A Holistic Approach to Problem Gambling Treatment

Super Summary:

Main Topics:

• Backgrounds and roles of Maureen Greeley and Tana Russell
• Services provided by the Evergreen Council on Problem Gambling
• Importance of certified gambling counselors and specialized training
• Screening for gambling disorders in substance use disorder assessments
• Strategic plans for addressing emerging gambling and gaming issues

In this episode of the All in the Addicted Gamblers podcast, host Brian interviews Maureen Greeley and Tana Russell, executive director and assistant director of the Evergreen Council on Problem Gambling in Washington state. Maureen shares that she initially pursued a career in wildlife conservation and journalism but ended up working as the communications director at the Washington State Lottery. Concerned about the potential harm of gambling, Maureen became involved with the Washington State Council on Problem Gambling and eventually became its director.

She has since been involved with the National Council on Problem Gambling as board president and vice president and is now back on the board.

Tana Russell started her career as a parole officer in Arkansas before becoming a counselor specializing in tobacco treatment. She later became a gambling counselor and eventually assistant director of the Evergreen Council on Problem Gambling.

Evergreen Council’s Mission and Services

The Evergreen Council provides treatment, training, and awareness programs for problem gambling in Washington state. They provide funding for Washington residents to attend residential or inpatient treatment outside the state and also provide outpatient treatment.

• They offer high-quality training programs for professionals
• Two major conferences a year
• Quarterly training

They also provide public awareness campaigns such as TV and radio ads, billboards, brochures, and posters. Tana works on curriculum development, education programs, Twitter chats, and screening days.

Washington State offers a variety of legal gambling options, including tribal casinos, house-banked card rooms, the lottery, pull tabs, and bingo. The state does not allow video lottery terminals but has recently approved sports wagering through tribal casinos. The state also has illegal forms of gambling, which are regulated and monitored by the Washinton state gambling commission.

Regarding treatment, if someone in Washington state seeks outpatient treatment for problem gambling, they can receive funding from the state or the Evergreen Council. Certified problem gambling counselors can apply for and obtain a contract with the state’s problem gambling program. However, the state’s budget for treatment is limited, so the Evergreen Council also contracts with treatment providers to provide reimbursement with the funds they receive.

The Significance of Certified Gambling Counselors

The next topic concerns the importance of certified gambling counselors and the need for better training and screening for gambling disorders in the substance use field. Maureen stresses that people with gambling disorders need a counselor who is knowledgeable in this specific area, just as someone with heart issues would seek out a cardiologist. Tana explains that while there are similarities between substance use disorders and gambling disorders, there are also vast differences and specific training is necessary for counselors to diagnose and treat gambling disorders effectively. Diagnosing a gambling disorder differs from diagnosing a substance use disorder, as it requires meeting four out of nine criteria. In contrast, a substance use disorder requires meeting two out of 11 criteria.

Screening for Gambling Disorders

They also discuss the issue of screening for gambling disorders, with Tana pointing out that while all substance use disorder assessments are required to ask about a gambling history in Washington state, not all assessment tools are effective at doing so. It’s important to screen for gambling disorders at intake and continue to screen later on, as people recovering from substance use disorders can develop problem gambling during that period. Counselors must also be trained to help clients navigate cultural differences, as many cultures have embedded gambling practices.

The pandemic made it challenging to conduct research studies, but the task force has still managed to make progress through Zoom meetings. Jeff, Brian’s cohost, asks how receptive treatment providers are to getting trained in gambling. Tana Russel says substance use disorder counselors who attend the training are fantastic and eager to learn. However, Maureen Greeley notes that getting trainers to attend is challenging, partly because gambling disorder isn’t integrated into the overall mental health umbrella.

When people claim they don’t have any clients with gambling problems, Tana suggests asking better questions. Some counselors discover that between 22 and 25% of their clients need gambling disorder treatment by simply including gambling disorder screening. This realization can increase interest in the subject, but funding needs to follow, as reimbursement rates for gambling treatment are often lower than for substance use disorders.

Tana highlights the importance of proper screening for gambling disorders during the intake process for mental health treatment. Clients with untreated co-occurring gambling disorders may not have the best recovery rates for other issues since they aren’t treated holistically. Jeff agrees that comprehensive assessments should include screening for major addictive disorders like gambling.

Maureen points out that even mental health professionals might not be aware of gambling disorder as an addictive disorder, as listed in the DSM-5. She also emphasizes the need to revisit the traditional definition of gambling, as new issues are blurring the lines between gambling and gaming. Tana adds that it’s essential to ask clients about gambling habits in a non-judgmental and specific way.

The First Step to Seeking Help

Maureen emphasizes that the first step for someone seeking help with a gambling disorder is to contact their gambling helpline, which has a live chat and text capability, translation services, and is staffed 24/7 by trained individuals. The goal is to connect people to someone who can provide compassion and help immediately, as taking that first step to stop gambling can be difficult. The organization also hopes to offer a warm handoff in the future, where counselors and gambling recovery coaches can be on the line to connect people directly to treatment providers.

Both Tana and Maureen emphasize the importance of providing various resources to those in need, as each individual’s recovery journey is unique. They discuss the need for a holistic approach to gambling treatment and the benefits of working with various gambling support groups and treatment modalities. The conversation touches on the importance of incorporating cultural practices into recovery, as each person’s background and community play a significant role in their healing process.

When asked about the essential thing needed to help problem gamblers in Washington, Maureen explains that she would like to see several geographically located treatment facilities that offer holistic care. These facilities would provide easier access to care for urban and rural people, addressing the long travel times for those seeking help. Maureen also emphasizes the need for more treatment providers and greater awareness of the issue to secure funding and support.

Tana mentions that it would be a game-changer if Medicaid covered gambling treatment. (Medicaid is a U.S. government health insurance program providing healthcare coverage for low-income individuals, families, and people with disabilities.) Currently, Medicaid only covers substance abuse and mental health treatments. Maureen Greeley and Tana Russel aren’t sure why gambling is excluded, but they’re working with a task force in Washington State to try and increase services for problem gambling.

Evergreen strategic plan

Maureen and Tana discuss their strategic plan for addressing new areas of gambling. With sports wagering arriving in their state, the plan will focus on awareness, prevention, and responsible gaming issues. They’ve launched a responsible gaming training program called RG Starr for card rooms, tribal casinos, and their employees. Tana emphasizes the importance of training treatment providers, office staff, and others who might interact with clients.

The Evergreen Council on Problem Gambling has expanded its mission to include gaming, and they plan to launch new training in this area. They’re also working on improving clients’ “warm handoff” process. Additionally, the council has embraced digital formats for communication, such as podcasts, live streaming, and digital training. They will continue incorporating these methods in their strategic plan, and face-to-face training.

Tana then talks about their recently launched podcast, Connections Podcast Healthy Gaming and Gambling, which covers responsible gaming, recreational gaming, healthy gaming, and recovery. The podcast aims to discuss video games and gambling from various perspectives, acknowledging the merging of these two worlds. It’s a joint venture with the Oregon Council, and Julie Hynes, the Executive Director of the Oregon Council on Problem Gambling, co-hosts the podcast with Tana.

If you want to listen to the full podcast episode or many others, you find the podcast here.

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