The Advocate Magazine 2022 Issue 1 | Page 13

In my years as a counselor and now a counselor educator , I rarely thought about problem gambling as a significant addiction — or an addiction at all . I focused on clients who presented with “ traditional ” disorders , like depression , anxiety , trauma , and a host of other diagnoses . It wasn ’ t until a colleague asked me to serve on the Rhode Island Council for Problem Gambling that I realized the extent to which this hidden disorder impacts problem gamblers and their families .

Gambling Disorder , listed in the DSM – 5 as a non-substance related disorder ( 312.21 ), is a “ persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress .” Five pages of the DSM-5 are dedicated to the diagnosis , prevalence , development and course , risks , cultural and gender-related issues , comorbidity , and more . We clinicians often miss this diagnosis , due to lack of education , understanding , or insight . Despite being an invasive , significant disorder , Gambling Disorder is frequently overlooked and / or omitted in intake assessments .

Cheryl Almeida , PhD , is the director of the master ’ s-level Clinical Mental Health and Addiction Counseling programs at Johnson & Wales University in Providence , RI . She has a doctoral degree in Developmental and Educational Psychology from Boston College and has been a full-time faculty member in the Counselor Education program since 2011 , where she has been integral in developing and facilitating the MS in Counseling degree programs . She has worked as a case manager in a rehabilitation facility , a vocational rehabilitation counselor , and an administrator before returning to her first love — teaching . A faculty member teaching psychology and counseling courses at JWU since 1995 , Dr . Almeida is an active member of AMHCA , the American Counseling Association , and the Association for Counselor Education and Supervision ( ACES ).

In my experience , clinicians rarely encounter problem gambling as a primary diagnosis . Often the gambling problem is comorbid with more of the “ traditional ” disorders listed above . Recently , federal and state initiatives focusing on treating the problem gambler have provided many resources to educate clinicians , families , and the public on this insidious disorder . Resources — such as links to Gam-Anon meetings , articles and brochures , information on criteria for problem gamblers ; testimonials from recovered gamblers , FAQs , and even assessments — are available through the national , regional , and state councils on problem gambling .

In addition , training and educational programs have been developed to certify clinicians to diagnose and treat the problem gambler . Just two examples : the International Gambling Counselor Certification Board www . igccb . org / certifications offers certification programs , and a free , eight-module series of courses on treating problem gambling ( that provides CEs ) is hosted by the Oregon Health Authority Problem Gambling Services and the Oregon Council on Problem Gambling ( available via bit . ly / 3xfYXmL ).

The “ prevalence of gambling problems in the general population is likely to be significantly larger than generally thought ,” according to an article in the October 2019 issue of Journal of Gambling Studies . The researchers argue that survey selection bias has resulted in an artificially low estimate of the prevalence of problem gambling in the United States — 1.3 percent — when it is actually 7.7 percent ( bit . ly / 3tMwClR ).

CHALLENGES FACED BY THE FAMILIES OF PROBLEM GAMBLERS

While the needs of the problem gambler are being better identified through academic research , what about the families of the problem gambler ? How do they navigate the host of issues related to living with a problem gambler ? Problem gamblers become expert at hiding the disorder , at lying , at “ robbing Peter to pay Paul .” When at last they are outed , the ramifications for the problem gamblers — as well their family members — are devastating .

Gambling problems affect the core foundation of the family unit by :

• Disrupting the functioning of family and intimate relationships , including partners as well as children , parents , siblings , and grandparents .

• Causing impaired family relationships , emotional problems , and financial difficulties ( three of the most common impacts on family members of people who have gambling problems ). continued on page 14 The Advocate Magazine 2022 , Issue # 1 American Mental Health Counselors Association ( AMHCA ) www . amhca . org

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