• What kinds of messages have I received about people from different cultures?
• What have I heard about this client’s community?
• How accurate is the information I have about it?
• How do I usually react to members of this community, emotionally and intellectually?
• What do I think of this group and where did these opinions originate?
• What has happened between me and members of this community that affected the way I perceive them?

Counsellors also need to consider their own views and cultural perceptions of gambling and those who engage in it. In other words, they need to assess how and what they have learned about gambling and gamblers through their own culture, and what messages they have internalized. Above all, it is imperative for them to develop an understanding of how their views, perceptions and opinions can interfere with the counselling process and to seek the assistance of a supervisor to address related issues. This process of self-analysis would include considering notions of gambling as right, wrong, sinful, fun, addictive, destructive, part of social life, a profession, a disease, a spiritual problem, immoral, exciting or a crime, to mention just a few possibilities. In other words, what kinds of messages have I learned about this activity? Counsellors also need to examine if they view gamblers, for example, as people who are weak, losers, sinners, people who like to take risks, wise or wealthy.

In my professional life, one of the aspects of this process was becoming aware of how I had developed different perceptions of gamblers and of gambling. These were shaped by family messages and cultural values. When I was growing up, my family saw gamblers as people from a higher class. My peer group perceived gamblers as streetwise. Although these views about gamblers were positive, in both groups gambling activities were seen as something to be avoided, something that could lead someone to financial ruin, something that had to be kept secret. As I began to work with problem gamblers, these conflicting views could have been communicated and interfered with clients’ understanding of my views on the matter. Issues like these need to be addressed during peer group supervision and individual supervision meetings.

Becoming aware of one’s cultural self is a fundamental aspect of creating favourable circumstances to explore clients’ cultural dimensions. By doing that, counsellors first create those circumstances for his or her own cultural dimension. Because they have become aware of their own cultural characteristics, they have become familiar with the process and can recognize its importance and facilitate it for their clients.

Case example 2: When I conducted this assessment with one of my clients, who self-identified as Southeast Asian, he said that gambling had “taken away who he really was” and that he felt the “need to do things that would remind him of who he was in reality.” During this informal assessment of this client’s level of acculturation, he told me that before gambling became a problem, he used to spend a lot of time with his extended family, speaking the language of his parents, and being in touch with other expressions of his culture of origin. For this client, reconnecting with his culture and reclaiming lost aspects of his cultural self were essential elements in his efforts to change his gambling behaviour. For him, this process included spending time with his immediate and extended family, practising the language his parents spoke at home, listening to music and watching movies from his country of origin, and participating in social events within his ethno-cultural community.

Case example 3: Another client, from a Middle Eastern background, who had been a victim of torture in his country of origin before coming to Canada at age 28, saw things in a different way. This client expressed regret for the loss of parts of his cultural self, but trying to reconnect with them only reminded him of the pain that had been inflicted on him before he moved to a new country. For that reason, he had no desire to be involved with his ethno-cultural community. In this case, it was more beneficial to first help him find a support group for survivors of torture, and to develop a social network. In addition to receiving counselling for his gambling problems, he was also referred to services working with survivors of torture. 

A culturally skilled counsellor would actively attempt to understand the worldview of culturally different clients without negative judgments, and to acquire some knowledge about clients’ cultures. Cultural competence demands that counsellors understand and experience the worldviews of their culturally different clients with respect and appreciation. This is not to suggest that counsellors have to hold those worldviews as their own, but that they must be able to accept them as a different legitimate perspective (Sue et al., 1992). This would include asking clients about their culture, and allowing clients to educate the counsellor about their culture and its views on gambling and problem gambling.

Counsellors need to explain to clients that they need the clients’ help in order to help them better. Practitioners need to help clients understand the process of counselling, and explicitly give clients the option of not answering some questions if they are not comfortable doing so. Counselling is a collaborative relationship that requires information and participation from both parties. Sometimes clients from other cultures do not understand why counsellors need to ask so many questions or need so much information. Counsellors need to explain to clients that providing information is one way the client can bring his or her collaboration into the process. Practitioners need to explore clients’ cultures in terms of family structure and hierarchy, family roles, social attitudes towards seeking help and the role of spirituality. Additional areas to explore are indicated in other sections of this chapter. Counsellors should also gather cultural information by asking questions such as:

• “What do people in your culture think of gambling?”
• “What do they think of people who have a gambling problem?”
• “Is it something that people usually talk about?”
• “Are you comfortable talking about gambling with your family/friends?”
• “Are there any kinds of games that are connected to social activities?”
• “Can you tell me a bit about the role of spirituality in your culture?”
• “How about the influence of religious beliefs in the way people view gambling?”
• “How would you define problem gambling? Do you think most people in your culture would agree with it?”

These are just examples of some areas to explore in order to acquire a greater understanding of clients’ cultural views on gambling and problem gambling. It is beneficial to help the client define what gambling and problem gambling is and this can often be accomplished by visually placing them on a continuum.

Counsellors need to be creative so they can formulate the necessary questions in a sensitive way. This would allow them to become more effective with culturally different clients, and to create a cultural context for the presenting problem, in our case, problem gambling. This context will help practitioners better understand the client’s cultural framework and enable them to see the problem from the client’s cultural perspective, or through clients’ “cultural eyes.”

Here is an example of how some of these elements may interfere with the counselling process. When working with clients of Jamaican origin, counsellors need to be aware that the strength of Jamaican families lies in their being so close-knit (Baker, 1996). This perspective needs to be respected and taken into consideration when considering treatment options. Rather than insisting that clients proceed with individual counselling, professionals could use this unique characteristic of Jamaican culture as a resource for treatment. Including family members in the counselling process could prove to be an excellent source of motivation and support for a client trying to change his or her gambling behaviour. Flexibility in counselling format, (such as capitalizing on the “close-knit” nature of Jamaican families) needs to be considered when approaching various cultural groups. Clearly, counsellors need to be not only aware of cultural differences, but also aware of how differences affect the problem gambler’s response to treatment and the subsequent flexibility of treatment approaches required.

Understanding the family’s structure and expected roles may also help counsellors find elements that are important in the process of changing gambling behaviour. One of my clients from South America resisted bringing his wife to his counselling sessions. Even though he clearly understood how he could benefit from her occasionally being present during our meetings, we never reached an agreement as to when she would come. As we continued meeting, he explained to me why that was happening. According to him, in his culture, he was seen as the head of the family. However, since he had started trying to change his gambling behaviour, he felt that his wife had taken over more and more aspects of that role. For example, he no longer managed the family finances, and he had no autonomy as to what to do with his free time. As he saw it, his counselling sessions were the only part of his life that he felt was still his own, or his “domain,” as he put it. For him, bringing her for his counselling sessions would mean giving up the last place that he felt was still his own. In this case, it was more beneficial to opt for a direction that would comply with his cultural needs, than to prematurely insist on a course of action that might have limited his stay in treatment.

For another client of East Indian background, exploring family roles in his culture pointed to an element that was later used as a motivational tool. In this instance, the client revealed that he had decided to look for help because he had started to ask for money from his son to keep his gambling activities. According to this client’s explanation, in his culture, his role is to offer support to his son, and there is a strong expectation that he will be the provider. The client said that he could not live with the fact that the roles had been reversed and his son was now providing for him. His desire to be the father he believed he should be was a great motivation for him to change his gambling behaviour — one that I often reminded him of.

When trying to understand how culturally different clients view gambling, counsellors can rely on training and reading on related issues, as well as on consultation with members of ethno-cultural communities. Above all, as mentioned above, they can always acquire information from clients.

In my present work with problem gamblers, it has been helpful to create the cultural context by also investigating the following areas in clients’ ethno-cultural group: history of cultural context of gambling; perception of gambling; and common forms of gambling. These areas could be explored as follows:

History of Cultural Context of Gambling
Although gambling has occurred in nearly all cultures and in every period of time, the process has differed from culture to culture. When working with problem gamblers who belong to a different cultural population, it would be important to learn about the history of gambling in the client’s culture and how long the activity has been part of it. It is equally important to understand how gambling was introduced into the culture and the process through which it happened, for example, exploring whether gambling had been introduced as a leisure activity, as a religious-related ritual, or as gambling to exchange objects or for money. This exploration is just as relevant as assessing history in other areas of clients’ lives such as family and mental health. It may provide important information to assist counsellors’ understanding of clients’ perspective on gambling.

Perception of Gambling
Developing greater cross-cultural sensitivity also demands that counsellors acquire some knowledge of what forms of gambling are acceptable in clients’ cultural groups and which ones are not. Moreover, it is important to explore if there is a hierarchical sequence for various gambling activities in terms of acceptability. In addition, counsellors need to consider how a client’s culture views the gambling activity and its consequences. Cultures have different views about the gambling activity and its consequences, often depending on how gambling affects a person’s life. Furthermore, often views and interpretations within a cultural group vary, particularly about gender roles. For example, if gambling is perceived as a financial activity, problem gambling may be more greatly associated with “money mismanagement” rather than other factors that contribute to problem gambling behaviour.

The perception of gambling in Australia also illustrates the importance of understanding how gambling is viewed by the members of a client’s particular culture. Unlike other western societies, gambling in Australia is viewed as an instinct and a natural propensity (McMillen, 1996). This significant difference has resulted in a revision of the South Oaks Gambling Screen (SOGS) so that it better reflects cultural reality for Australians. As opposed to the score of 5, which indicates a possible gambling problem for other populations, the corresponding Australian score is 9.

Another relevant area to explore is the cultural meanings attached to gambling, such as cultures that see it as a sign of masculinity, or of being “street wise” (such as some Latin American cultures), or as a sign of wealth.

Common Forms of Gambling
In addition to the areas mentioned above, an investigation of the common forms of gambling in a client’s culture would also be necessary for developing cross-cultural competence. Like other elements mentioned here, this would help professionals in understanding clients’ choices for one game over another as well as why problems originate with some activities and not others. For example, while lotteries are popular and accepted by most western cultures, this is not the case in Islamic cultures. Likewise, while many western cultures have a limited acceptance of horse racing, in Hong Kong it is very common and very widely accepted.

The third aspect of becoming culturally competent is developing skills that would be beneficial to culturally different clients. A culturally skilled counsellor is in a process of actively developing and practising appropriate, sensitive, and relevant intervention strategies and skills when working with culturally different clients. Such counsellors would be able to improve their effectiveness by using modalities and defining goals that are consistent with the life experiences and cultural values of clients (Sue et al., 1992).

As I began my work with clients from diverse cultural backgrounds, I was under the impression that always being non-directive would be the most effective approach. Experience with this type of work proved that it was an incorrect assumption. Through reading related material, observing clients’ reactions, and above all, allowing clients to educate me, I learned that some cultures, for example some African and Asian cultures, prefer a different approach. These cultures count on the counsellor to be the expert on problem gambling and are likely to be more responsive to a more directive therapist.

The process of developing these three areas (Guidelines 1, 2 and 3) was summarized by Sue & Sue (1990) in the following manner: “These three goals stress the fact that becoming culturally skilled is an active process, that it is ongoing, and that it is a process that never reaches an end point. Implicit is recognition of the complexity and diversity of the client and client population, and acknowledgement of our own personal limitations and the need to always improve” (p. 146). Exploring the areas mentioned above would result in greater effectiveness when professionals work with culturally different problem gamblers and help professionals progress towards greater understanding, acceptance, and respect for different cultural perspectives.

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