Reflecting on Recovery with Christopher Kennedy Lawford

In the closing session of the 7th annual NCRG Conference on Gambling and Addiction, Christopher Kennedy Lawford admitted that, in writing his memoirs, Symptoms of Withdrawal: A Memoir of Snapshots and Redemption, his primary goal was to kick-start a writing career. What he didn’t anticipate was that the book would become a pathway to advocacy, a course he says he now embraces in a pursuit to help people like him who have struggled and continue to struggle with addiction.

Speaking to a room packed with conference attendees, Lawford shared his experiences both as a member of a famous family and as a person addicted to and in recovery from addictions to drugs and alcohol.

“Addicts are not bad people doing bad things who need to be handled in the criminal justice system,” Lawford said, reminding the audience that addiction is a chronic illness that needs to be treated.

While Lawford never suffered from gambling addiction, he made the connection between his experiences and those of gambling addicts by explaining that “addicts and alcoholics are all running away from something, we just choose different colored sneakers.”

To describe how important it is for addicts to seek outside help to turn their lives around, Lawford quoted Albert Einstein who said, “We cannot solve the problems we’ve created with the same type of thinking that created them.”

In addition to being a powerful message for those suffering from addiction, the quote also reminds researchers, clinicians, treatment providers, policy-makers and other stakeholders to be open and engaged in the development of new solutions to help people suffering from addiction. Lawford further emphasized that point by reminding he audience that getting someone sober is only the first step; recovery is contingent on a daily commitment to recovery. For all the stakeholders involved in problem gambling issues, Lawford’s comment can be translated into a daily commitment to reduce gambling-related harms.

Dr. Howard Shaffer closed the keynote session by noting that Lawford’s story is proof that science still has a long way to go in order to understand addiction, but that his story also serves as a powerful reminder that the ultimate purpose of the work of all stakeholders in problem gambling issues is to help people suffering from addiction.

Women and Gambling: Does Gender Make a Difference?

While conventional wisdom often implies that gender does make a difference when it comes to gambling behavior, Debi LaPlante, Ph.D., an instructor of psychology in psychiatry at Harvard Medical School, reminded participants in today’s opening session that it’s important to examine what we think we know to be true to ensure it actually is.

With that tenet in mind, LaPlante and her colleagues from the Division on Addictions sought to explore gender’s role in gambling addiction with their research of individuals participating in the Iowa Gambling Treatment Program. The research team chose to focus specifically on gender’s role in the progression of a gambling disorders and choice of games.

In the case of disorder progression, LaPlante and her colleagues discovered that gender is an important predictor of disorder progression in treatment-seekers, but that the effect of gender on gambling problem trajectory is only a small part of the whole picture. In fact, their findings suggest that other psychosocial characteristics contribute as much or more than gender in the progression of the disorder within individuals. LaPlante emphasized that these other factors deserve at least as much weight as gender in prevention and treatment efforts.

With regard to game choice, the researchers found that gender doesn’t hold as much unique discriminatory power for distinguishing gambling preferences as many have thought. LaPlante pointed out that the factors providing essential distinguishing information for gamblers who prefer specific games were personal demographic, economic and health-related profiles.

LaPlante, and her fellow panelist, seminal women and alcohol researcher Dr. Sharon Wilsnack, maintained that there are definitely differences between men and women when it comes to gambling disorders and alcohol abuse. However, LaPlante emphasized that it’s imperative for treatment providers and others to avoid the tendency to over-generalize the importance of any one specific demographic characteristic, such as gender. Over-generalization, LaPlante said, values simplicity at the cost of precision in the identification of individual preferences, risk factors and tendencies related to gambling.

NCRG Conference: Day 3 At-A-Glance

The 7th annual NCRG Conference on Gambling and Addiction concludes today, but be sure to join us for today’s sessions and special events.

Plenary Session:
8:30 – 9:30 a.m. – Women and Gambling: Does Gender Make a Difference?
Moderator:
Christine Reilly, Executive Director, Institute for Research on Pathological Gambling and Related Disorders
Presenters:
Debi LaPlante, Ph.D., Instructor of Psychology in Psychiatry, Harvard Medical School
Sharon Wilsnack, Ph.D., Chester Fritz Distinguished Professor, Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences
Location:
Tropical Room


Keynote Address:
9:30 – 10:30 a.m. - Symptoms of Withdrawal: Reflections on Addiction and Recovery
Introduction:
Howard J. Shaffer, Ph.D., C.A.S., Associate Professor of Psychology in Psychiatry, Harvard Medical School and Director, Division on Addictions, Cambridge Health Alliance
Speaker:
Christopher Kennedy Lawford
Location:
Tropical Room

Internet Accountability: Responsible Gaming in Cyberspace

As the moderator for this afternoon’s panel on responsible gaming in cyberspace, Alan Feldman, senior vice president of public affairs for MGM MIRAGE, gave attendees a brief overview of the Unlawful Internet Gambling Enforcement Act of 2006 signed into law last month by President Bush. Among an assortment of reasons for the creation of the new law, Feldman pointed to the commonly held belief that problems that affect gambling are even worse on the Internet as one of the primary factors, but then posed the question, “Is this assumption true?”

Wolfgang Schwens, Mag. theol., M.B.A., corporate social responsibility manager at the Vienna, Austria-based Internet gaming company bwin Interactive Entertainment AG, discussed the responsible gaming practices bwin has undertaken as well as a relatively new research project his company is participating in that they hope will shed light Feldman’s question.

In 2004, bwin began a joint research project with Harvard Medical School to investigate addiction to online gambling. Currently, there is no other project like it in the field. According to Schwens, the cooperation between bwin and Harvard Medical School allows for a unique combination of theory and real-life situations that benefits scientific research and bwin’s online customers. Schwens says bwin will make the project results a “role model” for the industry, providing the early identification of addicted gamblers and state-of-the-art intervention strategies.

In the long-term, says Schwen, bwin hopes the research project will result in both partners (bwin and Harvard) to respond to questions regarding public order policy in the context of gambling addiction, research to support bwin’s notion that online gambling is a customer friendly and safe form of entertainment, the development of tested scientific models allowing bwin to observe and analyze gambling behavior, and research results that will put in place systematic measures for the protections of online gamblers who are at risk for addiction.

The company already has adopted a number of policies to minimize gambling-related harm, including self-exclusion tools, immediate account closures for customers saying they have a gambling problem, intervention strategies, company and customer determined betting limits (including a 72-hour waiting period for raising limits), internal monitoring systems to track conspicuous gambling activity, employee training programs, self-help kits and more.

“We have to walk the fine line between the customers’ responsibility and the company’s responsibility to reduce harm,” Schwens said. “We don’t think these programs are in the final stages, but they’re on their way.”

Presenting findings from a pilot section of the longitudinal study of bwin customers being conducted by Harvard Medical School, Richard LaBrie, Ed.D., put the study into context by explaining that there currently isn’t any information about online ambling and its relation to addiction. LaBrie, instructor in psychiatry at Harvard Medical School (HMS) and the associate director for research and data analysis of the Division on Addictions at the Cambridge Health Alliance, is leading the research team conducting the study.

According to LaBrie, the current body of knowledge on Internet gambling consists of small surveys of special populations, and relies largely on self-reporting and anecdotes. The new information they’re collecting in this study will begin to fill the information void by describing the actual gambling behavior over a long period of time of a large sample of European sports gamblers.

In the pilot group, the research revealed that the large majority of sports bettors wager moderately, incurring a “cost” of between two to three U.S. dollars per day they gambled. The data also showed that the “high rollers” didn’t lose as much money (8 percent stakes lost) as those betting smaller amounts (13 percent stakes lost).

LaBrie offered the following examples for future research: seek patterns of betting that are predictive of the progression to more disordered behavior; investigate the utility of company- and self-determined limits on promoting responsible gaming; study interventions that can remediate problem gambling behavior; and, identify risk factors general to disordered gambling in general and specific to the Internet environment.

LaBrie and his team currently are in the process of analyzing the data from the larger, 18-month longitudinal study of bwin’s customers, but their findings have not yet been published.

Is Pathological Gambling Hereditary?

Not exactly, says Dr. Donald Black, professor of psychiatry at the University of Iowa Carver College of Medicine, citing the fact that pathological gambling is a social construct rather than an inheritable trait. During the first Track A: Scientific and Clinical session today, Black explained that what are hereditary are certain traits, such as impulsivity and reward dependence, that may predispose an individual to pathological gambling. But, he points out, environmental triggers must be present as well in order for an individual to develop of pathological gambling, meaning that without an available way or means to gamble, a person can’t be a pathological gambler.

In his presentation, Black focused on two family studies he’s conducted that look at the occurrence of pathological gambling among family members. According to Black, a family study can tell us whether a disorder is familial; can demonstrate patterns of familial aggregation of illness, meaning it can uncover what other disorders run in the family, which therefore might tell us what a disorder might be related to, in turn giving treatment providers other specific factors and illnesses to look for in addition to problem gambling indicators. Additionally, family studies can suggest proper classification of the disorder, allowing researchers and treatment providers to better define the disorder and leading to treatment approaches focused on genetics.

Black’s research revealed that disordered gambling runs in families. Additionally, he found that substance misuse and anti-social personality disorders also tend to run in these pathological gambling families. And, in an interesting finding, Black’s research showed that the families in which pathological gambling runs are large and chaotic, a fact which Black says complicates research efforts.

Perhaps the most important reason to study the genetics of pathological gambling is that it can lead to the development of new treatments for the disorder. Contributing further to the body of knowledge on the genetics of pathological gambling, Black will build on one of his small family studies, which was funded by the NCRG, to conduct a larger study of approximately 200 families which will be funded by the National Institute on Drug Abuse.

Please visit the Institute for Research on Pathological Gambling and Related Disorders’ NCRG Conference Resource Page to view Black’s family interview study and an article from The WAGER on his research. Enter the case sensitive password: institute when prompted. You can also read the Responsible Gaming Quarterly article on Black’s research by clicking on the linked publication title.

Scientific Achievement and Outstanding Poster Awards Presentation and Luncheon

The awards luncheon began this afternoon with the presentation of the NCRG’s 2006 poster award winner. Richard LaBrie, Ed.D., an instructor of psychology in psychiatry at Harvard Medical School, bestowed this year’s honor to a team of researchers from the University of Missouri (Anna E. Goudriaan, Kenneth J. Sher and Wendy S. Slutske) for their collective work on Longitudinal patterns of gambling activities: Preliminary findings. The 16 teams of nominees in competition for the award showcased their work at last night’s welcome reception, discussing their empirical findings and research methodologies with conference attendees.

After the poster award was announced, Dr. Peter Nathan, the University of Iowa Foundation Distinguished Professor of Psychology, took the stage to award the NCRG’s Scientific Achievement Awards, now in their fifth year. Dr. Suck Won Kim, professor of psychiatry and director of the Impulse Control Disorders Clinic at the University of Minnesota Medical School, was awarded with the 2006 Senior Investigator Award. Kim is well-known throughout the research community as a pioneer in the pharmacological treatment of gambling disorders. His study of naltrexone, an anti-opioid drug typically used to dull cravings for alcohol, has shown the promise of such drugs for treating gambling disorders. The original study, funded by the NCRG in 1998, has been expanded with a grant of $464, 463 from the National Institute on Drug Abuse.

“Some years ago I received a grant from the NCRG for my naltrexone research thanks to Christine Reilly and Dr. Howard Shaffer,” said Kim. “At the time I was struggling and the seed money I received from the NCRG helped me to conduct all of my research. Without them and the organization, none of this would have been possible.”

Dr. Rina Gupta, unable to attend the awards luncheon, accepted honors for the 2006 Young Investigator Award via video. Gupta, co-director of the International Centre for Youth Gambling Problems and High-Risk Behaviors and assistant professor of school/applied child psychology at McGill University, is an accomplished scientist who has advanced the understanding of gambling disorders among children, adolescents and college-aged populations. Her research has led to important implications for intervention, prevention and social policy, and she has received international recognition for her expertise, sitting on the board for the South African Responsible Gambling Trust and consulting with the government of Singapore on the establishment of gambling prevention programs.

Recipients of the awards were selected by an independent committee of distinguished leaders in the in the field of addictions and gambling research, chaired by Joseph Coyle, the Eben S. Draper professor of psychiatry at Harvard Medical School.

Coverage of Morning Plenary Sessions: Helplines, Natural Recovery

Making the Call: How Can Helplines be More Helpful?

Christine Reilly, executive director of the Institute for Research on Pathological Gambling and Related Disorders, kicked off this morning opening plenary session, Making the Call: How Can Helplines be More Helpful?, with a quick overview of the helplines that currently exist in the U.S., including what they cover, what kind of services they offer and how they offer those services.

Peter Bensinger, president & CEO of Bensinger, DuPont & Associates, a company that operates a number of helplines throughout the country, and J. Michael Ryan, executive director of the Missouri Gaming Association, whose organization funds the Missouri problem gambling helpline, followed Reilly's overview with specific examples from the helplines they're involved with.

According to Bensinger, the most important factor in the success of a helpline is making sure it's not a secret. In addition to ensuring a high level of availability and awareness (through publicizing it in a variety of ways), the helpline's services have to be able to accommodate both a large number of callers and callers who speak a variety of languages with live counselors, Bensinger says. He also strongly encourages referring callers to Gamblers Anonymous (GA), as data collected by his company indicates attendance at GA meetings was a common factor among callers who stopped gambling.

To be truly effective, Bensinger believes helplines need to provide immediate, live response (no answering machines); a deep staff of qualified, masters degree level counselors so that no one is put on hold; the ability to handle calls in multiple languages; accurate, in-depth data collection and reporting; extensive knowledge of available treatment resources near the caller; a solid relationship with the local GA chapters; familiarity with state and federal legislative and executive processes so the helpline can better understand and encourage government funding; briefings to the gaming board, industry and the public; the ability to conduct training and research, including providing information to researchers; and, financial stability and credibility.

Ryan echoed Bensinger's emphasis on the importance of a well- and diversely-publicized helpline, citing statistics from the Missouri helpline in which 67 percent of callers found the helpline number on their players cards, a wallet-sized card required by the state of Missouri for patrons to enter a casino gaming facility. Ryan also pointed out that the helpline is the gateway to other programs run by the Missouri Alliance to Curb Problem Gambling, a partnership of state and private agencies that includes the Missouri Gaming Commission.

All the panelists acknowledged there is a lack of research on how effective helplines are, in part, perhaps, because there are no national standards for helplines and the goals of some helplines are different, with certain helpline focusing on providing information and other going a step further and providing treatment.

"If all we're doing when people call is telling them where the GA meeting is or referring them to a care provider, we're missing an important opportunity to help," Bensinger said.

Additionally, all agreed that facilitating and promoting more research on helpline outcomes will be important to defining future improvements helplines can make to ensure their effectiveness.


Getting Well on Your Own: New Research on Natural Recovery Among Disordered Gamblers

Immediately following the opening plenary, Dr. Wendy Slutske, associate professor of psychology at the University of Missouri-Columbia, shared with a diverse audience her research on natural recovery among pathological gamblers. As reported in the pre-conference post on this session, Slutske found that approximately one third of pathological gamblers recover without seeking or accepting formal treatment. Slutske further clarified her definition of natural recovery by explaining that the pathological gamblers she characterized as experiencing natural recovery may have calsubstantialbstantialbstansial support from family and friends, but they didn't attend GA meetings or meet with a mental health or counseling professional about their problems

Among the most interesting outcomes of Slutske's research is that that pathological gambling does not always follow the chronic and persisting course the disorder is assigned under the DSM IV, the "diagnostic bible" for psychiatric disorders.

Slutske laid out five insights about natural recovery for the audience: first, that reducing gambling may not always be a deliberate choice; the fact that someone recognizes he or she has a gambling problem is not the same as that person having a clinically diagnosable pathological gambling disorder; recovery does not require abstinence; intentional natural recovery involves many of the same strategies used in formal treatments; and lastly, that there are individual differences that can determine who can achieve natural recovery, but there isn't yet enough data to know what makes someone a good candidate.

Slutske also offered some ways natural recovery can be incorporated or addressed in practical applications. She said that just being told that there are people who do get better can help people currently struggling with disordered gambling. She also encouraged the use of treatment strategies that promote moderate solution, for example controlled gambling outcomes and exclusion programs that last for perhaps a one year period rather than a blanket, lifetime exclusion.

These moderate solutions are particularly important for people who don't identify with the stereotyped picture of a problem gambler. Slutske stressed it is important that counselor and helplines don't just offer referrals, but that they also promote self-recovery. She also encouraged stakeholders to create a different public picture of problem gamblers, not the dark pictures currently promoted, to help raise public awareness and help people with gambling problems to be more comfortable in identifying with and recognizing themselves as problem gamblers.

Please visit the Institute for Research on Pathological Gambling and Related Disorders' NCRG Conference Resource Page for Slutske's full study and articles on her research from The WAGER. Enter the case sensitive password: institute when prompted. You can also read the Responsible Gaming Quarterly article on Slutske’s research by clicking on the linked publication title.

NCRG Conference: Day 2 At-A-Glance

The 7th annual NCRG Conference on Gambling and Addiction continues today with a full schedule. Here’s a quick look at the sessions and special events happening today.

Plenary Sessions:
9 – 10 a.m. - Making the Call: How Can Helplines Be More Helpful?
Moderator:
Kathy Scanlan, Executive Director, Massachusetts Council on Compulsive Gambling
Presenters:
Peter Bensinger, President & CEO, Bensinger, DuPont & Associates
Christine Reilly, Executive Director, Institute for Research on Pathological Gambling and Related Disorders
J. Michael Ryan, Executive Director, Missouri Gaming Association
Location:
Penn & Teller Theater

10 – 11 a.m. - Getting Well on Your Own: New Research on Natural Recovery Among Disordered Gamblers
Moderator:
Ken Winters, Ph.D., Professor of Psychiatry and Director, Center for Adolescent Substance Abuse Research, University of Minnesota Medical School
Presenter:
Wendy Slutske, Ph.D., Associate Professor of Psychology, University of Missouri-Columbia
Location:
Penn & Teller Theater

4:30 – 5:30 p.m. - Dealing with Disordered Gamblers: What are the Boundaries of Responsible Gaming?
Moderator:
Phil Satre, Chairman, National Center for Responsible Gaming
Presenters:
Pieter Remmers, Managing Director, Jellinek Consultancy
David Stewart, Partner, Ropes & Gray
James Whelan, Ph.D., Associate Professor of Psychology, Director of the Psychology Training Clinic and Co-Director of the Gambling Clinic, University of Memphis
Location:
Penn & Teller Theater


Track A: Scientific and Clinical
11:30 a.m. – 12:30 p.m. - Runs in the Family: New Research on Genetic Links of Disordered Gambling
Moderator:
Ken Winters, Ph.D., Professor of Psychiatry and Director, Center for Adolescent Substance Abuse Research, University of Minnesota Medical School
Presenter:
Donald Black, M.D., Professor of Psychiatry, Carver College of Medicine, University of Iowa
Location:
Tropical Room

2 – 3 p.m. - How Research Informs Clinical Practice: New Research on Gamblers Anonymous and Cognitive Behavioral Therapy for Gambling Disorders
Moderator:
Lisa Najavits, Ph.D., A.B.P.P., Professor of Psychiatry, Boston University School of Medicine; Adjunct Faculty Member, Harvard Medical School; Director, Trauma Research Program, McLean Hospital
Presenter:
Nancy Petry, Ph.D., Professor of Psychiatry, University of Connecticut Health Center
Location:
Tropical Room

3 – 4 p.m. - The Heart of Addiction: A New Approach to Disordered Gambling Behavior
Moderator:
Lisa Najavits, Ph.D., A.B.P.P., Professor of Psychiatry, Boston University School of Medicine; Adjunct Faculty Member, Harvard Medical School; Director, Trauma Research Program, McLean Hospital
Presenter:
Lance Dodes, M.D., Practicing Psychiatrist and Psychoanalyst, and Assistant Clinical Professor of Psychiatry, Harvard Medical School
Location:
Tropical Room


Track B: Government and Industry
11:30 a.m. – 12:30 p.m. - Global Gaming, Part 2: Three Continents’ Approaches to Responsible Gaming
Moderator:
Jennifer Shatley, Program Vice President, Code of Commitment, Harrah’s Entertainment, Inc.
Presenters:
Peter Dean, Chairman, U.K. Gambling Commission
Clive Keegan, Research Manager, South African Responsible Gaming Programme
Pieter Remmers, Managing Director, Jellinek Consultancy
Location:
Palma Room

2 – 3 p.m. - Internet Accountability: Responsible Gaming in Cyberspace
Moderator:
Alan Feldman, Senior Vice President, Public Affairs, MGM MIRAGE
Presenters:
Richard LaBrie, Instructor in Psychiatry, Harvard Medical School and Associate Director for Research and Data Analysis, Division on Addictions, Cambridge Health Alliance
Wolfgang Schwens, Mag. theol., M.B.A., Corporate Social Responsibility Manager, bwin Interactive Entertainment AG
Location:
Palma Room

3 – 4 p.m. - The Real Costs: How to Effectively Measure Social and Economic Impacts
Moderator:
Alan Feldman, Senior Vice President, Public Affairs, MGM MIRAGE
Presenters:
Kate Spilde Contreras, Ph.D., Visiting Scholar and Managing Director, Center for California Native Nations, University of California, Riverside
William Eadington, Ph.D., Professor of Economics and Director, Institute for the Study of Gambling and Commercial Gaming, University of Nevada, Reno
Douglas Walker, Ph.D., Associate Professor of Economics, Georgia College and State University
Location:
Palma Room


Special Events
12:30 – 2 p.m. - NCRG Scientific Achievement and Outstanding Poster Awards Presentation and Luncheon
Sponsored by International Game Technology
Location:
Brasilia Ballroom

Global Gaming, Part 1: Asian and Australian Approaches to Responsible Gaming

The recent rapid growth of the gaming industry in Asia has been accompanied by increased interest in responsible gaming practices and policies targeting Asian populations. This afternoon’s session, Global Gaming, Part 1: Asian and Australian Approaches to Responsible Gaming, sought to shed light on the existing responsible gaming practices in Asia as well as those being implemented in Australia.

In his presentation, Ivan YIU, head of the Youth and Family section and Coordinator of Addiction Counseling Services at the Tung Wah Group of Hospitals in Hong Kong, examined the meaning of gambling in Chinese culture and the implications it has for prevention and treatment. YIU pointed out that Asian people generally are regarded as liking gambling more than people from Western cultures, and that research shows countries with primarily Chinese populations have a higher prevalence rate of pathological gamblers than other places in the world.

YIU identified some of the cultural characteristics of Chinese gamblers, which included the knowledge that gambling is a socially recognized way of making money in Chinese culture, a strong belief that intuition and inspirations will help winning and a strong illusion of control in gambling, which is aggravated by cultural beliefs of supernatural factors like “Fate,” “Luck” and “Feng Shui.” YIU also pointed to the fact that Asian families often are more willing to pay off debts of gambling family members.

These characteristics have an important influence on the types of responsible gaming programs that are created and implemented in Asian populations, YIU said. To best fit the needs presented by these cultural characteristics, Asian community prevention efforts include education about the probability of winning in different forms of gambling activities, education about alternative ways to relax and cope with stress, education on assertive skills relating to dealing with peer pressure and more. Similarly, Asian treatment efforts include the development of culturally sensitive screening tools, such as the newly created Chinese G-MAP, which differs from Western tools in that it puts more focus on the family environment rather than just on the individual; relapse prevention by paying attention to high-risk occasions such as Chinese New Year, and cognitive therapy that takes into account cultural and supernatural beliefs.

The need to adjust responsible gaming education tools for Asian population was echoed by Scott Ross, director of government relations for the Las Vegas Sands Corporation. Las Vegas Sands opened the first U.S.-owned casino in Asia, the Sands Macao, in May 2004 and will be opening the Venetian Macao next year. In some of its recent responsible gaming education efforts, Ross explained that the company has had to adjust its programs to ensure they are tailored to the cultural needs of their Asian employees and customers. These adjustments range from translating acronyms so they make sense in the new language to adjusting the premises and values upon which the education efforts are based.

Ross stressed that the key to any good responsible gaming program is partnerships with the health sector, the government and other key stakeholders. Las Vegas Sands’ Asian responsible gaming program will include a responsible gaming policy and mission statement, the implementation of a responsible gaming committee, a self-exclusion program, staff training and education sessions conducted by fellow staff members and partnerships with health and government groups.

In addition, Vicki Flannery, a gaming industry consultant and the first CEO of the Australian Gaming Council, offered some history and insights on responsible gaming strategies in Australia, including the emerging trends in current strategies. These trends include a continued call for tough measures with regard to the advertising and restrictions surrounding gaming, loss limit and pre-commitment measures, community awareness and education, school programs, financial literacy counseling and the continued measurement of treatment effectiveness. She pointed out that policy issues surrounding responsible gaming remain a “hot issue,” but that there has been some trend to a public health model, which focuses on the collaboration of myriad stakeholders and helping consumers make an informed choice, in some Australian states. Additionally, Flannery said the industry really has improved its performance in the realm of responsible gaming over the past five to six years.

Opening Plenary: Gambling Research: What We Know and What We Need to Know for "Best Practices"

In today’s opening plenary session, Gambling Research: What We Know and What We Need to Know for "Best Practices," Dr. Howard Shaffer set the tone for the 7th annual NCRG Conference on Gambling and Addiction by identifying some of the obstacles that exist in the process of taking solid scientific research and turning it into best practices for the treatment and prevention of gambling addictions, as well as discussing the trends in disordered gambling research over the past 100 years.

According to Shaffer, the process of translating research to practice is very complex, involving a number of steps in which clinicians, researchers, industry advocates and patients can “get lost” (i.e. drop out) of the process. With this in mind, Shaffer stressed how important it is for all those involved in the prevention and treatment of gambling disorders to focus on the ultimate goal of research and practice: to prevent, reduce and ameliorate addiction-related suffering. During this session, Shaffer used treatment to cover a broad range of generic treatment activities, ranging from clinical and counselor facilitated programs to responsible gaming practices and public policy.

Shaffer identified a number of obstacles to achieving the ultimate objective including the willful disregard for the ultimate objective by research proponents and critics alike, the natural debates among researchers and clinicians that are corollary to the translation process, and the fact that some treatment providers already think they know the best practices despite having little or no evidence. In a youthful field like disordered gambling research, each of these obstacles is dangerous for the development of best practices, Shaffer said.

In the study Trends in Gambling Research: Quantifying, Categorizing, and Describing Citations, Shaffer and his colleagues examined the growth of knowledge in the field of gambling studies by examining the literature published between 1903 and 2003. Their study found that the growth of gambling studies has been exponential, with 97 percent of gambling-related articles having been published since 1963, and 33 percent of all gambling-related citations being published between 1999 and 2003. The most popular topics explored in gambling studies citations have been pathology, risk-taking, decision-making and addiction. Additionally, between 1999 and 2003, studies addressing epidemiology, drug abuse, comorbidity and neuroscience have become increasingly prevalent. According to Shaffer, these findings imply there is a trend toward placing gambling in a larger context to understand not only the behavior, but also the behaviors and factors that surround it.

Before closing, Shaffer encouraged treatment providers to not let patients get lost in translation. He stressed that patients must be treated with compassion, empathy and respect as part of the treatment process. To illustrate his meaning, Shaffer offered case studies from his Expressions of Addictions project, which is a collection of photographs and mini biographies of people who have suffered from addiction at any time in their lives.

To access Dr. Shaffer’s study on trends in gambling research, click here, or visit the Institute for Research on Pathological Gambling and Related Disorders’ NCRG Conference Resource Page. When prompted, please enter the case-sensitive password: institute.

NCRG Conference: Day 1 At-a-Glance

The 7th annual NCRG Conference on Gambling and Addiction kicks-off today at 2 p.m. Here’s a quick look at the sessions and special events taking place this afternoon.

Plenary Sessions:
2 – 3 p.m. - Gambling Research: What We Know and What We Need to Know for “Best Practices”
Moderator:
Phil Satre, Chairman, National Center for Responsible Gaming
Presenter:
Howard J. Shaffer, Ph.D., C.A.S., Associate Professor of Psychology in Psychiatry, Harvard Medical School and Director, Division on Addictions, Cambridge Health Alliance
Location:
Penn & Teller Theater

3 – 4 p.m. - What Happens When We Ignore Science? Risks to Public Policy and Public Health
Moderator:
Linda Cottler, Ph.D., Professor of Epidemiology, Department of Psychiatry and Director of the Epidemiology and Prevention Research Group, Washington University School of Medicine in St. Louis
Presenters:
Bo Bernhard, Ph.D., Assistant Professor in the Departments of Sociology and Hotel Management, University of Nevada, Las Vegas
Peter Nathan, Ph.D., University of Iowa Foundation Distinguished Professor of Psychology
Douglas Walker, Ph.D., Associate Professor of Economics, Georgia College and State University
Location:
Penn & Teller Theater


Track A: Scientific and Clinical
4:30 – 5:30 p.m. - Speaking the Language: Cross-Cultural Issues in Treating Pathological Gambling and Related Disorders
Moderator:
Linda Cottler, Ph.D., Professor of Epidemiology, Department of Psychiatry and Director of the Epidemiology and Prevention Research Group, Washington University School of Medicine
Presenter:
Nolan Zane, Ph.D., Professor of Psychology and Asian American Studies, University of California, Davis
Location:
Tropical Room


Track B: Government and Industry
4:30 – 5:30 p.m. - Global Gaming, Part 1: Asian and Australian Approaches to Responsible Gaming
Moderator:
Bo Bernhard, Ph.D., Assistant Professor in the Departments of Sociology and Hotel Management, University of Nevada, Las Vegas
Presenters:
Andy Abboud, Director of Government Relations for the Venetian, Las Vegas
Vicki Flannery, Gambling Industry Consultant, First CEO of the Australian Gaming Council
Ivan YIU, M.Soc.Sc., P.C.Ed., C.G.C., R.S.W., Head of the Youth and Family Section and Coordinator of Addiction Counselling Services, Tung Wah Group of Hospitals
Location:
Palma Room


Special Events
5:30 – 7 p.m. – Poster Session and Reception
Location:
Brasilia Ballroom

Women and Gambling: Does Gender Make a Difference?

Past gambling research suggests that disordered gambling is more prevalent among men than among women. Recent studies have observed that women are now as likely to have gambled within the past year as men. We are now seeing new investigations focused on how gender differences might influence the development and treatment of the disorder. Do women with gambling problems and other addictive disorders have a unique experience compared to men?

In the plenary session Women and Gambling: Does Gender Make a Difference?, Drs. Debi LaPlante and Sharon Wilsnack will discuss these questions using the findings about women and addiction they each have found in their own research.

Dr. Wilsnack will provide the historical context for understanding women and addiction. Her groundbreaking research has focused primarily on alcohol use disorders and problem drinking in women, includinga a 20-year national longitudinal study of U.S. women (the National Study of Health and Life Experiences of Women [NSHLEW]), in which the investigators re-interviewed the same women at five-year intervals between 1981 and 2001 (about 1600 women in total). During the session, she will share some the findings from the NSHLEW, including some of the risk factors for problem drinking that were identified in the study. Research into gambling addiction in women has revealed that women with gambling-related problems seem to have some of the same characteristics as problem drinking women, as well as some of the same special treatment needs. (Click here for more information on Dr. Wilsnack’s current research.)

Dr. LaPlante, whose research has examined disordered gambling and other addictions in minorities and women, will discuss how gender operates both independently and in conjunction with other factors that predict addictive behavior. She also will discuss the gambling-related gender differences that seem to have endured, despite greater social acceptance of female gamblers, as well as gender differences that seem to be disappearing.

The Women in Gambling session is scheduled for Tuesday, Nov. 14 at 8:30 a.m. To access Dr. LaPlante’s gender-related research on problem gambling, visit the Institute for Research on Pathological Gambling and Related Disorders’ NCRG Conference Resource Page. When prompted, please enter the case-sensitive password: institute.

Global Perspectives on Responsible Gaming Practices

As the gaming industry expands into non-U.S. jurisdictions, casino companies are recognizing the importance of adapting their responsible gaming education and outreach programs to the needs of the population centers in which they are opening and operating properties. As part of its Government and Industry conference track, the NCRG’s 7th Annual Conference on Gambling and Addiction will feature a two-part series in which both research experts and industry insiders will discuss the many issues involved with international expansion and how the industry can develop culturally-sensitive responsible gaming programs.

On Sunday, Nov. 12, Global Gaming, Part 1: Asian and Australian Approaches to Responsible Gaming, will explore the challenges facing Australia, which has one of the most highly regulated gaming industries in the world. Panelists will also discuss how native and foreign companies developing new properties in Asia may have to adjust responsible gaming messages and tactics to better suit Asian employees and customers. The impressive line-up of panelists for the session includes Ivan YIU, head of the youth and family section and coordinator of addiction counseling services of Tung Wah Group Hospitals in Hong Kong, Vicki Flannery, the first CEO of the Australian Gaming Council, and Andrew Abboud, director of government relations and community development for the Las Vegas Sands Corporation.

In Global Gaming, Part 2: Three Continents’ Approaches to Responsible Gaming, which will take place on Monday, Nov. 13, cultural perspectives from the U.S., Great Britain, South Africa and Holland will be shared. Panelists will offer their views on how casinos in each country can use science to further refine and improve the effectiveness of their responsible gaming programs. They will explore which guidelines are most effective in differentiating junk science from legitimate research and which approaches resonate most among each of their unique populations. Speakers include Peter Dean, CBE, chairman of the U.K. Gambling Commission, Clive Keegan, research manager of the South African Responsible Gaming Programme and Pieter Remmers, managing director of the Jellinek Consultancy in the Netherlands.

View the conference program for session times – both sessions will be held in the Palma room.

Internet Accountability: Responsible Gaming in Cyberspace

In October, Congress passed the Unlawful Internet Gambling Enforcement Act of 2006. The law aims to choke off financial transactions related to online gambling in order to prevent Americans from gambling over the Internet. The new legislation and the discussion that have sprung up around it raise a number of legal, economic and political questions, including questions about connections between online gambling and addiction.

On the Monday of the 7th Annual NCRG Conference on Gambling and Addiction, the session Internet Accountability: Responsible Gaming in Cyberspace will examine the conventional wisdom that asserts online gambling poses a public health risk. Concerns have been raised about people who gamble alone in their homes without the social controls of other types of gambling; the allure of Internet gambling for young people; and the speed of play associated with online gambling. In fact, Rep. Robert Goodlatte has claimed that all of the risks of gambling are magnified on the Web: “There are family problems, bankruptcy problems, gambling addiction, gambling by minors…It does not help our society.”

Until now, there has been only sparse empirical research to examine these concerns. During this session at the NCRG conference, Dr. Richard LaBrie of Harvard Medical School will report on a new study of the gambling patterns of more than 40,000 sports gambling customers of bwin Interactive Entertainment AG, an online gambling company based in Vienna, Austria. It is the first study of its kind, and should shed new light onto how we view online gambling and online gamblers. Joining him on the panel will be Wolfgang Schwens, corporate social responsibility manager for bwin, who will discuss the company’s responsible gaming measures, including self-limit programs and an online self-help guide for customers worried about their gambling. Schwens also will address the challenges of implementing responsible gaming programs online and how bwin is evaluating the effectiveness of the programs it has implemented.