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by Charlene Sloan
Historically, the proximity or availability of gambling opportunities - such as in Las Vegas - has increased the rate of participation. The Nevada Council on Problem Gambling recently reported planning for the treatment needs of nearly 2,000 gambling addicts. In the past year, The Salvation Army Adult Rehabilitation Program (ARP) in Las Vegas has served 800 resident substance abuse clients, 120 of whom received gambling addiction recovery services.
The ARP is geographically located in the middle of North Las Vegas¾a poor, mostly minority population area with high crime rates. Since 1987, the ARP has been the only adult treatment facility located in that area among some of the county’s poorest residents. The poverty rate in the area is 31.4 percent, according to 2005 data from the U.S. Census Bureau. In January 2002, the ARP began providing gambling addiction services to its clients.
The main facility, usually referred to as the ARP, is an 89-bed men’s residential treatment center in North Las Vegas with 24-hour controlled entry. This location provides all residential and outpatient services for gambling addicts. Female clients from the Women’s Adult Rehabilitation Facility (WARP), located nearby, are transported here to participate in services including gambling classes and support groups. The clinical staff consists of a gambling licensed program director, a clinical supervisor, one part-time certified gambling intern counselor and one full-time administrative assistant. All staff is licensed by the State of Nevada for Gambling Treatment.
Committed to restoration
The ARP assessment statistics show that approximately 20-25 percent of current residents in North Las Vegas have gambling issues that need attention. Depending on the individual, gambling is either a trigger to substance abuse relapse or a diagnosable disorder itself. The Salvation Army provides a full continuum of care meeting the needs of those who might not otherwise access services having both chemical and behavioral addictions.
Over time, the ARP has established the “typical gambling client” statistics, which include: 40-year-old male, divorced or never married, obtained high school diploma or GED, currently unemployed, average debt of $17,846, and average material loss of $187,567. Of their clients, 41 percent face legal issues and 37 percent have been imprisoned in the past. Their mode of gambling includes 23 percent slots, 19 percent video poker and 16 percent table cards. The majority of participants report this is their first and only attempt at treatment for their gambling addiction. Eighty percent claim residence in Southern Nevada. In addition, approximately 20-25 percent of current residents have a co-occurring substance abuse or a separate independent diagnosable disorder.
The facility is operated without regard to race, color, national origin, sex, age (over 18), sexual preference, religion, financial condition, chemical of choice or the progression of the disease. Our commitment is to treat the addict professionally with care, respect, responsibility and knowledge. Our goal is to restore him or her to productive living in the community.
Structure for healing
While on the waiting list for entry to the ARP, applicants are offered outpatient services. All clients are screened and formally assessed for gambling disorders using the South Oaks Gambling Screen and the Gamblers Anonymous Twenty Questions to determine levels of need. Tests are also given to ascertain motivation for change at intake, at each phase of treatment and at completion of the treatment episode.
The recovery program is content and structure-dependent, but tailored for the individual client by the development and implementation of an individual treatment plan. Our programs rely on the 12-step programs for their structure and content. The program utilizes educational classes, groups, work therapy, recovery fellowships and individual counseling to ensure a lifetime program of 12-step sober and gambling-free living.
The agency uses a general therapeutic cognitive/behavioral approach with much emphasis placed on the rational emotive therapy process. The environment¾with its rules, regulations and expected conformity¾supports behavioral modification theory. Individual and group sessions focus on distorted thinking and mistaken beliefs as causative factors in the adverse consequences causing the client’s pain and suffering. Our counselors focus on the “here and now” with acceptance of responsibility for individual actions. All of this is compatible with the 12-step program philosophy.
Residential clients also participate in work therapy. While some work therapy schedules may vary, most involve five days per week, eight hours a day. Positions support the daily collection of donations, the repair or refurbishment thereof, and the preparation for sale through The Salvation Army thrift stores. Work therapy provides a time structure for the day and an opportunity to practice self-discipline, to gain self-respect, to learn how to accept personal responsibility and to contribute as a team member. One of the most important goals of work therapy is the building of trusting relationships that foster an ability to work with others. Work assignments conclude with time allocated for personal hygiene, relaxation and the evening meal prior to the beginning of the program’s evening activities.
Instruction for living
Classroom instruction focuses on identification and acceptance of the crisis or presenting problem, recognizing the need for help, turning to that help, and making a commitment to that help. Classes are offered four times each week for 50 minutes. Middle recovery focuses on the fact that addiction produces functionally independent, gambling centered dispositions, attitudes, habits and behaviors, thus requiring a radical reorientation of life. These character defects or self-destructive personality traits are identified, defined, removed and replaced. The latter recovery focuses on values clarification, relapse prevention and the learning of new positive habits based on conscious, rational choices. It is also the initial preparation for return to the community and, as such, studies the impact of relationships, the acquisition of needed social skills and self-support through the seeking, obtaining and keeping of adequate employment.
After class each day, all clients participate in a group therapy session. Group focus is not only on the dependency problem but also on the living problems that remain after abstinence has begun. These sessions normally last one hour, four nights each week and provide additional substance for the class sessions. Each client receives at least one hour of individual counseling during every program week.
A variety of supporting activities are scheduled, including in-house Alcoholic, Narcotic and Gamblers Anonymous meetings, Nicotine Dependency Treatment, and study periods. Days are purposely structured to be full thereby minimizing free time and maximizing exposure to positive influences.
- Charlene Sloan is the supervisor for gambling counseling at The Salvation Army Adult Rehabilitation Program in Las Vegas, Nevada.
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