To train or not to train, THAT is the question!

I’ve been working therapeutically online, alongside face to face counselling, for around six years now providing therapeutic interventions via VOIP, synchronous and asynchronous text and over the phone.  I’ve worked with groups, one to one and supported an entire global online therapeutic community.  Believe me when I say the switch incurred a steep learning curve in the early days and I’m still learning now!

So, when I hear other practitioners saying that they’re qualified to work online because they’re qualified counsellors, therapists, psychologists or psychiatrists I break out in a cold sweat and develop a bit of a twitch!  Is it true that the BACP don’t tell you, you HAVE to undertake additional training to work on line?  Well…yes it is, but what they actually say is:

“Practitioners who offer online services need to ensure that they are suitably trained and qualified for their work and BACP recommends (Anthony, K. And Jamieson, A., 2005) that online work should be considered as a specialist area and practised only by those with extensive post-qualification experience of face-to face work. In addition, appropriate further training or professional development is strongly recommended before deciding whether to use the Internet for provision of therapy.” (BACP, October 2007)

And in my opinion we need to take their recommendation very seriously.

To work online, particularly with text, you need to find beauty and power in the words you use to sculpt your responses.  You need to be able to find the hidden meaning (where one exists) in a pause or typo and you need to enjoy creating vivid pictures, and indeed worlds, with your text.

Now….it will be of no real surprise to you that I love words :).   I’ll reread a well crafted phrase and the insights it allowed a client to reach with a sense of deep satisfaction and reflect on things I could have said differently to promote further development for the client.  There is a clarity provided by a complete transcript of a session that can’t be obtained through the subjective reflection on a face to face session that I relish.

To work online takes passion, and faith that this type of therapy works…it also takes preparation and training because you’ll feel things you didn’t know where possible, you’ll be frustrated at times and you’ll be surprised and even shocked if you haven’t done your research!

Imagine for a moment that you’re in your counselling room sitting opposite an acutely distressed client…they hold their head in their hands and clutch a tissue as tears stream uncontrollably down their cheeks.  Struggling to breath, and on the verge of the disclosure you’ve been working towards for several months, they promptly disappear…into thin air…..POOF!  How would you feel and what would your concerns be?  What would you have in place to make sure that client was safe?  Of course this doesn’t happen outside of the realms of sci-fi but when you’re working online a disconnection (deliberate or otherwise) will feel very much as I’ve described.

The considerations involved in working online are numerous they include the technology you would need to look into, a difference in the way we practice, the law, insurance issues and many other areas.  In all honesty it’s a minefield…but it’s worth it.

If you’d like to contact me to talk about the subject please e-mail me at jane.fahy@hushmail.com and if you’d like to learn more about some of the training that’s out there please go to http://onlinetherapyinstitute.com/ .

Thanks for reading 🙂

Jane Fahy (RMBACP)

 

Clinical Services Manager, Gambling Therapy

Tutor, Online Therapy Institute

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The Forgotten Friends and Family

Many organisations that work with problem gamblers focus mainly on the problem gambler themselves however, the effects on those around them can be devastating. Just take a look at how people are affected by the problem gambling of someone close to them for an idea of how much of an impact problem gambling can have on families:

The partner or husband/wife of a PG

• My PG often causes rows to give him an excuse to go out and gamble
• My wife is too busy gambling online to attend family functions
• My boyfriend no longer showers or takes care of himself in the way that he used to
• My fiancé is moody all the time and I don’t know what to say for the best
• My husband is often withdrawn and won’t talk to me about what is bothering him
• I worry about the emotional health and security of my children

The child of a PG

• I worry about the constant fights my parents have
• My dad isn’t getting any younger and I am concerned about the effect this might be having on his health
• I never seem to be able to do anything right, all I get is criticism
• My mom is embarrassing me in front of my friends with her appearance and behaviour
• I never expect anything for my birthday anymore but it hurts me when my dad forgets about his grandchildren
• We don’t spend time together anymore
• I can’t get the uniform and other things I need for school and I am being made fun of because of it

The parent of a PG

• My son is always lying to me and manipulating me so that he can get his own way
• My daughter regularly takes money from my purse and has now been caught shop lifting
• My daughter frightens me sometimes because she can become violent if I don’t give in to her
• My son can take off for days at a time and I don’t know where he is
• My son has lost his job and now I feel that I have to help him to provide for his family
• My daughter tells me that this addiction is all my fault

The friend of a PG

• My friend is always asking me for money
• My friend often lets me down when we are supposed to be going out
• My friend asks me to lie for him when anyone asks where he is or what he is doing
• My friend has stolen from me

Counselling, or otherwise supporting, the friends and family of problem gamblers often feels harder to me that supporting the gambler themselves. Each time I speak to someone new to the online service I work for I feel the same sense of powerlessness being transmitted through the Wi-Fi. I hear the same woeful cries of “If I could stop gambling FOR them I would” and the question that pulls at my heartstrings the most… “Is it my fault?”

As practitioners we have to fight through the feeling of powerlessness, there ARE ways in which friends and family can protect themselves and there are ways in which we can support them. Sometimes the most liberating thing we can say to a friend or family member is “It can happen to anyone, at any time, from any background so no, this isn’t your fault”.

Our role is to provide a safe outlet for the confusing emotions pouring out of our clients and give them the information they need to make sense of their situation. Of course the more practical advice around separating finances etc. is important but it’s secondary to the most valuable tool in our toolkit, acceptance. That might sound pretty common sense but given that problem gambling is still not widely understood, or in some cases even accepted as an addiction, those that love a problem gambler might have a battle on their hands when it comes to getting the support they need outside of their relationship with us.

In my remote training course, Counselling Problem Gamblers Using Blended Technologies, I talk more about the specifics around supporting the friends and family of problem gamblers online. You can find more information about this training course via the following link:

http://www.kateanthony.net/cpdspecials/

Thanks for reading 🙂

Jane Fahy (RMBACP)

Turtor, Online Therapy Institute

Clinical Services Manager, Gambling Therapy

Unleashing the Training Brain

I was recently called upon, by Kate Anthony CEO of the Online Therapy Institute, to empty the contents of my brain, concerning working with problem gamblers, into a platform for remote training. It’s an odd sensation trying to pick over the knowledge and experiences you’ve accumulated over six years to try and determine what information might be interesting and useful and help others to support a client group you’ve developed quite a passion for. I think part of me was initially reluctant to share too much, what if everyone started supporting problem gamblers and I had no one left to work with?!? But then I thought about that, what if many more counsellors, social workers, support workers and addiction specialists started to support problem gamblers? Surely that would mean the client group I cared so deeply for, and frequently commented there wasn’t enough support globally for, DID get more support? That’s exactly what I want! 🙂

So here I am, after weeks of wondering… “Will they want to know about this” and hunting down other online resources each time asking myself…”Will they find that useful?” I’ve finally finished writing the course content! I’ve tried to cover as many of the aspects of working online, offline or both, with problem gamblers as I could fit into a ten hour course. I feel it will give anyone with an interest in working with problem gamblers by blending face to face and online support a robust grounding in the subject.

The areas covered are:

• How do you know if someone has a gambling problem?
• The theory of problem gambling
• Working with problem gamblers
• Working with friends and family
• Online support for problem gamblers
• Gaming and internet use for problem gamblers
• Managing suicide and risk online
• Using blended technology in a face to face and residential setting

If you’re interested in helping problem gamblers and you want to know more about the course please drop me a line at the following e-mail address, I’m eager to share my passion for working with this remarkable client group with others!

If you want to learn more about online therapy in general, the Online Therapy Institute have some amazing short courses that might be of interest to you 🙂

jane.fahy@hushmail.com

 

Merry Christmas?

We’re coming up to a time of year that’s typically very tricky for problem gamblers and the people that love them. So I put together a Christmas recovery journey based on bits and pieces I’ve heard or read over the years, I hope you like it and take something from it.

Christmas Zero

Christmas creates panic….gut wrenching, soul destroying panic that steals the breath from your lungs and leaves you in a heap on the floor….paralysed. You’d managed to save a little, not a lot; to get the few things you wanted to get for the people that mattered most. You wanted to prove to them that you’re ok now and they can let you back into their lives……but the moneys gone. The urge was so strong you felt like your feet had a mind of their own and before you knew it you were stood outside the bookies with nothing……your Christmas hopes bob and weave on the back of the crumpled betting slip you threw into the flooded gutter.

You can’t believe it’s happened again, but you don’t know if you can change…you don’t know if it’s even possible. You switch your phone off and head back to your cold flat alone and on the walk you make a decision. Next year will be different.

There’s hope.

Christmas One

Christmas seems like a bloody big mountain to climb! It’s only been a matter of weeks since your last bet and although you’re feeling quietly confident you don’t relish the idea of being tested like this. “What if’s” buzz around in your mind seeking to derail you and erode your confidence and as you look down you notice your knuckles have turned white because you balled up your hands with the strain of it all.

You don’t trust yourself with money yet so you’re waiting for a friend to turn up with the money he’s holding for you so you can both crack on with a little Christmas shopping…the little you’ll be able to get this year still makes you feel a bit of pride when you think about it. But your mate’s late and the bus stop you’re waiting for him at is over the road from the arcade…sweat trickles down your neck as you pick up your phone and punch in his number.

“Where are ya mate?” you almost shout…as he hops off the bus right in front of you. You breathe a sigh of relief. You did it…you got through it….

There’s hope.

Christmas Two

Christmas means family but someone’s missing from yours. Your son hasn’t called for about three months now and you’re desperate to know where and how he is but when he called and asked for money you told him “No” and now you’re frightened you won’t see him again. You know you’re doing everything you’re “supposed” to do, what people told you to do…but it goes against every fibre of your being. As you lay the table with one less place setting than normal, you start to cry.

A few months ago he seemed better, he seemed to really be trying, but after he lost his job all the fight went out of him and he was back down the bookies as though nothing had changed. He said he didn’t know if he had the strength to get back on the wagon…you said you didn’t have the strength to be around him if he didn’t. Despite the ultimatums, tantrums and recriminations on both sides you really thought he’d be back on track by Christmas.

Your phone rings and you pick it up….there’s a moment of silence and then,”Hi mum, room for one more?”

There’s hope.

Christmas Three

Christmas seems like one big stress…got to get the kids the latest iPad…mum wants a nice perfume and HOW much is the works Christmas meal going to cost? You’re managing your debts and you’ve been paying them off for a while now but this kind of expense is really pushing you to your limits! You wonder to yourself if there will ever be a time when things are “normal”…sometimes it seems like you’ll never escape from the consequences of your gambling.

A single white envelope rattles through the letter box and plops on to the mat….you know that hand writing, and even if you didn’t the word “Daddy” is a big give away! It’s an uphill struggle, and there are days when you question whether it’s all really worth it, but looking at the card you know it is. Today it’s good to be in recovery.

There’s hope

Christmas Four

Christmas has a new meaning since you stopped gambling a few years ago and each time it comes around it reminds you of why did :). You look at those around you and the smiles on their faces when they open gifts you were able to buy for them and you’re momentarily transported back to a time when things were altogether different. You let the remembered sadness wash over you and then pass….and you’re relaxed, happy and stuffed to the gills with all kinds treats.

Christmas hasn’t been stress free…it rarely is….but it’s another year of being gambling free and when you reflect on that, you smile.

When you share the story of your recovery, you give others a lot of hope!

Thanks for reading 🙂

Chatty Woman

The difference between online therapy groups and chat rooms

 

Until recently, I hadn’t been in a bog standard chat room for a while…not since my misspent youth whiled away online in the company of my yahoo buddies! I’ve encountered a few newbies in my online therapy groups recently, and this left me wondering how I might be able to make the therapy groups I offer less intimidating to the technologically bashful 🙂 . I reached the conclusion that I needed to try and recreate my first time by diving back into the middle of the internet and finding a generic chat room I wouldn’t usually access. My feelings about the experience surprised me!

 

SO…I went into my chosen average looking chat room and quickly realized I’d made a mistake. I hadn’t turned off the personal message function!! Many of you will already know what’s likely to have happened next, but for those of you that don’t, I was immediately inundated with unwanted male attention. “A/S/L” tessellated across my screen as the windows popped up and I found myself edging backwards away from my desk as though responding to a threat in the room. I didn’t answer any PM’s and tried to engage the others in the room in general chit chat but I got the feeling that I was a goldfish in a sea of piranhas…a “fresh meat” sensation flooded over me and left me cold.

 

Nevertheless I dived back in….the people in the chat room appeared loud, even though there was no noise, and the individuals there seemed to be clamoring for attention and speaking at cross purposes. Trying to engage with these people was like standing in the middle of a department store at the start of the January sales asking passersby if they fancied a chat! To say the contrast between this chat room, and the rooms I’m usually in online was STARK, would be a tremendous understatement 🙂

 

Maybe it’s an age thing 🙂 , because when I reflect back on early experiences of using chat rooms I know I felt differently about the situations unfolding within them and the characters I found there! I was about 21 when I used to use chatrooms….I was outgoing and enjoyed engaging with large groups of people so they met my requirements at the time. I wasn’t concerned about sharing a common goal with others in the room and I didn’t enter the room with a specific agenda in mind. The chat rooms I went in were for entertainment purposes and on that front they certainly delivered. I remember feeling as though a whole new world had opened up to me at the time and I spoke to my friends about how liberating the experience was. I think my only frustrations stemmed from not being able to type fast enough, not a frustration I suffer from anymore LOL.

 

I still love the chat rooms I’m involved in but they’re mainly work related now….I’m either delivering a therapy group or facilitating a peer supervision session but the thrill of communicating with others in real-time and in writing hasn’t lessened over time. I’m glad I chose to sample the old rooms again though because I don’t think you can ever lose sight of just how hard it is for people to access therapy no matter what medium they use to access it. It takes courage to seek help and if there’s an extra barrier to people seeking help because of their perception of what that help will look like, it’s our job to know about it, and correct it. There’s a lot of help out there on the internet for a myriad of problems so maybe we need to get better at telling people about the differences between online chat rooms and online support/therapy groups and reassuring them that they’ll be safe, they’ll be heard and they’ll be welcome?

 

Thanks for reading 🙂

 

Jane Fahy (RMBACP)

Clinical Services Manager

Gambling Therapy

Same Day…Different Username :)

Do you meet people in online therapy groups over and over that seem familiar?

 

People using online support often adopt online personas or “roles” within groups that coincide with an associated set of behaviours which can often appear unhelpful at the time. These sets of behaviours are referred to, in counselling terms, as “Games”. What I’ve attempted to do for the purpose of this blog is to identify some of these patterns of behaviours, using the Transactional Analysis Model as a loose framework to look at ways of working with them.

I’ve experienced a degree of psychological game playing in some of the groups I’ve facilitated and in one to one online therapy sessions over the years. They can be both frustrating and confusing at times, especially when I was new to all this :), because I might have had a sense of a game being played, but it felt like no one had told me the rules!

So….what I wanted to do was to blog about my perception of the kind of roles that seem to be reoccurring most often in my groups to see if anyone else had experienced similar things. During my group work I’ve spotted some of the following roles and the games they typically play, let me know if they sound familiar:

The Lurker – The lurker will spend most of his or her time saying nothing. Attempts to involve them in the group discussion will receive monosyllabic responses, if they respond at all. Whilst they may outwardly appear to avoid receiving attention their behaviour indicates a strong need for attention which others provide as they become “hooked” into the game and repeatedly attempt to elicit a response. The game usually ends when the lurker has received enough attention, positive or negative, when they will abruptly log out.

The apparently contradictory behaviour can be very frustrating so it can be easy to make numerous attempts to engage this person and effectively “play the game”. In order to manage the flow and dynamics of the group it’s important to fight this urge and ask only once or twice whether the individual has anything to contribute to the group.

What I’ve found is that if the individual isn’t getting the desired outcome they’ll choose to either log out, or engage with the people around them…of course we always hope for the latter outcome 🙂

Now, I KNOW that many people are shy and don’t really know how to use therapy groups when they first arrive and they’re not the people I’m talking about…of course it’s ok to be shy or reserved and all efforts should be made to encourage new people to feel at home. A Lurker is someone who carries out the above behaviour repeatedly over time without considering the impact it may have on others in the group which I feel is something completely different.

The Monopoliser – This person will talk (type) a great deal. They will often ignore what’s being said by others and carry on with their own train of thought regardless of any questions they’re asked. The aim of the monopoliser during this game is to receive collusion and sympathy. Ultimately to offload without being challenged in order to continue doing what they‘ve always done.

As no other comments have been made, or if they have been made they may not have been “heard”, the monopoliser can reassure him or herself that no one can help them to change their situation and there’s nothing to be done.

In order to counteract the game, the facilitator will need to involve others in the group by asking if they’ve ever been in a similar situation. The facilitator is required to manage the flow of the group to ensure that others all have a chance to share.   This might mean explicitly stating that time is limited and others in the group might be in need of support. If forums are available, it can be a good idea to direct the monopoliser toward them so they can share at length without being restricted by the group format. They’re then also unable to “block” responses from others by simply continuing to type.

The Joker – Diversion, distraction, smoke and mirrors are the currency of the joker. During this game the Jokers intention is to feel that he or she is working on their emotional wellbeing by attending the group whilst avoiding any meaningful discussion about the issues at hand. As their name suggests, the Joker will make jokes and potentially inappropriate comments during the group which can often derail the conversation and upset other group members.

It’s my job to tentatively challenge this behaviour by acknowledging that it can be very difficult to discuss emotional issues and making light of the situation can make it feel less intimidating.

Whilst we would like the Joker to engage on a deeper level they might not feel able to do so at this stage so we’re only able to manage their input to a certain degree and exclude them as a last resort if they become too distracting or offensive.   Terms and conditions, a contract or code of conduct are useful tools when it comes to challenging inappropriate behaviour online.

The Rebel – The rebel will appear averse to any suggestion. Ideas that the rebel is presented with by the facilitator or other attendees will typically be responded to with the words “Yes but….” before they go on to list the reasons why the idea wouldn’t work.

….”Yes but I couldn’t get to that meeting because….”

.…”Yes but I tried that and it didn’t work because……”

….”Yes but I would have done that if….”

My own experience of providing support online would seem to suggest that this is the most common game played by the people accessing online help. Individuals who are not ready to fully engage in recovery may use a site to “dip a toe in the water” but when faced with suggestions that could appear too difficult or even frightening they’ll discount them.

It’s important not to simply keep putting forward a myriad of ideas for the Rebel to discount as this leads to frustration on both parts. This could lead the Rebel to feel misunderstood or even bullied, potentially leading them to discount counselling altogether.

The facilitator can put an end to the game by reassuring the Rebel that recovery is a very personal thing and not all suggestions will suite everyone. The rebel should then be encouraged to take a creative look at their recovery and use groups to seek feedback on the ideas they come up with.

Online psychological games are common place, perhaps even more prevalent than during face to face support or counselling. The games people play are their way of confirming the facts as they see them whether that is that no one understands, that no one can help or that no one cares and our role is to attempt to show people that this perception is incorrect.

It can be frustrating when faced with any of the games I’ve talked about here and this frustration will only be exacerbated if we allow ourselves to be hooked into playing. With these, and many other psychological games, the only way to avoid frustration and hurt feelings is not to play.

The idea of psychological games is an integral part of the Transactional Analysis model for counselling. For further information on this please visit the following site: http://www.ericberne.com/Games_People_Play.htm

Thanks for reading 🙂

Running Online Support Groups

Making the move from musician to conductor

I love all of the therapeutic work I carry out online, the one to one interventions are both challenging and rewarding due to the speed with which they progress, and the forums allow for the intervention of a therapeutic online community which complements the support I, and my team, provide.   By far and away my favourite method of support and therapy online though is group work. For the purpose of this blog “group work” refers to a synchronous, text based, group of up to nine attendees and one practitioner.

I run a range of online groups from structured therapy groups to themed groups and groups for people new to me and to recovery from addiction. Each group has a different feel to it dependent upon the group type, who’s in it and how many people are there.

Small groups require a lot of practitioner participation…at times I find myself posing hypothetical questions or sharing something about my own experiences to get the ball rolling (so to speak). In other small groups I might find myself in a situation where I have to remind people that others entering the group (if the group’s access isn’t restricted in some way) may be able to see some of what they have typed in order to ensure they’re mindful of the depth of material they’re sharing. I do this because it’s easy for people talking about intense emotions online to lose track of “where” they are and get drawn in by the anonymity of cyberspace and the feeling of intimacy created when talking to only a few people. In these kinds of groups I feel like a musician in an orchestra…playing along and harmonising to make sure the overall effect is what it needs to be.

A larger group is a different beast altogether 🙂 it takes focus and fast fingers to facilitate a large group and keep them on track…at times it feels rather like trying to herd cats but most of the time it’s captivating. It’s my role to make sure the flow of the group makes sense and that everyone has the opportunity to share. Of course this is something that counsellors do in a face to face group but online we have the disadvantage of not being able to see who’s leaning forward…chomping at the bit with a desire to share…or who’s been upset by a comment and may need support or clarification. Part of what I do is to involve people and clarify what is meant and understood by comments throughout the session. At times I encourage people to explicitly state what their bodies are doing so the group can see a mental image of how a discussion is affecting them. It’s up to me to spot if someone has withdrawn from the discussion and involve them again if appropriate. I also have to manage potential group monopolisation in a sensitive way. Ultimately I have to make sure people feel safe and heard in groups and to do this I make the transition from musician to conductor as I view the group as a whole and pay attention to the nuances in the conversation to better direct the symphony.

If you’re a counsellor considering trying online groups I can’t recommend them highly enough but I would strongly urge you to ensure you have taken part in the appropriate training before hand. Training providers I used, and was very happy with, are http://onlinetherapyinstitute.com

Thanks for reading 🙂

Gaming, Gambling…Gambling, Gaming…Let’s Call the Whole Thing Off!

If you search “Gaming” in Google the first listing is for a gambling website…and in my search for clarification over what is considered “gaming” and what’s considered “gambling” I stumbled across a number of terms:

• Social Gaming
• Real Money Gaming
• Online Gambling
• Online Gaming
• Social Casinos
• Closed Loop Gaming

And more…

I looked at a few different sources including recent articles in marketme and WhaTech to try and get to the bottom of what’s meant by all of these terms but struggled to find a definitive answer because sometimes the terms were used interchangeably to refer to the same activity. I also wanted to better understand the potential relationship between gaming and gambling and to think about where I stand on the issue of regulation.

So I’m going to start by looking at games played via social networking that bear no resemblance to well known gambling activities (“Social” or “Closed loop” gaming)…I’m referring to games like Candy Crush and Bubble Witch Saga which I’m sure many of you will have heard of.  You can choose to play these games without ever spending a penny or you can make in game purchases for different content or “lives” if you want to.  The games are colourful, lively and loud and usually repetitive in nature which can create a soothing effect potentially creating an almost hypnotic state over time.  Now, if a player chooses not to spend any money, the amount of time spent on a game is usually limited by the skill of the individual playing….for instance, if you fail to complete a level on Candy Crush, you lose a life and if you lose five lives you have to wait for a life to “refresh” or ask Facebook friends to send you a life before you can continue.  This forces individuals’ to take a break from the game…but you can buy more lives if you want to carry on.  I guess there could be an argument here that says if you are paying for lives you are already at risk of using the game excessively, so can we therefore develop algorithms that use payment amounts and frequency on these games as an indicator of potential problems as is already the case with online gambling?  Something to be considered by treatment providers and potential future regulators perhaps…

What about the games that DO mimic gambling activities but don’t require money to play (Social casinos) like roulette, slots and poker….what, if any, is the relationship between these games and gambling for money?  The sights and sounds are the same…in game money or “tokens” are accrued and lost.  Players may feel a buzz or experience a sense of winning and losing, as with gambling, although it could be argued that these feelings are less intense if no money is involved.  I have previously seen research, conducted by the BBC, which highlighted the differences in player style when playing for free and playing for money…it would seem to indicate that people take more risks when they’re not playing for money (which makes sense).  A change in playing style would potentially change the outcome of games leading the player to think they may win, or lose, more than they actually would if they switched from free play to real money gaming.  These kinds of inconsistencies have occasionally led to conflicts between players and gambling companies because players feel the odds have changed and the game is no longer fair.  In my opinion, more research needs to be conducted to review the number of players jumping from free play to real money gaming, paying particular attention to problem gamblers in order to ascertain when they began to develop a problem and what indicators may have existed in the early stages of the problem that could have been acted upon in some way.

As we can already see, there are many similarities between gaming and gambling both emotionally and visually and, certainly in the case of social gaming, the potential exists to lose/spend a lot of money, as well as time, while playing.  However, the potential also exists to engage in both recreationally and without incident.  Players can exist in any of the following states:

• Playing for enjoyment – No problem
• Playing excessively/compulsively – Problem with gaming
• Switched to gambling for enjoyment – No problem
• Switched to gambling excessively compulsively – Problem with gambling

So I guess the question is…would excessive gaming lead to excessive gambling if a player were to make the switch? And is a gamer who’s been playing responsibly likely to develop a gambling problem if they make the switch?  The two are so similar that my feeling would be similar behaviours would carry over.  Conversely, can a problem gambler make the switch to responsible gamer?  The problem gamblers I’ve worked with would give a definitive “NO” in answer to that question!

I don’t want anyone reading to think I’m anti gaming, or indeed anti gambling, because that’s certainly not the case.  I have been in the past, and still consider myself to be, a gamer…I’ve lost myself in Candy Crush from time to time and I’ve spent more than a few hours waging war on ogres in World of Warcraft  🙂   I’ve developed many friendships, experienced joy and excitement and fended off boredom by playing games responsibly and I wouldn’t want to discourage anyone from doing the same thing.   I do however feel that the suppliers of any substance or activity that has the potential to become addictive have a responsibility to support treatment and education and adhere to some form of regulation.  Whether or not gaming leads to a switch to real money gaming, and in my opinion it’s a real possibility for some, gaming itself can create altered states, it can be used as a form of unhealthy escape and it can create emotional and financial hardship so for those reasons more research needs to be conducted on how to help excessive gamers.

If it’s found that social gaming does indeed lead to a net increase in the number of people gambling we have to consider that as the number of gamblers increases, so does the number of problem gamblers. So what is being put in place to cope with the influx of people into treatment?

Thanks for reading!  🙂

September is National Recovery Month – But what is recovery really?

When I came across a post from the Nevada Council on Problem Gambling alerting me to the fact that September is “National Recovery Month” I found myself reflecting on the term “recovery” and contemplating what it means to me and what it means to some of the many people I’ve worked with over the last six years……

You see, I hear the word “recovery” on a daily basis in a multitude of sentences like “I just can’t seem to get going in my recovery” or “I can’t seem to sustain my recovery” or “Life is great now I’m in recovery!” and of course “I’m working my recovery”.   I sometimes think to myself that if I were to come to a support site for gambling addiction, having never sought help before, and read all of the forum posts about recovery I might be confused by the different definitions applied to the word.

The way I talk to clients about recovery and the times I’d be likely to do that are pretty consistent.  When someone comes to talk to me for the first time we explore practical, emotional and financial changes that need to take place to improve their situation and these changes form the basis of their recovery plan….If they’re coming to talk to me after a slip or relapse we look at ways in which they may be able to hold on to their motivation in order to sustain their recovery.  On the very happy occasions when an individual wants to check in with me and talk me through their successes we always touch on ways they can retain their recovery focus to avoid deadly “complacency”, the enemy of recovery.  What isn’t consistent however, is what all of these people mean when they talk about recovery because it’s such a very personal thing.

Now, for some of you that statement will make NO sense….you might be thinking “Well, surely you’re either gambling and don’t intend to stop…or you’re not gambling and you’re actively making sure that you don’t gamble in future?”  And for some, that’s accurate….but we all see things from within our own frame of reference through all of our distortions and emotional filters.  That means that some people in the initial stages of making a change (contemplative) may view looking at literature about problem gambling, or writing down a phone number to be kept in a draw, un-phoned, as entering recovery; others would dispute that.  Others may have abstained from gambling for months or even years but they don’t consider themselves to be in recovery because they haven’t accessed therapy or made any major changes but rely on things like self-exclusion and not having control of their finances to stop them from gambling.  This is commonly referred to as “White knuckling it” for obvious reasons!  One thing’s for sure though…….the personal definitions of recovery are as many and varied as the problem gamblers in recovery!

I have to wonder though…….is there ever a time when people are recovered?  And if not…..surely the pursuit of recovery is the very definition of insanity?  I personally believe recovery is an on-going process that requires constant effort and monitoring.   That’s not to say the problem gambler always has to be on high alert…but scheduling in time each month just to “check in” with some form of support and review any tweaks that need to be made to the recovery plan would be a good idea.  As for the argument that pursuing anything that can’t be achieved is a waste of effort….don’t we all pursue the impossible?  Aren’t we all trying to be better in some way?  I know that as a counsellor I work on my personal and professional development on an on-going basis with the knowledge that I’ll never be finished, and that’s ok 🙂

For some the word “recovery” carries a kind of magical power…..it’s worn like a protective shield that stops them from taking on too much too soon.  For others it can be provided as an explanation of their actions if needed but for many it’s uttered with pride.  Pride of following a path that’s so tough it can feel like trying to swim upstream in treacle……chased by sharks!  No matter the definition those that consider themselves to be in recovery are doing something remarkable and positive and I admire their courage and dedication.

Dictionary.com has a lot to say about recovery, but my favourite definition is “the regaining of, or possibility of regaining, something lost or taken away.” I like this definition because the people I work with have lost a great deal…but it’s the word “possibility” I really love because recovery for many problem gamblers is all about the possibility of living a “normal” life free from gambling.  They want many of the things others take for granted and they want to live without the constant threat of being found out, losing life or liberty or losing their families.

In conclusion, I think that for problem gamblers the pursuit of recovery is synonymous with the pursuit of happiness.  I wish them all well.  🙂

So you’re thinking of delivering therapy online?

 

A few points you might want to reflect on when it comes to online therapeutic interactions 🙂

When working online, using real time typed or “synchronous” chat for the purpose of therapeutic interventions, there are certain drawbacks you need to accept. If you work extensively with body language and base your insights predominantly on facial expressions it can be difficult to make the shift to taking advantage of a new form of “body language”.  The body language I’m referring to is evident in the text the client provides and the length of time taken to provide it.

Pay close attention to the way responses are being typed…….as well as their actual content. If a client starts the session typing in quite a precise manner, taking care to ensure correct spelling and grammar are used, but when a certain issue is raised typing becomes faster and less accurate that would give you an idea of some kind of emotional distress taking place linked to the subject at hand.  If a client takes a great deal of time to respond to a question but they then provide only a one word answer have they deleted something or was the question particularly hard to answer?

Something often talked about in the field of online therapy and support is the “disinhibition effect” (J, Suler) this term relates to the speed at which painful disclosures occur online. Seemingly, because of the anonymity and physical distance between client and counsellor present in online work, clients feel more able to discuss personal and painful information at an earlier stage of the helping process than they would have done in a face to face support situation.  This is something you need to bear in mind as you will need to manage the client effectively so they don’t later reflect on their rushed disclosures and feel embarrassed or ashamed.

As clients are unable to see the face of their counsellor you need to become used to explicitly stating how you feel in response to what the client is disclosing. As the client can’t see a smile you simply need to say something like “When you said that, it made me smile” or “When you talked about ….. it made me feel sad”.  This kind of statement helps the client to feel that they’re cared for and understood and it strengthens the therapeutic alliance.

Unlike face to face support, a client can quite literally take the information being discussed away with them; they can save it or print it off.  Whilst this creates a valuable point of reference for clients it also means you need to be mindful when typing responses.  You need to be very clear in your interactions with a client and make sure to clarify with the client any points they are unclear of.

As you can see, there are a few things you’ll need to consider about the actual nuts and bolts of working online that go beyond what level of encryption you need, what colour your website should be to make it look calming and which VOIP provider you should use….Don’t get me wrong, those are all important things but we are in the business of talking…and we have to make sure we can get the talking thing right first 🙂