Factors influencing treatment-seeking behavior in female pathological gamblers, Gambling Research Center Andrea Wöhr M.A. 1
Use of Treatment Only 7% 12% of those with a history of DSM-IV pathological gambling had sought either formal treatment or attended meetings of Gamblers Anonymous (Slutske 2006: 300) Michael Loeper / pixelio.de 2
Shame and Fear of Stigmatization Stigma and shame have been identified as major barriers to help-seeking for problem gambling (Hing et al. 2016b: 32) Lucie Gerhardt / pixelio.de 3
Stigmatization of Gamblers Addictions attract high level of stigma Individuals are perceived blameworthy for their behavior Problem gambling perceived as weakness of character or lack of self-control (Hing et al. 2016b: 36-37) 4
Stigmatization and Gender Concepts of gender: Daniel Stricker / pixelio.de Risky behavior more likely to be tolerated in (young) men (Hing et al. 2016a: 264) 5
Stigmatization and Gender Women seen in dependent role: Because of historically defined gender roles for women as caregivers, nurturers, mothers, partners and homemakers, women risk being judged as irresponsible, unrespectable, incompetent and selfish if they display problem-gambling behaviours (Hing et al. 2014: 72-73) 6
Internalization of Stigmatizing Beliefs Self-stigmatization participants described feeling weak, stupid, worthless, bad, ashamed and embarrassed. Self-esteem Self-efficacy Perceived social worth Health problems Problem is kept secret (Hing et al. 2014: 73-74, Hing et al. 2016a: 264) 7
Gambling Motivation Gambling as strategy to cope with problems and/or stress High stress level Multiple disorders/(psychic) comorbidities Quality of life (e. g. problematic childhood, traumas) (Vogelgesang 2011: 117) Married female problem gamblers often have poor relationships. (Boughton 2003: 5) women [feared] that treatment would require me to give up all gambling when I don't want to (Boughton 2003: 4) 8
Life Situation Persons with main diagnosis pathological gambling (in %) not living alone 63,5 62,4 partner 59,4 55,7 living alone 33,3 34,3 child(ren) 30,2 48,7 unknown 3,3 3,3 0 50 100 parent(s) other relative(s) 9,2 5,9 7,7 29,4 females (n=1.344) males (n=9.654) other person(s) 6,1 8,6 Source: Deutsche Suchthilfestatistik 2014 (German statistics of addiction aid) 0 10 20 30 40 50 60 70 females (n=853) males (n=6.028) 9
Perception of Treatment Programmes Do treatment programmes address and appeal to women and their needs? Sensitive topics (e.g. experience of violence) need protected environment Different age group Child care 10
Factors Influencing Treatment Seeking Stigmatization (gender role) Stress (comorbidities, biography, actual living conditions) Appropriateness of treatment services Ingrid Ruthke / pixelio.de 11
List of Sources Bellringer, M. et al. (2008). Problem gambling - barriers to help seeking behaviour, Final report, 1-188. Boughton, R. (2003). A feminist slant on counselling the female gambler: Key issues and tasks. Electronic Journal of Gambling Issues 8, 1-23. Hing, N. et al. (2016a). How does the stigma of problem gambling influence helpseeking, treatment and recovery? a view from the counselling sector, International Gambling Studies, 16:2, 263-280. Hing, N. et al. (2016b). Perceived stigma and self-stigma of problem gambling: perspectives of people with gambling problems, International Gambling Studies, 16:1, 31-48. Hing, N. et al. (2014). Stigma and problem gambling: current knowledge and future research directions. International Gambling Studies, 14:1, 64-81. Holdsworth, L. et al. (2013): All Mixed Up Together: Women's Experiences of Problem Gambling, Comorbidity and Co-occurring Complex Needs. International Journal of Mental Health and Addiction, 11(3), 315-328. Rodda, S. N. et al. (2014). Improved outcomes following contact with a gambling helpline: the impact of gender on barriers and facilitators. International Gambling Studies, 14:2, 318-329. Slutske, W. S. (2006). Natural recovery and treatment-seeking in pathological gambling: Results of two U.S. national surveys. American Journal of Psychiatry, 163(2), 297-302. Suurvali, H. et al. (2009). Barriers to Seeking Help for Gambling Problems: A Review of the Empirical Literature. Journal of Gambling Studies 25, 407-424. Vogelgesang, M. (2011): Gender. In Petry, J. et al., Pathologisches Glücksspielen, Suchtmedizinische Reihe Band 6, 114-121. 12