keep
gambling• Gambling help to escape life’s
problem, allows to forget• Consequences:
– Failing School– Problems with
friends/family– Risk of ending up in jail
McGill University11
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Students who gamble are more likely to participate in other risk behaviors
Gambling is one of many activities that carry risk and should be addressed as such in school and community prevention efforts
Casino nights in schools and other forms of gambling should be reconsidered.
Parents need to talk with their kids about gambling and gambling related consequences
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What prevention model do you follow?Public Health ModelEnvironmental ManagementYouth Empowerment and developmentSocial ecological theory
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Agent
EnvironmentHost
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Universal Intervention refer to efforts focused on every eligible member of a community.
· Selective Intervention are more focused at a more systems domain where higher-risk subgroups are targeted
· Indicated intervention are prevention efforts targeted at individuals, for example those who show signs of developing problems.
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Prevention is not just about “preventing” something from happening:
“ Prevention is a proactive process that promotes the well-being of people and empowers an individual, group, or community to create and reinforce healthy lifestyles and behaviors to meet the challenges, events and transitions of life.”
Prevention is building healthy people and healthy communities.
DMHAS Problem Gambling Services 2009
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delinquency
sexualbehavior
smoking
violent behavior
druguse
gambling
High RiskBehaviors
We know that high risk behaviors tend to cluster and gambling appears to fit within a risk behavior matrix
(Marotta, J, 2007)18
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Create awareness of gambling attitudes & behaviors;
Increase protective factors;
DMHAS Problem Gambling Services 2009
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Information Dissemination
Prevention Education
Alternative Activities
Community-Based Processes
Problem Identification/Referral
Environmental Approaches
Our Approach: Uses CSAP Prevention Strategies
Research shows that it takes ongoing efforts in all 6 areas for prevention to really work
(Marotta, J, 2007)20
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This strategy provides awareness and knowledge of the nature and extent of substance use, abuse, and addiction and their effects on individuals, families, and communities. Information dissemination is characterized by one-way communication from the source to the audience, with limited contact between the two. [Note: Information dissemination alone has not been shown to be effective at preventing substance abuse.]
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Clearinghouses and other information resources centers
Resource directories Media campaigns Brochures PSA’s Speaking engagements Health fairs
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This strategy involves two-way communication and is distinguished from the information dissemination strategy by the fact that interaction between the educator/ facilitator and the participants is the basis of its activities. Activities under this strategy aim to affect critical life and social skills, including decision-making, refusal skills, critical analysis (e.g., of media messages), and systematic judgment abilities.
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Classroom or small group sessions Peer leadership and peer helper groups Parenting and family management
classes Educations sessions for youth groups Groups for children of addicts
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This strategy provides for the participation of target populations in activities that exclude substance use. The assumption is that constructive and healthy activities offset the attraction to--or otherwise meet the needs usually filled by--alcohol and drugs and would, therefore, minimize or obviate resort to the latter. [Note: Alternative activities alone have not been shown to be effective at preventing substance abuse.]
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Social and recreational activities Youth and adult leadership activities Community drop in centers Mentoring programs
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This strategy aims to enhance the ability of the community to more effectively provide prevention and treatment services for substance abuse disorders. Activities in this strategy include organizing, planning, enhancing efficiency and effectiveness of services implementation, interagency collaboration, coalition building, and networking.
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Community and volunteer training Systematic planning Multi agency collaboration and
coordination Accessing services and funding Community team building
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Individualized environment Seek to socialize, instruct, guide, & counsel children to increase their resistance to health risks Shared environment Support healthy behavior, prevent risky behavior for all children Environmental strategies Price interventions, minimum -purchase-age, deterrence, location & density, counter-ads
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This strategy aims at identification of those who have indulged in illegal/age-inappropriate use of tobacco or alcohol and those individuals who have indulged in the first use of illicit drugs in order to assess if their behavior can be reversed through education. It should be noted, however, that this strategy does not include any activity designed to determine if a person is in need of treatment.
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Employee assistance programs Student assistance programs DUI education programs
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Individual Peer Family School/work Community Society/environmental
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USE MULTIPLE STRATEGIES OVER MULTIPLE DOMAIN
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37.9% - non-gamblers 49.3% Social gamblers 7.8% at risk gambler’s
9.5% males1.6%females
5% Probable pathological gamblers11.7%males4.9% females
Youth Gambling Problems: The Identification of Risk and Protective Factors: Report to the Ontario Problem Gambling Research Centre” Laurie Dickenson, MA, Jeffery L. Derevensky, Ph.D., Rina Gupta, Ph.D.
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Similar to public health model of disease prevention: focus on decreasing risk and increasing protection
Risk factors predict addictive behaviors and protective factors can buffer risk factors
To prevent high risk behaviors, such as gambling or substance abuse, reduce risk factors and increase protective factors throughout a child’s life
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Child of a compulsive gambler Belief that skill is involved An early big win Feeling that one must chase
gambling loss with more gambling Early age of onset Large first bets Otherwise addicted
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Emotional difficulties Stress Distorted expectations about
winning Social pressure to gamble Risky gambling behavior Attention deficits Impulsivity Illusion of control over outcomes Addiction history
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Plays with $ that is needed or borrowed.
Expects to win; keeps playing to win back losses.
Is revolved around
gambling.
Frequent, or spends more time
gambling.
Sticks to limits of money to play with.
Hopes to win butexpects to lose.
Can take it or leave it.
Occasional gambler.
PROBLEM GAMBLINGSOCIAL GAMBLING
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At-risk for a substance abuse problem Having a parent, sibling, relative, friend, or
significant person with either a gambling problem or substance use problem
Having or knowing peers with substance use problems is a risk correlate of youth problem gambling
Anxiety High risk propensity Low perception of risk regarding problem
gambling Early onset of gambling behaviorYouth Gambling Problems: The Identification of Risk and Protective Factors: Report to the Ontario Problem
Gambling Research Centre” Laurie Dickenson, MA, Jeffery L. Derevensky, Ph.D., Rina Gupta, Ph.D.
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Family connectedness Designing school-based prevention programs
that seek to develop student’s attachment, trust, and identification with larger groups(e.g., school clubs and sports teams, Scoutsor Guides).
Youth Gambling Problems: The Identification of Risk and Protective Factors: Report to the Ontario Problem Gambling Research Centre” Laurie Dickenson, MA, Jeffery L. Derevensky, Ph.D., Rina Gupta, Ph.D.
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Assessment Capacity Building Planning Implementation Evaluation All under the umbrella of cultural
competence and sustainability
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What is Assessment? Assessment of high risk behavior and
related problems Assessment requires us to explore
rates and patterns of high risk behavior as well as related problems (consequences). Prevalence data Incidence data Consequence data
(Adapted from CSAP Strategic Planning Framework)
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How do we know if our needs assessment data is valid?
Next- Stare at
the black "+" in the center.
What color are the moving
dots now?
First- What color
dots do you see?
Lastly- Keep staring at the black "+" in the center of the picture. What happens to moving dots now?
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There really is no green dot, and the pink ones
really don't disappear.
What does this optical illusion have to do with conducting a
needs assessment?
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Increase Awareness
Change in Attitude
Change in Behavior
(Adapted from CSAP Strategic Planning Framework)
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(Adapted from CSAP Strategic Planning Framework)
Types and levels of resources needed to address identified needs including:
• Human resources• Technical resources • Management and Evaluation
resources• Financial resources
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What is a Comprehensive Strategic Plan? A comprehensive, logical, and data
driven plan to address the problems identified in phase 1 using the capacity built or mobilized in phase 2
The plan includes Strategic Goals, Objectives, and Outcomes, as well as Logic Models and in some cases Action Plans
(Adapted from CSAP Strategic Planning Framework)
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Taking action as guided by the Strategic Plan developed in phase 3
Developing detailed action plans for elements of your intervention
Developing a final detailed evaluation plan that includes process and outcome measurements and continual monitoring of implementation fidelity
(Adapted from CSAP Strategic Planning Framework)53
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What does the Evaluation phase include?
Process evaluation Collection of required outcome data Review of policy, program, and practice
effectiveness Development of recommendations for
quality improvement
(Adapted from CSAP Strategic Planning Framework)54
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Why cultural competence? To eliminate service and participation
disparities for people of diverse racial, ethnic, and linguistic populations
To consider culture, gender, ability levels, and sexual orientation in all aspects of the SPF
To improve the effectiveness and the quality of the programs, policies and practices chosen to achieve outcomes
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Can be defined as “a set of congruent behaviors, attitudes and policies that come together in a system, agency or among professionals and enable that system agency or those professionals
to work effectively in cross-cultural situations.”
(The Lewin Group, 2002)
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Structures and formal linkages Champion and leadership actions Resources Administrative policies and procedures Expertise Ownership among stakeholders
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Prevention is a continuum Prevention is prevention is prevention Successful prevention decreases risk
factors and enhances protective factors Prevention requires adoption of known
effective prevention practices within a framework that works
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Why invent the wheel? We spent many years learning what
works and what doesn’t in substance abuse prevention, let’s adapt it to gambling prevention
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