Transcript New Faces of Problem Gambling Panel - MI-PTE

Deborah G. Haskins, Ph.D., LCPC,
NCGC-II, BACC
New Faces of Problem Gambling:
Cultural Competency and Problem
Gambling
Objectives
The cultural landscape of our neighborhoods/communities
are changing; therefore, problem gambling treatment
and prevention must change too. Participants will:
1. Briefly learn the cultural competency
Multicultural Awareness (Attitudes)
Knowledge and Skills (MAKS) model to use for
counseling problem gamblers.
2. Learn specific cultural knowledge about racial
and ethnic problem gamblers.
Cultural Competency: What is this?
 Individual Cultural Competence: “The state of being capable of
functioning effectively in the context of cultural differences.”
 Organizational Cultural Competence: 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.
 Culturally Competent Mental Health Care: Will rely on
historical experiences of prejudice, discrimination, racism, and other
culture-specific beliefs about health or illness, culturally unique symptoms
and interventions with each cultural group to inform treatment
(Cross, Bazron, Dennis, & Issacs, 1989; Pope-Davis, Coleman, Liu, & toporek,
2003)
Cultural Competency
Clinicians have Multicultural:
 Awareness of importance of his/her own
identity, socialization experiences, and influence
of culture on functioning and therapeutic
relationship
 Knowledge base of cultural factors and how
treatment and prevention must incorporate
what we understand about tailoring
interventions/awareness to meet diversity of
consumers
 Skills to translate this to the therapeutic
relationship
Cultural Research
• Volberg (1994) found great majority of
pathological gamblers entering treatment are
White, middle-aged men
• Ethnic minorities were seriously
underrepresented among pathological
gamblers entering treatment, even on Native
American tribal governments
Problem Gambling and Cultural
Diversity Research
• Minorities were much more likely than Whites
to be problem gamblers (Weite, Barnes,
Wieczorek, & Tidwell, 2004)
• Their study found that Race was the most
potent predictor of pathological gambling
symptoms per person: Blacks and American
Indians have more symptoms per person,
Hispanics and Asians in the West had more
symptoms than those outside the West
Cultural Research
• Materially poor persons may see gambling as
an escape from poverty, making them more at
risk to gambling pathology
• U.S. minorities have a much lower net worth
than Whites, even at similar income levels
(U.S. Dept. of Commerce, 2001); therefore,
lower wealth means the same gambling losses
will cause more financial hardship, and more
pathology (Schissel, 2001)
Cultural Research
 In a study examining gender-related differences in the
characteristics of problem gamblers using a gambling
hotline (n=562, 349 males; 213 females ) in southern New
England found: disproportionately fewer calls received
from minorities, especially Hispanic and African
American men, compared with estimated rates of
problem gambling in these groups
Issue: How do we make gambling helpline services
more available or attractive to minority groups?
Potenza, M. N., Steinberg, M. A., McLaughlin, S. D., Wu, R., Rounsaville, B. J., & O’Malley, S. (2001).
Culture and Addictions Research
• More understanding of the contextual factors
surrounding race, ethnicity, and culture when
working with trauma survivors from diverse
backgrounds (Hien, Litt, Cohen, Miele, &
Campbell, 2009).
Summary: So What Needs To Change?
1. More research needed to understand cultural context
and relationship with addictions and problem gambling.
2.
Patterns of alcohol & drug use and medical comorbidities have affected cultural & ethnic groups in
similar and divergent ways. Prevention and treatment
involve medical, public health, and changes in minority
community attitudes and mores, law
enforcement, education, media, technology
(Westermeyer, J. & Dickerson, D., 2008).
Summary/Recommendations
3. Perceived barriers to care within a
minority group can impede treatment
seeking, even when services are
available (Westermeyer, J. & Dickerson, D.,
2008).
Question:
 How do we reduce the barriers that impede
minorities from seeking treatment and/or
connection to our public awareness efforts such as
National Problem Gambling Awareness Week?
 How do we develop more culturally relevant
treatment?