We feature an expert in the mental health and substance use disorder field to answer questions. This issue we talk to Katie Richard of Vinland National Center about helping those with problem gambling.
What is your role at Vinland National Center and what inspired / led you to work with compulsive gamblers?
Currently I am Vinland’s Manager of Outpatient Services for both the Substance Use and Gambling programs. When I started my roll at Vinland, the previous manager and another staff member were establishing the gambling program with the state of MN. When I came, I was able to jump in and help build it from the beginning. I have knowledge of all the aspects of the program from the clients’ direct care and therapy, to how to bill and work directly with DHS. Gambling specific clients, like all clients, have interesting stories of where they come from and how they have found themselves with an addiction. Getting to know the gambling clients drew me in. Also, it was not a subject I knew much about so learning more about the subject showed me the differences in client needs.
Can you share a bit about the outpatient program at Vinland National Center and how it is unique in its approach to help those with problem gambling?
I am a certified brain injury specialist and Vinland substance programming does have a large client base of people who have brain injuries or cognition challenges. The gambling program is open to all adults regardless of cognition level. I have worked, and continue to work, with clients who have histories of head trauma or accidents and gambling addiction. During the sessions we work on how to slow down, as impulse control is a challenge for almost all clients. I teach all clients about how the brain is affected by addiction and then healthy ways to change. I have worked with clients who come with limited knowledge of addiction and how it is not just the gambling behavior that changed their life, it’s a larger issue that includes family, friends, their mental health, physical health, etc. Learning to see the bigger picture can take time.
Are you seeing a trend in different types of problem gambling/gaming?
One thing I have noticed is people who do sports betting don’t always like traditional gambling (casino, lotto, tabs) and set themselves apart. Helping them understand the way someone’s brain reacts to addiction is similar regardless of what the person plays can help. Also quite a few of the older clients I have worked with have no idea how to do online casino or sports betting, whereas the younger or tech savvy crowd will use multiple online platforms to gamble or bet.
What are some signs that gambling has become problematic?
A couple of main signs are the amount of time spent doing the gambling – either at the actual casino or spending large amounts of time on their phone managing accounts. Also not wanting to spend money on small things; meaning they have a loss tolerance to gambling spending but cannot bring themselves to buy actual self-care needs like shoes, clothes, sometimes meds, depending on how deep the addiction is.
Who is at risk for compulsive gambling? (Are people with cognitive impairment more at risk?)
Everyone can be at risk. An example would be people who use pull tabs or e-tabs due to the wide accessibility of them – they are EVERYWHERE. From what clients have told me about pull tabs and e-tabs, they slip into their life because they play them, it’s fun, it usually starts socially and sometimes with drinking, and then it becomes an issue without them realizing it. People who have head injuries depending on level of impairment could become addicted to any substance or gambling easier because they have deficits they cannot control. Or someone may cross addict, meaning they are in recovery from substances, however they gamble.
Do mental health and substance use disorders tend to go along with problem gambling?
There are usually mental health concerns, sometimes there is no actual diagnosis because gambling counseling is the first provider the client may have sought help from. Recommending mental health services paired with the counseling can be helpful. Not all gambling clients have substance addiction and/or they need more education on how both addictions affect their life.
What are some actions that a family member or friend can take if they are concerned about their loved one’s gambling?
If a family member or friend is concerned and is not comfortable with talking to the person directly at first, they are welcome to reach out to a gambling provider to seek education, and even potentially counseling. Some signs they should be concerned about is the person not having enough money even though they work a steady income job. Taking out loans that have high interest rates without the ability to pay back. Borrowing money from people without paying them back. Being on their device for long periods of time and becoming irritated or upset when questioned about it. Attending a casino alone on a regular basis for long hours. Being suicidal without an obvious mental health concern. The family or friend should try to talk with the gambler and see where they think their addiction is and provide resources for what the client wants to work on. If the client only believes it’s a mental health concern, start there with a therapist.
Any other things you’d like to add/mention about the work you are doing OR things you are seeing with problem gamblers?
There are many people who struggle with gambling addiction and may not want to seek services or know they are available. Hopefully in the future this will change.
Things I am a part of right now are being the VP of the board of directors for MN Alliance on Problem Gambling and staying aware of all things advocacy and education on gambling. I also sit as co-chair of the MN DHS committee for gambling providers in MN. I stay current with DHS and legislation needed to help further the availability and quality of services for providers and clients in MN.
Katie Richard, LADC and MN Certified Gambling Treatment Provider, has been a substance use counselor since 2015 and became problem gambling certified in September 2020. Katie helped establish the gambling program at Vinland National Center and is leading the efforts to build their outpatient program and the MN gambling community.
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Last Updated on March 8, 2023