ST VINCENT’S GAMBLING CLINIC STACKS THE ODDS IN FAVOUR OF A CURE

Australia has a long history of gambling. Our first official horse race was in 1810 at Hyde Park in Sydney; the first official Australian lottery was in 1881.

It’s estimated that more than 80% of Australian adults engage in gambling of some kind, the highest rate in the world.

And a recent report found Australians bet $242 billion in 2017-18, and lost more than $24.8 billion.

For most people gambling is not a problem, but for some it’s an addiction that ruins their lives and the lives of those around them.

Dr Kate Fennessy, a senior clinical psychologist at the St Vincent’s Health Network Sydney, and her team run a gambling addiction program that has had astounding results: up to a 95% success rate for those completing the course, since its inception in 1996.

Kate says the main thing to know is that a gambling addiction can be treated, and it’s a free, confidential service.

But with so many Australian’s affected, there is plenty of work to be done. “I have a colleague working in this area for some time who says, if an alien fell to earth in NSW and looked around to see what our culture looked like, it would have to include gambling; it’s on every street corner.”

How do you know if you gambling is a problem?

“Ask yourself, have you lied to others about your gambling, and have you bet more than you intended to,” Kate says. “It’s known as the lie-bet test, and if you answer yes to either, you may be negatively affected by your gambling.

“Another factor we look at in treatment is, do you ‘chase’. If you lose, do you go back the next day to try and win back your losses, and do you chase your wins – if you win, what happens to that money, do you put it all back through to try to win more?”

Kate says that unlike other addictions, there is currently no widely accepted drug treatment for gambling. Instead, the best treatment that we know of is a talking therapy: cognitive behavioural therapy, or CBT.

“CBT involves looking at the thoughts, feelings, urges and behaviours before, during and after gambling to break the gambling cycle and introduce new patterns which are more consistent with what the person values in life” she says.

“There are some common misconceptions and evidence about how pokies are built, and about probability that we can look at to help them challenge common gambling related thoughts or respond differently to their thoughts. Thoughts are important as they lead to actions and the consequences of those actions.

“People are sometimes in two minds about whether to cut down or stop, and we meet them where they are in terms of motivation and readiness to make a change. Supporting someone through conversations and exercises is the first line of treatment and has been demonstrated to be effective in gambling.”

The process typically involves one-on-one weekly sessions to talk through the participant’s personal situation, their thoughts, and what their urges are before, during and after gambling.

The conversations also cover practical things such as living situations, personal relationships, and how much money is coming in. “We talk about money quite a bit, as it is the life blood of gambling,” Kate says.

There may also be cause to call on other experts such as a specialist lawyer, a financial counsellor, or in some cases a psychiatrist.

“In between there are tasks such as reading or trying something new. Initially we are looking at three factors, the trifecta of money, access to venues, and what the person is doing with their time, and work on these to give the person more room to make alternative choices, as sometimes gambling feels automatic.”

Kate estimates that the St Vincent’s program has been extremely successful, and more than 1000 participants have used it to beat their problem with gambling.

“It’s very successful, but the caveat is that’s only for people who make it to the end. We have found it difficult to measure outcomes for people who drop out after the second session.

“It has been estimated that around 50% of people with drug addiction are in formal treatment at any time, 6% of people with an alcohol problem are in treatment, but it’s estimated that only around 3% of people affected by gambling seek treatment. This might be due to a number of factors, one of which is that many people affected by gambling can successfully self-manage without professional help.

“We tend to see people at the pointier end of things, who really can no longer ignore a consequence anymore. They may be about to go to court or lose their house or their relationship, or they are about to have a baby and they don’t want to be that kind of dad, for example.”

“We are also seeing younger and younger people come through too, which is good. Gambling advertising is massive for that age group, and they may also be more open to working on things earlier.”

Problematic gambling also affects others around the person who is gambling, including family and friends. The program has separate counselling for partners, children and family members affected by gambling, helping them to recover and work out how to manage. This extends to parents who may be trying to manage a son’s or daughter’s gambling.

Kate says problem gambling is not all pokies and traditional betting now.

Online gambling means sports betting is now available 24-hours-a-day. And with COVID there has been a dip in casino games – blackjack and poker – but an uptick in online trading not traditionally related to gambling.

“For example, CFD (contract for differences) trading is not considered gambling so it’s not regulated in the same way, but people can end up with huge debts.

“But most are still having problems with pokies. We have the most poker machines in the world per capita, more than Las Vegas. And we have the highest levels of harm caused by gambling in the world.”

Clients can self-refer to the Gambling Treatment Program by calling 02 8382 9601. Email: svhs.gamblingtreatment@svha.org.au