At what point should staff bocome involved with a 'problem gambler'?

[Randall P. McMurphy]

...and what constitutes a problem?

[anon_e-mouse]

Staff or client?

Not being flippant here but it might be that you are asking for help about the behaviour of a member of staff.

Whats your concern?

[Randall P. McMurphy]

Staff or client?

Not being flippant here but it might be that you are asking for help about the behaviour of a member of staff.

Whats your concern?

I feel it probably is the behaviour of the staff that needs addressing but in this case the person gambling is a client.

This person can lose between £40-£60 in an hour or so playing fruit machines. As he rightly says its his money to do with as he pleases, this can antagonise staff but I agree with him. However how much money should he start to lose before staff have a valid point re him being a problem gambler?

[anon_e-mouse]

It will be tricky for a staff team to say at what point gambling is a "problem". apparently "Pathalogical gambling" is a more clinical term. The DSM-IV definition of pathological gambling is widely accepted, pathological gambling is an impulse control disorder that is a chronic and progressive mental illness.
Pathological gambling is now defined as persistent and recurrent maladaptive gambling behavior meeting at least five of the following criteria, as long as these behaviors are not better explained by a manic episode:

Preoccupation. The subject has frequent thoughts about gambling experiences, whether past, future, or fantasy.
Tolerance. (As with drug tolerance), the subject requires larger or more frequent wagers to experience the same "rush."
Withdrawal. Restlessness or irritability associated with attempts to cease or reduce gambling.
Escape. Subject gambles to improve mood or escape problems.
Chasing. Subject attempts to win back gambling losses with more gambling.
Lying. Subject attempts to hide the extent of his or her gambling by lying to family, friends, or therapists.
Loss of control. Subject has unsuccessfully attempted to reduce gambling.
Illegal acts. Subject has broken the law in order to obtain gambling money or recover gambling losses.
Risked significant relationship. The subject gambles despite risking or losing a relationship, job, or other significant opportunity.
Bailout. Subject turns to family, friends, or another third party for financial assistance as a result of gambling. Research is out there but I don’t know how much of it is looking at LD/MH some useful net stuff at http://www.camh.net/egambling/issue1/feature/index.html (http://www.camh.net/egambling/issue1/feature/index.html) and http://grants.nih.gov/grants/guide/pa-files/PA-98-106.html (http://grants.nih.gov/grants/guide/pa-files/PA-98-106.html) as examples.

The clinicians here can probably help with what to do if you feel that the behaviour is fits these criteria.

[forumAdmin]

The clinicians here can probably help with what to do if you feel that the behaviour is fits these criteria.

Thank you again anon_e-mouse for the education.

I think this will turn into an interesting debate and I know our clinicians will be hot on my heels with some responses when their face to face work is done.

[bethr]

I suppose the next question could go back to our original 'poster' - does the client meet any of the criteria hightlighted by anon e-mouse?

[bethr]

And, who is 'qualified' to make judegements on whether the client fits the criteria or not? Can this simply be done through observation, talking to staff and clients by anyone? I don't know the answer to that, so would appreciate a reply???!

[dave]

A bit of common sense from someone with a lot of experience of working with 'addictions' (and I'll use that phrase very loosely).

I presume your client isn't loaded so loosing £40 - £60 an hour sounds like a major problem to me even if your client doesn't see it as one. What you, your staff team or your client choose to do about it is another matter.

More information required

[Randall P. McMurphy]

It will be tricky for a staff team to say at what point gambling is a "problem". apparently "Pathalogical gambling" is a more clinical term. The DSM-IV definition of pathological gambling is widely accepted, pathological gambling is an impulse control disorder that is a chronic and progressive mental illness.
Pathological gambling is now defined as persistent and recurrent maladaptive gambling behavior meeting at least five of the following criteria, as long as these behaviors are not better explained by a manic episode:

Preoccupation. The subject has frequent thoughts about gambling experiences, whether past, future, or fantasy.
Tolerance. (As with drug tolerance), the subject requires larger or more frequent wagers to experience the same "rush."
Withdrawal. Restlessness or irritability associated with attempts to cease or reduce gambling.
Escape. Subject gambles to improve mood or escape problems.
Chasing. Subject attempts to win back gambling losses with more gambling.
Lying. Subject attempts to hide the extent of his or her gambling by lying to family, friends, or therapists.
Loss of control. Subject has unsuccessfully attempted to reduce gambling.
Illegal acts. Subject has broken the law in order to obtain gambling money or recover gambling losses.
Risked significant relationship. The subject gambles despite risking or losing a relationship, job, or other significant opportunity.
Bailout. Subject turns to family, friends, or another third party for financial assistance as a result of gambling. Research is out there but I don’t know how much of it is looking at LD/MH some useful net stuff at http://www.camh.net/egambling/issue1/feature/index.html (http://www.camh.net/egambling/issue1/feature/index.html) and http://grants.nih.gov/grants/guide/pa-files/PA-98-106.html (http://grants.nih.gov/grants/guide/pa-files/PA-98-106.html) as examples.

The clinicians here can probably help with what to do if you feel that the behaviour is fits these criteria.

Apologies for the delay in replying.

Of the criteria above I can only be certain this person would match two, with the possibility of another two areas.

I know for a fact having observed this person on several occasions that he will try and win back his loses on fruit machines and he has asked parents and carers to borrow money after being left short.

The other two criteria he may or may not fulfill are loss of control and lying. I'm not sure whether he has attempted to control or alter his gambling to any extent. As for lying over the amount he spends/loses gambling I'm unsure. When I have spoken to him in the past he has not been accurate with the amount of money he has lost. However he has very poor numeracy skills and doesn't keep account of the amount of money he puts in the fruit machines, making this more difficult for him to be accurate.

[dave]

Randall - what do you think about your clients behaviour?

[steveg]

I would suggest staff have to look at the overall issue. Forget the issue is gambling, (you could insert any addictive behaviour i would persume) and think of the following questions in terms of any behaviour

Taking into account the chaps overall character, at what point would this behaviour infringe on the rights and safety of others and himself?

How does this ultimate challenge fold out?

Would he steal to make ends meet?

How far would he go to get money?

How can we balance it all out, he gets what he needs without harming anyone or himself

He's an addict, gambling is his thing.

Is he addicted to the money side?, the anticipation of the (or a) win?, the need to win?

Is it the loads of coins in his hands?

What would happen if you gave him one of those friut machines that use tokens?

Have you been down these roads yet?

interesting and dont want to ramble on yet!

It reminds me of the news this week of a hospital in Staffordshire supporting self harmers in doing so safely, but i think Andy started a thread on that somewhere here

[Randall P. McMurphy]

Randall - what do you think about your clients behaviour?

I feel this person has a right to gamble if he so chooses, I gamble (Cheltenham week wasn't my most successfull though) and so do other clients eg the National Lottery.

It is my opninion certain staff want to try and control his spending and recommend he spends this money on more 'suitable' pursuits.

I fully support this client in that he should be able to spend his money as he sees fit, however if he has a gambling problem I wouldn't want to encourage this and would want to actively support him.

In short I think it would be fair to say if he isn't a 'problem gambler' then I would support him in his right to gamble.

[Randall P. McMurphy]

Does anyone have any further comments they would like to add to this thread?