Category Archives: Support for problem gamblers

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  • My husband is often withdrawn and won’t talk to me about what is bothering him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:

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 🙂


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 🙂

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:

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…’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. 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.  🙂

World Suicide Prevention day

It’s world suicide prevention day today so I thought I’d pen (type) a few words on the way in which we can work safely with suicidal clients online.  I’ll be talking about problem gamblers specifically as they’re the client group I work online with.

It will come as no surprise to anyone that problem gamblers can sometimes be suicidal….people who are addicted to gambling are often able to hide the addiction for quite some time, maybe even years, from those closest to them.  If you’re in a relationship with a problem gambler you might get the sense that something is wrong…your partner might be distant, anxious, depressed and even have angry outbursts for reasons you can’t identify but none of these things would necessarily lead you to the conclusion that he or she was a problem gambler.

Thoughts of suicide thrive if the thinker feels no one cares and in their distorted view of the world a problem gambler might interpret a loved one’s lack of understanding as apathy.  Of course it’s pretty difficult to show understanding regarding a situation you know nothing about!  Another contributing factor to the consideration of suicide as an option for many problem gamblers is the fear of being “found out”.  Think about it….you’ve spent a long time hiding your addiction….getting rid of the betting slips…clearing your browser history….taking the bills away and putting them somewhere “safe” before they even have a chance to hit the mat and you’ve managed to keep all of your balls in the air BUT you know that tomorrow you’re going to get caught.

If a problem gambler knows that the secret is going to come out because there is some form of communication on the horizon that can’t be controlled heading in the direction of a partner, such as a call to the bank the partner intends to make to find out just what the hell is going on, they may feel utterly desperate!  The idea of facing someone they love as the extent of the chaos they’ve created is unearthed before they’re very eyes can be too much to bear for some and there only seems to be one way out.

I work for an international online counselling and support site for problem gamblers and sometimes I “meet” people who have reached the exact state of mind I’ve described.  Now, I don’t want to go into the ins and outs of what can and can’t be done to get help to people in distress when working online because although there may be a few things, involving IP addresses etc, they are very limited if you’re working on a “drop in” basis to provide emotional support.  Obviously if you’re working in a structured way, with a contract and details of Doctors and next of kin, which you would have if counselling someone, you have greater control over what you can and can’t do.  So, for the purpose of this Blog, let’s focus on the people who click a button and get through to us without having had any prior contact with our staff team.

First and foremost and in the words of Hitchhikers Guide….DON’T PANIC! If you receive contact from someone who implies or explicitly states that they are suicidal.  The service user is seeking help by speaking to you which is a positive thing.   There’s no empirical or anecdotal evidence to suggest that talking about suicide or indeed naming it, if service user talks about “not wanting to carry on” etc, will increase the likelihood of a suicide attempt.  In fact, quite the opposite is true as many people report feeling relieved at being able to explore their feelings about the subject.

Discussions around suicide should be handled sensitively and if your client hasn’t mentioned the word “suicide” explicitly, word your questions carefully and seek clarification about what they’re trying to tell you.  Questions such as “You seem to be saying to me that you don’t want to be here anymore, would I be right in thinking you’re having thoughts about ending your life?” can offer the client the opportunity to open up because it shows them suicide isn’t a “taboo” subject.  You don’t want the client to think they’ll freak you out if they tell you what’s really going on after all.

When a suicide risk has been identified the first step to take is to find out where they are and who, if anyone, is with them.  The primary aim of the conversation at this point is to encourage the client to get some face to face help…whether that’s from a friend; family member, mental health professional or doctor is irrelevant.  If the caller tells you they’re alone and have no one to turn to it’s important to make sure they have a link or telephone number for services such as the Samaritans or Befrienders (outside the UK) before the call comes to a close.  If you build up a rapport they may even give you an address or telephone number you can use to get help to them if it comes to that, which in my experience it very rarely does.

One thing you can do to take the pressure off both of you is to employ a brief “no harm” contract that applies to that particular session.  This means that the service user agrees not to act on suicidal thoughts during or immediately after the session and they agree to access additional support from a friend, family member or organisation following the session.  Without this commitment from the service user you may struggle to have peace of mind and should decide for yourself if you can be effective with such uncertainty in the air.

Some suicidal thoughts are fleeting and vague and occur only when an individual is in crisis whereas other thoughts can be constant and well considered.  In order to help the service user to better understand their feelings you could ask them to rate the intensity of their suicidal thoughts on a scale of 0 to 10 (0 being no strong thoughts and 10 being a determination to act on their feelings in the immediate future).  This will help you determine the level of risk you’re working with.

Another method of assessing risk is to ask the client whether they feel this way as a result of a prolonged period of depression or whether they may be feeling this way as a response to another situation which will pass.  If the feelings are being driven by current circumstances allow the client to explore the possibility of resisting the feelings until their circumstances change.  The emphasis here should be on the way in which circumstances change, has the service user considered coping strategies that are flexible and can change along with their situation instead of employing such a permanent solution?  You can do this by looking at different scenarios with the service user such as talking to the people in their lives that they find to be supportive and helpful.  If the clients’ feelings appear to be more prolonged, encourage them to access a mental health service or their GP to assess whether they may be clinically depressed and identify potential treatment.  Whether clinical or reactive we know that depression can be treated and the low feelings will eventually pass, so try to focus the client on the fact that however painful, their feelings are temporary and death is permanent so wouldn’t it be more logical to look for ways in which to cope until they pass?

Encourage the service user to look at times in the past when they may have felt this way, ask them about what coping strategies they employed before in order to survive.  When working with our client group we have to be aware that the answer to this question may be “I gambled” in which case exploration of other methods of coping in a healthy way should take place.

Always remember that if someone decides to end their life it’s their decision.  I know it’s sad and monumentally frustrating but there are no magic words we, or anyone else, can pluck out of the air to “fix” anyone.  By letting a person talk about suicide openly and without judgement you’re giving them something very special, you’re accepting them….and maybe that’s what they need.

When ending the call the service user should have a clear idea of what to do next and what methods of support are available to them and you should make a note of your experience so you can talk it through with your clinical supervisor.

Take a Punt on Online Support (Unedited version of article published in Therapy Today July 2014)

Working Online with Problem Gamblers

Hi, my name’s Jane Fahy and I’m the Clinical Services Manager for Gambling Therapy, a website that supports roughly sixteen thousand people around the world who either have a gambling problem or are close to someone who does. The work we do in Great Britain involves providing wrap around support for people accessing residential treatment in one of the Gordon Moody Association Residential Treatment Centres. We also educate and support their friends and families. Outside Great Britain we offer a range of services in different languages to supplement the face to face support provided by other agencies. We do this on our forums, in online groups, via e-mail or on our helpline.

The number of problem gamblers worldwide is hard to pin down for a variety of reasons that I won’t bore you with now….but generally speaking it’s accepted that between one and four percent of individuals that gamble have a gambling problem. Working with addictions is tough, ask any addiction specialist! On one hand your client wants to change, they’re desperate to, but on the other hand they are driven by a white hot desire to continue doing what they have always done. After all, it keeps them safe doesn’t it?

Some people struggle to understand how an addiction without the introduction of a foreign substance can hold an addict in its thrall in the same way as an addiction with the introduction of a substance. I mean I get it, why would you do something that cost every penny you had, destroyed your family and left you homeless unless you were high? So I suppose this leads us on to a discussion about what we mean by the term “high”, an altered state maybe….euphoria? Escape? All words I’ve encountered when working with problem gamblers.

How then is it that problem gamblers are unable to stop when they’re not actively gambling because surely the effects wear off quickly right? Wrong, the brain needs time to acclimate to working within a more “normal” range of stimulation, which can take a while! To put it in more simple terms, if you’d spent hours on a roller coaster and adjusted to such a high level of stimulation your head would spin for quite a while after you got off! So the cycle continues, the thoughts become more distorted and the gambler gambles until one day the cost is too high. That’s when I “meet” them 🙂

So how does it all work? Well, it’s kind of like a jigsaw puzzle that people coming to us for help put together themselves to form their own recovery picture. It’s a picture that changes depending on where someone is within their recovery and what they need on any given day. Accessing online services like ours means people can take a dynamic approach to their support and tailor their recovery so it’s personal to them. In practice that means that if the person accessing our site wants to talk to someone who’s “been there”, someone who’s bought the T-shirt they can do that. If people want to talk to a counsellor who can help them to explore the “whys” of their situation, they can do that too…kind of a pick and mix solution!

If we’re looking at the nuts and bolts of supporting problem gamblers online via an established website with a vibrant community, I guess we first need to look at online support in more general terms. What is it, and what is it our clients are getting from it? I view it in terms of the following categories:

  • Accessibility
  • Community
  • Anonymity
  • Flexibility

Accessibility – A client using online support can access that support at any time of the day or night irrespective of the time zone they’re in. Support can be accessed on a laptop, PC, Mac, on a tablet or even a phone. Effective and comforting assistance can be a coat pocket away!

Community – An online therapeutic community is a powerful entity. Many people who have accessed a support group talk about the feeling of acceptance that hit them like a wave when they walked into a room with others in similar situations. Now, imagine that room was a virtual room containing thousands of people from all over the world, all understanding at least part of your story, all wishing you well and offering you a hand across cyber space. Then that feeling of acceptance has the potential to turn into something altogether exceptional…maybe even overwhelming in its ability to wrap an individual up in a blanket of understanding.

Anonymity – As therapists we often hear clients talk about shame, the shame of an addiction, an experience or even a relationship. Part of the work we do is to break through that shame and allow our clients to express themselves freely through their experience of our unconditional positive regard. Understandably it can take our clients time to perceive our lack of judgement and feelings of warmth towards them which allows them to speak freely but what happens if they don’t have to look us in the eye? Kate Anthony, CEO at the Online Therapy Institute and Fellow of the BACP, refers to this as the online “disinhibition effect” a term initially coined by eminent psychologist J.Suler.  Anonymity allows clients to express themselves on a deeper level, perhaps more quickly than they would in a face to face setting and, if managed correctly by the therapist; this can lead to some very valuable work carried out over a relatively short period.

Flexibility – We all respond differently to different kinds of support and different people but sometimes it can be hard for us to be specific about what we need and what works for us. Without the need to maintain premises that can only be open at certain times, staffed by at least two people, usually more, when open for the sake of safety and often held back by physical constraints, online support is often more dynamic, lean and capable of rapid change than a land based practice. The range of services can be adjusted relatively quickly to meet the needs of those accessing them and feedback concerning what those needs are is often frank and forthcoming thanks to the aforementioned disinhibition effect. This means people accessing this form of support can choose from a wide range of help, some in real-time and some where the response is not immediate (as with forums), they can tailor to suit their personality and preference.

So we know why this kind of support works, but what specifically are the benefits and pitfalls of supporting problem gamblers in this way? Human beings are complex and problem gamblers are no exception, so when looking at how best to support them and deliver therapy we have to consider why they do what they do, what are they likely to respond to…most of all WHO ARE THEY?

I’ve come into contact with problem gamblers from all over the world who gamble on everything from poker to scratch cards…online or in a casino or betting shop…games that are legal or illegal…..alone or with others trapped in the same downward spiral. I guess the thing you need to know about problem gamblers is that there are no two the same. But what remains the same with all of them is the pain behind their actions. So, ok they’re all different but that doesn’t explain why supporting problem gamblers online works so well?

Well, let’s not beat around the bush, with addictions to substances there will be many occasions when the people accessing support won’t be in a coherent state, particularly if they’re in their home environments and early on in their recovery. Being coherent is something that’s a basic requirement when it comes to getting help online and, where no dual presentation exists; it’s something that people I’ve supported don’t generally struggle with.

Something that helps problem gamblers in recovery is the use of practical barriers. These can include handing over financial control to someone they trust, self excluding from land based venues or adding blocking software to a PC or mobile device. Many barriers involve the avoidance of triggers and one of the biggest triggers for many is walking past a bookies. For those of you reading this article from within the UK I’m sure you can imagine just how hard it would be in many of our towns and cities to plot a route somewhere that didn’t take you past a bookies? Whilst I don’t object to seeing bookies on our high streets, as I’m aware many people can, and do, enjoy gambling responsibly and recreationally, I have to feel for those that must feel they can’t escape from them. You don’t have to walk past a bookies, a casino, an arcade or a shop selling scratch cards to access help online so in a vulnerable moment the people we support relish the opportunity to connect and talk to us without taking that risk.

Of course it’s not possible to avoid all triggers, emotionally charged situations or vulnerable moments over an entire lifetime so in order to regain a sense of living a “normal” life in which avoiding triggers doesn’t play such a prominent part, problem gamblers may initially use online support as a safe and secure stepping stone back to the life they want. If we revisit the idea of the online therapeutic community that I mentioned earlier, the potential for the community as a whole to role model recovery and a return to normality is vast particularly for those who’ve completed residential treatment because leaving that bubble can be extremely daunting! The community also performs the very valuable function of acting as an ongoing safety net, always there if needed, never judging the individual in need.

Our virtual doors are open to male and female problem gamblers but something that I found surprising when I first started delivering online support was the number of women accessing the support when compared to men. I had wrongly assumed that problem gambling was a predominantly male concern…I guess I had an image of Del Trotter in my head standing outside the bookies clutching a betting slip and proclaiming “This time next year…” Needless to say, that’s not what I found and shame on me for making assumptions J Perhaps because of this common assumption women often hold off on accessing face to face counselling or group support but they seem more willing to engage with therapy online….maybe because they can choose whether or not to even disclose their gender at first. Maybe because they’re not walking into a room full of men, which they could be imaging will be the case, or maybe because they feel less judged online for being women who gamble for the reasons I’ve already mentioned. You might be surprised to learn that out of the 1868 most recent contacts, women made up roughly 46% of the people accessing the Gambling Therapy helpline or online groups.

Styles of gambling vary so much from country to country, as do attitudes towards gambling and the help available to problem gamblers. In countries such as the USA many people are used to getting support for a variety of reasons and help is readily available. However, in some other countries help might be limited and people in need of it may be being actively discouraged from seeking help outside of the family unit. Because we work in the way we do, with people from all over the world, we have to work in a truly transcultural way. We can’t know everything of cultural significance relating to every corner of the globe so we HAVE to work with the person on the other end of the screen without making any assumptions based on where they’re from. We find out everything we need to know about them, from them, and put the individual client at the centre of the process rather than being influenced, however subconsciously, by a cultural stereotype.

As with any personal development work it can be rewarding to reflect on our progress. Some use forums as a journal open for people with similar experiences to read and contribute to. Others use them to pose questions and support their peers. What is ALWAYS useful is to look back during vulnerable moments to see how far we’ve come.

So, that’s all from me, I’m sure you’ll agree that there is value in online support and see its potential particularly in terms of supporting problem gamblers. I hope you’ve enjoyed this small glimpse into our world. Thanks for reading 🙂 TTFN


Jane Fahy (MBACP)

Clinical Services Manager

Gambling Therapy, Part of the Gordon Moody Association