Someone needs to talk to you

You may be the person’s GP, or their care co-ordinator in a mental health service, or a key worker in a drug or alcohol service. You may also be someone offering advice with finances, housing, employment or a student counsellor.

You know that the person participates in gambling and suspects that it has gotten out of control. The signs are there: reports of financial problems, debts, family tensions and arguments, stress, difficulties at work or with studies, days off sick and unexplained absences, impending court cases, poor sleep and appetite, drug and, or, alcohol misuse, anxiety, depression and thoughts of suicide.

You reflect back on the pattern of events you have observed with concern (“This must be difficult for you…”) and raise a question as to whether they are linked to gambling. The person may not be willing to admit they have a problem yet, not even with further probing. However, you have created an open door. When the person is ready and wants to talk, they can approach you as a ‘trusted’ professional in whom they can confide in.

Alternatively, the person may be struggling with their gambling and want to talk. They may not have told family members because of shame, fear of recrimination, loss of trust if they reveal the full extent of their debts, and guilt and remorse about the impact that their gambling is having on others. Or, their gambling may have already led to broken relationships. Experiencing these emotions can be overwhelming and the person may not be able to think or say clearly what is going on. You can help them identify their worries and discuss the options for help and support available to them.

Your approach

It is helpful if you:

  • Talk about gambling in practical, everyday terms.
  • Maintain a non-judgemental and compassionate approach towards the individual and their specific circumstances.
  • Explore reasons for change with the person through reflection, reframing and inviting new perspectives (and avoid arguing or confrontational approaches which provoke defensiveness and resistance).
  • Instil a realistic sense of hope that with the right help and support, things can get better.

Screening questions

If the person is worried that gambling has taken over their life and is creating serious problems, answering the following PGSI questions may help.

If the person has scored 4 points or more, they are likely to benefit from a gambling treatment service.

This short self assessment is taken from the Problem Gambling Severity Index (PGSI)

When you think of the past 12 months, how often…

1. Have you bet more than you could really afford to lose?
2. Have you felt people criticised your betting or told you that you had a gambling problem, regardless of whether or not you thought it was true?
3. Have you felt guilty about the way you gamble, or what happens when you gamble?

Gathering further information

It is helpful if you can check out with the person:

  • How long they have been gambling, when they started to be worried by it and the reasons why.
  • Other problems they consider to be linked to their gambling; such as debt, depression, and using alcohol to cope.
  • Safety issues – risks of self-harm and/or harm to other people, and actions to take.
  • What their overall aims are – whether they want to limit or stop their gambling and the benefits they anticipate from this. [Note: Controlled gambling is difficult to maintain because of the ease with which loss of control can occur].

Discussing options

If the person has scored under 4 points with the screening questionnaire and is concerned about their gambling and wants to change, you can direct them towards the self-help resources on our website.

Alternatively, the person may decide that now is the time to seek outside help for their gambling.

You can discuss the offer from the West Midlands Gambling Harms Clinic here.

Our service is delivered by Inclusion, which is part of the Midlands Partnership NHS Foundation Trust. It offers free, confidential and specialist treatment and recovery for problem gambling for people aged 18 years and over and registered with a GP in Stoke-on-Trent, Staffordshire, Telford and Wrekin, Shropshire, Birmingham, Solihull, Black Country, Coventry, Warwickshire, Herefordshire and Worcestershire.

You can find details on how to refer the person, with their consent, here.

If, for any reason, the person does not feel an NHS service will work for them, you can discuss other options for help with them through the NHS website.

Additional help required

The person may need help with other problems that are linked to gambling, to support positive outcomes.

The West Midlands Gambling Harms Clinic can offer brief (1 to 3 sessions) interventions with some of these. However, if intensive or longer-term support is required, referral or signposting to another service and integrated care would be a preferred approach. For instance, referral to a local Increasing Access to Psychological Therapies (IAPT) service for depression or anxiety-related conditions.

For more information, contact us.

External support

There are also many services providing advice and support to help manage the impact of problem gambling and gambling addiction, such as debt, housing, legal or relationship advice, mental health and drug and alcohol services. Take a look at our recommended support sites below.

For more information on services that are available in your area, visit your local authority or CCG website.

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