prevention of problem gambling: what every preventionist needs to know jim wuelfing owner and...

Prevention of Problem Gambling: What Every

Preventionist Needs to Know

Jim WuelfingOwner and Principle Associate

The New England [email protected]

Prevention and Recovery ConferenceInspiration. Connection. Motivation.

Oklahoma City, OklahomaNovember, 2014

Never underestimate the Never underestimate the power of a few committed power of a few committed

people to change the world. people to change the world. Indeed, it is the only thing Indeed, it is the only thing

that ever has.that ever has.Margaret MeadeMargaret Meade

About the Meaning and Challenges of Prevention

PreventionNo progress has ever been

made against any epidemic by treating only the casualties. We simply replace them with more.

PreventionIs an active process of

changing conditions and fostering personal attributes that supports the well being of people.

Challenges and Principles of Challenges and Principles of Prevention PlanningPrevention Planning

Based prevention in tested theory, research and data

Use a proven prevention planning model Using multiple strategies over multiple domains Use evidenced-based strategies Reduce risk and enhance protective factors Utilizing best practices

Based on Tested Theory, Based on Tested Theory, Research and DataResearch and Data

What prevention models are you following?– Public health model– Environmental management– Youth empowerment and development– Social ecological theory

What do you know about your population?

Quality and Accuracy of DataQuality and Accuracy of Data Luxury Car –Valid and reliable measures that

allow you to observe outcomes over time (examples surveys)

Sedan – Proxy measure that may or may not be valid indicators of outcomes of interest

Compact Car – Qualitative data such as focus groups and people’s perception of the problem.

CSAP’s Strategic Planning CSAP’s Strategic Planning FrameworkFramework

AssessmentCapacity BuildingPlanningImplementationEvaluationAll under the umbrella of cultural

competence and sustainability

AssessmentAssessment

Assessment involves using data to access:– Problem gambling and related problems (i.e.

needs) which leads to recommendations for state and community priorities

– Capacities and resources in existence to address the problems and gaps in capacities

– Readiness of state and communities to act.

(Adapted from CSAP Strategic Planning Framework)

Capacity BuildingCapacity Building

Involves identifying types and levels of resources in the prevention system and enhancing those systems by:– Workforce development– Improving data-based systems– Increasing coordination– Building community resources.


PlanningPlanning

Includes developing a comprehensive, logical and data driven plan to:– Address priority problems and issues– Decrease risk factors– Increase protective factors– Minimizes gaps in resources and capacity– Selects complementary strategies (multiple strategies

over multiple domains.


ImplementationImplementation

Involves:– Infrastructure development– Implementing evidenced-based strategies.


EvaluationEvaluation

Involves:– Assessing technical assistance and training

efforts needed– Policies and procedures needed to foster

positive outcomes– Measuring positive change that occurred.


Six Prevention StrategiesSix Prevention Strategies[Center for Substance Abuse Prevention [Center for Substance Abuse Prevention

(CSAP)](CSAP)]

Information Dissemination

Prevention Education

Alternative Activities

Community-Based Processes

Environmental Approaches

Problem Identification and Referral

Information DisseminationInformation Dissemination

Complementary to more intensive / interactive approachesIncludes all types of passive education

– Posters– PSAs (print, radio, TV)– pamphlets

Choice air timesTarget audienceAvoid authority figures & exhortations

Prevention EducationPrevention Education

Combine information, skills, protective factors

Interactive, intense, with booster sessions

Peer-led components

Provide social skills training & practice

Involve parents individually & with students

AlternativesAlternatives

May be more effective with high-risk youthIntense programs with varietyComponent of integrated comprehensive

strategyCommunity service, mentoring, recreation,

cultural activities

Community-Based ProcessesCommunity-Based ProcessesUtilize multi-agency activities & interagency

coordinationClear purpose, appropriate planning,

commitment to resultsActive participation by meeting members’ needsLeadership essentialAppropriate roles for paid staff Implement proven effective strategies to achieve

outcome-based goalsEffectiveness based on strategies not structure

Environmental ApproachesEnvironmental ApproachesIndividualized environment

– Seek to socialize, instruct, guide, & counsel to increase their resistance to health risks

Shared environment– Support healthy behavior, prevent risky behavior

for all in the population

Environmental strategies– Price interventions, minimum -purchase-age,

deterrence, location & density, counter-ads

Problem Identification and Problem Identification and ReferralReferral

Estimate accurately people who justify intervention

Ensures appropriate referral to meet needs

Realize relationship between substance use, gambling and other health problems.

Risk of exposure to other risk behaviors

Brief interventions appear promising

PREVENTION DOMAINSPREVENTION DOMAINS

IndividualPeerFamilySchool/workCommunitySociety/environmental

MULTIPLE STRATEGIES MULTIPLE STRATEGIES OVER MULTIPLE DOMAINSOVER MULTIPLE DOMAINS

Questions to Consider in Selecting Strategies

Who is the strategy targeting ? Why are you targeting this population and what

data/information supports your targeting this group ? What factors is your strategy addressing ? Why do you feel this strategy will lead to a desired

change? Is their any evidence that indicates that this strategy is

effective ? What change due you want to occur in this group or

population?

Effective*Innovativeand/or Unproven Conditionally

Effective*Promising*Of

Interest*Insufficient Current

Support*

SAMHSA’s Emerging Evidence-Based SAMHSA’s Emerging Evidence-Based ContinuumContinuum

* SAMHSA/NREPP effectiveness levels

Little-to-NoEvidence of Effectiveness

Evidence of Effectiveness Based on Rigorous Evaluation

NewNewNREPPNREPP

2005+

Protective and Risk Factors

Protective and Risk Factors

Protective factors – Factors that decrease the chances of someone (or a community) developing health and behavioral problems are called protective factors. Having multiple protective factors can override risk factors.

Risk factors - Factors that increase the chances of someone developing health and behavior problems are called risk factors. Individuals, families and communities which possess these factors are considered at risk. Those that possess several are considered high risk.

PROTECTIVE FACTORS

A relationship with a caring adult role model

Having an opportunity to contribute and be seen as a resource

Effectiveness in work, play and relationships

Healthy expectations and a positive outlook

Self-esteem and an internal locus of control

Self-discipline Problem solving and

critical thinking skills A sense of humor Family cohesion School/community

connectedness

Protective Factors

Family connectednessDesigning school-based prevention

programs that seek to develop student’s attachment, trust, and identification with larger groups (e.g., school clubs and sports teams, Scouts or Guides).

YOUTH GAMBLING PROBLEMS: THE IDENTIFICATION OF RISK AND PROTECTIVE FACTORS:: Report to the Ontario Problem Gambling Research Centre: Laurie Dickson, M.A.Jeffrey L. Derevensky, Ph.D., Rina Gupta, Ph.D.

Risk Factors for Problem Gambling

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 behaviour

YOUTH GAMBLING PROBLEMS: THE IDENTIFICATION OF RISK AND PROTECTIVE FACTORS::Report to the Ontario Problem Gambling Research Centre: Laurie Dickson, M.A.Jeffrey L. Derevensky, Ph.D., Rina Gupta, Ph.D.

High Risk Categories

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 (8.5 years for pathological gamblers; 11.5 years for non-pathological gamblers)

Large first bets Otherwise addicted

Characteristics of Low Risk Gambling

For fun or recreation, never for financial gain

Knowledge that over time nearly everyone loses

Socially with family and friends, not alone

Limited time – frequency and duration

With predetermined limits for losses

Acknowledging that knowing a lot does not make you a better gambler

Minimizing Your Risk

Always bet with a predetermined amount of money to be lost

Never borrow money to gambleNever gamble illegallyKnow your personal risk factorsKnow where to get helpBe willing to help others

Three Consistent Messages

The choice to abstain from gambling as a lifelong practice is a legitimate choice that many people make.

We want you to be legally allowed to gamble before you do so and we do not want you to gamble illegally ever.

If you still choose to gamble, we want you to know enough about gambling so that you can lower your risk of gambling problems.

Best Practices in PreventionBest Practices in Prevention

Research and Conceptual Framework

Accuracy, Efficacy and Credibility of Approach

Needs Assessment Measurable Goals and

Objectives Outcome and Process

Evaluation

Comprehensive Approach Integrates Overall Health

Promotion Community Involvement

and Ownership Long-Term Commitment Replicability

The Connection Between Prevention and Recovery

Both are primarily concerned with wellnessBoth focus on both building personal

recovery capital as well as community recovery capital

There is much overlap in the skills used by preventionists and recovery support personnel

Both support a holistic approach

Prevention of Problem Gambling on the National Level

National Council on Problem Gambling NCPG) – Prevention Committee– Co-chairs: Julie Hynes (OR) [email protected]

Susan McLaughlin (CT) [email protected]

NCPG Annual Conference – July 10-11, 2014, Baltimore, MD

State Efforts

Oklahoma Association on Problem and Compulsive Gambling (www.oapcg.org)– Wiley Harwell, Executive Director

405-801-3330

Other State Affiliates of NCPG– Go to www.ncpgambling.org and click “About

Us” and then “State Affiliates”

Evidenced-based curriculum for the prevention of problem gambling among teens and young adults.

Created by Robert Williams, Ph.D., Alberta Gaming Research Institute and Robert Wood, Ph.D., University of Lethbridge, Alberta

Teaches young people to approach life as smart risk-takers, weighing the pros and cons of their actions to determine the odds of achieving positive results.

Stacked Deck

Thank you.Thank you.

prevention of problem gambling: what every preventionist needs to know jim wuelfing owner and...

Documents