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Problem Gambling Treatment: Family & Finances
Joanna Franklin MS NCGC IIMaryland Center of Excellence on Problem Gambling
University of Maryland School of Medicine
Children of Pathological Gamblers
• High School Youth with a problem gambling parent were more likely to report:– Abusing stimulant drugs – Overeating– Describe childhood as unhappy– Be depressed or Suicidal– Have legal action pending (Jacobs 1989)
– More likely to have a gambling problem themselves (Lesieur and Klein 1987)
Children of Problem Gamblers• 8-10 other people are affected by every
pathological gambler. (Lobsinger & Beckett, 1996)
• Consequences include but are not limited to:– Financial losses– Communication problems– Trust Issues– Chronic lying– Legal problems– Domestic violence (23-40% - Gerstein et al 1999 and Bland, Newman,
Orn & Stebelsky 1993)
Family Treatment Issues
• Monitor levels of conflict• Assertiveness and Communication Skills
Training• *Coaching on financial issues and decision
making• May need money manager outside of family• Treat within the context of the Culture.
Family Treatment Issues
–Assess need for individual counseling for family members– Time for expressing anger, fear, distrust– Specific counseling around abuse/violence – Facilitate discussion around issues of
separation/divorce–Counseling on limit setting, detaching with
love
Family Treatment Issues• Education– On comorbid psychopathology and risk factors as
well as pathological gambling– Coping with suicidality– Interaction of gambling progression and
psychopathology– Maintaining personal as well as financial safety for
family– PG as potentially recurring, chronic disorder
Family Treatment Issues
– Dealing with Toxic Anger– Control v. Involvement (limit setting with family
members)– Family pathology often severe– Family offers little or no support– No local self-help resources– Family pathology and money management- need
for financial safety
Family Treatment Issues
• Help family understand shared dynamics/pathology– Listening/Communication skills– Here and Now orientation– Maintaining adult ego state– Conflict Resolution and Problem Solving skills
Treatment Issues
• Final Assessment– Discussion of relapse warning signs– How can family provide feedback– How can gambler listen to feedback– Gambler’s and family members’ triggers
Integrative Behavioral Couples Therapy IBCT (Jacobson & Christensen 1996, 2001) suggests:
1. Regularly discuss differences between the couple- this is to reinforce seeing the problem as an “it.”
2. Discuss upcoming events in light of their differences anticipating potential conflicts.
3. Therapist and couple would process recent negative events with empathic joining to diminish negative feelings around unpleasant exchanges.
4. Process positive events reinforcing how each contributes through tolerance and acceptance of each other’s difference.
IBCT & Family Gambling Treatment
Couples seem to abandon quickly precise, clearly operationalized strategies so carefully taught. (Jacobson & Christensen 1996)
Data analysis indicates behavioral change can only go so far. People have a limited capacity to change.
Successful intimate relationships exhibit a high degree of tolerance.Developed the paradox of acceptance and change-we change best
when we feel accepted.
Rather than teaching an array of artificial communication techniques, wouldn’t make more sense to teach strategies that felt natural.
IBCT Family Treatment• Present the couple with a formulation of how things
got the way they are.
• A tentative hypothesis for which the couple provides feedback
• Provides a tool for empathic joining- problem is the “it”, not him or her, or him and him, or her and her.
• Polarization vs. acceptance: each tries to change the other, digs in heels, acts out, control battles…
Financial Management Issues:
• The Budget vs. Asset Protection Plan• G.A. Pressure Relief Group– List of all debts and creditors– List monthly expenses– List of all income and assets– Prepare the Plan– Restitution– Money Management
Assessing DebtOwed To Amount %
InterestMin.Payment
Responsible
Priority
Defining Asset Protection Plan
Income Source
Date Received Paid To Amt afterDeductions
Defining Monthly ExpensesExpense Pay To Due Date Amt Due
Rent/Mortg
Gas
Electric
Water
Taxes
Food
Phone
Etc
Other Personal/Emotional Debts
Name of Person
Nature of Debt Approx Date Means of Amends
Money Protection Plan• Case examples – Sally
– 58 year old, school teacher– Depleted savings, owes $10,000 on credit cards, cashed in insurance
policies, bad checks– She has always managed finances– Husband very angry, very controlling, relationship marked by power
struggles– Children live out of state, but very supportive– Has close friend who is recovering alcoholic and wants to be
supportive– Husband’s brother is financial planner
IBCT Family Treatment
Caution:Over-predicting of negative consequencesCatastrophizing crisis circumstances-believing “I can’t cope.”Anger as a defense against re-victimizationSelf-blame for gambling behavior
Response:Cost-benefit analysisConcrete examination of resourcesAnger reduction techniques- alternative defenses, focus on self
and personal growth.Challenge “character” conclusions about self
Treatment Resources:Counseling the Problem Gambler: A Self Regulation Manual Joseph Ciarrocchi PhD.
Pathological Gambling: Eitology, Comorbidity and Treatment. Nancy Petry PhD
Don’t Leave it to Chance . E.J. Federman, C.E.Drebing & C. Krebs.
Losing Your Shirt. M. Heineman
Behind the 8 Ball. L. Berman & M.E. Siegel.
Personal Financial Strategies for the Loved Ones of Problem Gamblers. National Endowment for Financial Education and National Council on Problem Gambling.
Gamblers Anonymous Pressure Relief Workbook www.Gamblersanonymous.org
