Rosemary Hilbert

Gambling in Ontario is now accessible to people of all ages, cultures and socio-economic groups and we are learning that, though gambling offers excitement and the anticipation of winning, problem gambling has wide ranging impact on the gambler’s workplace, on our justice system and on the life of the community. Most of all, it is the gambler’s family who suffers when the gambling is no longer simply an occasional entertainment.

This section describes some of the issues and needs of family members who are affected by problem gambling, specifically, the issues of couples, children, adult children and parents. The Ontario government has declared that the family of the problem gambler will have access to all counselling and treatment opportunities funded by the Ministry of Health. This policy ensures access to resources for confidential, non-judgmental, and empirically based counselling. As counsellors (often from the field of substance abuse), working with problem gamblers offers new challenges and opportunities for creative learning.

“How could this happen?”

“It isn’t fair. He knew how hard we worked for that money.”

“How could I be so stupid?”

“My Dad says he wants to spend time with me when I visit him on the weekend. He just takes me to the mall so he can stand at the lottery kiosk and scratch his tickets.”

“Every night she goes to bingo. Is it because of me?”

“Can I ever trust anything he says again?”

“I’m afraid to answer the telephone.”

“He forged my name on a bank loan!”

“His parents just told me they loaned him $20,000 last year. I never knew.”

“Why should I have to come to counselling? It’s her problem.”

The vast majority of spouses who seek and attend counselling are female. The spouse of the gambler, as research subject, has been almost exclusively female. Little is known of the experience of the male spouse of the problem gambler. Limited and anecdotal clinical experience would describe the typical male spouse as passive, emotionally distant, often denying the extent of the problem and unwilling to participate in treatment either individually or with his partner. Obviously these characteristics only describe the men who remain with the gambling partner and who were seen in a counselling setting. As the male spouse is uncommon in the treatment setting, “the spouse” referred to in this chapter is assumed to be female. Shame, anger, hurt, shock, confusion, betrayal and desperation. Intense feelings fill your office as the family member of a problem gambler enters your office. The spouse, not the gambler, may be first to seek help for the problem. In some situations the spouse, or other family members, will remain your primary clients, because the gambler chooses not to enter the treatment system. The immediate task of the clinician is to meet the needs of the family. The longer-term challenge is to effect change in the gambling behaviour through the family member. The physician or a credit counsellor may refer the family member to your office. Or she may have discovered your service through the Problem Gambling Helpline. A crisis may have precipitated the contact. This person is asking for education, information and strategies and hope in order to cope through the chaos. Or perhaps the gambler is your client. During your work together you agree that the spouse, or other family, ought to be included in the counselling. The response of the spouse may be one of resistance: Why should I have to seek treatment? He’s the one with the problem. This may be more than a hesitancy to seek treatment; there may be a refusal to participate. It may because of fear of violence, or because the family has given up any hope of change. The family unit may already be apart. Whether apart or together, family members have been impacted by the gambling and can benefit from the opportunity to tell their story and begin the process of healing. Perhaps the family member would be willing to meet with another counsellor in your agency.

Five men entered the office bringing the youngest brother, a problem gambler, with them. In past, he had approached each brother, individually and in secrecy, for a bail-out. In turn they had covered his debt, found him employment, and provided him with accommodation when he had lost everything due to his gambling. This time, however, they met together and agreed “no more” bail-outs. They literally brought him to treatment.

Differences between the Impact of Problem Gambling and Substance Abuse on the Family

• Gambling behaviours are easier to hide than is substance abuse.
• Gambling is legal and socially acceptable. Few people would consider giving alcohol or drugs to an 11-year-old child. However, many families gamble with their children, in spite of the law, which states that gambling under age 18 is illegal.
• Problem gambling can wipe out a paycheque in one telephone call to place a bet or in one hand of cards. It may take days or weeks — even years — of drinking or drug use to cause the same financial damage as gambling can cause in minutes.
• Generally, problem gambling is unrecognized in our communities. This means that early problem signs may be overlooked until the consequences have become devastating.

Issues for Couples

Scenario one
Gambling may have long been accepted as an entertainment enjoyed by the couple or at least grudgingly accepted by the spouse. The couple may have travelled to Las Vegas or been on a cruise that offered gambling. At home, a husband may have been pleased when his wife went with her girlfriend to bingo for a “girls’ night out.” There may have been winning streaks, major jackpots. Whether a win occurs at the casino or at bingo, a secondary reward awaits the gambler who returns home displaying money won and describing details of the win to the family. One wife spoke of the excitement associated with her husband returning from the poker tables waving hundred-dollar bills. During the winning phase of the gambling, the spouse may live the gambler’s fantasy as well, vicariously following the excitement, and the anticipation of the win. However, as problems develop, what was entertainment becomes a gambler’s preoccupation and winning becomes a pattern of chasing losses.When the gambling is identified as the source of problems, the spouse may feel guilty about having colluded in the fantasy. In an attempt to control the amounts wagered and the time spent gambling, sometimes a family member will accompany the problem gambler to the casino or racetrack. The spouse may also be seduced by the Gambler’s Fallacy, the same cognitive distortion held by the gambler: “I must win,” “I deserve it.” They may come to believe that “after so many losses, the game has to turn in our favour.”

Scenario two
The spouse may not have known that the gambler was gambling. She may have thought the gambler’s preoccupation and absence was due to an affair, or to work pressures. She may have made excuses for him. She may have questioned herself when the budget didn’t balance. She trusted him and believed the excuses. Now she is furious with herself for accepting the lies and afraid that she will uncover even more untruths. Family members struggle to confront their reality and to protect themselves emotionally and financially. Shock, fear and anger may have exhausted them. It takes so much energy to make decisions, to deal with the reality. Counselling can provide a confidential, informed and supportive environment for family members. They can find answers to their questions, develop healthy strategies for managing immediate practical problems, learn to cope with intense emotional responses, and set goals.

The Family Assessment

Traditionally, clinical assessments were based on the medical model, which meant a detailed assessment, completed over many sessions. This assessment focused on family problems, or pathology. Current treatment practice is to assess the family situation using a solution focused, client-centred perspective. (See Section “ Solution-Focused Brief Therapy, ” for more details about this approach). This perspective identifies family strengths and the changes the family wants to achieve.

The counselling may be brief. The experience of many agencies is that the family member may attend for only one or two sessions to obtain information and referrals. Or she may participate in counselling over several months, alone or with the gambler. Counselling may take a variety of forms: individual, family, by telephone or perhaps in group.

What is expected in the first session? Often it’s a crisis that has triggered the initial contact with your agency. The family member will have immediate needs for crisis management, legal and financial advice, assurance and empathy.

Assessment tools
There are a limited number of family assessment tools geared to the family of a gambler. The Gam-Anon 20 Questions is readily available. Completing this questionnaire may be positive for it reassures the spouse that her experience is not an isolated situation. However, this questionnaire is problem-based and does not capture many facts necessary for understanding the client’s situation.

In your assessment, you may wish to determine:

• What, if any, was the crisis that brought the family member to your office?
• How long has the gambling been known to the spouse?
• What has the family done in the past to change the gambling? What worked? What didn’t?
• Are the gambling and the resulting problems a family secret?
• What are the immediate financial concerns?
• In what way has the family been affected by the gambling?
• What is the emotional and physical health of the spouse?
• Who does the spouse, or other family member, turn to for support?
• All families have strengths and resources.What are yours? (This question from Pam Kuruliak, AADC)

A timeline may be a useful tool for establishing a chronology of events. An efficient method of gathering family history and life patterns is by using the Genogram (see appendix at the end of this section) The Genogram (McGoldrick & Gerson, 1985) is a pictorial image of the family drawn with the collaboration of the client. In a few minutes, with direction and descriptors from the client, the counsellor has an understanding of the family structure, demographics, relationships, alliances and functioning. Intergenerational patterns can be identified.Using symbols and /or coloured pens, the counsellor draws and identifies family history of:

• gambling
• substance abuse
• physical and emotional abuse
• education and employment
• separation and divorce
• trouble with the law
• mental health problems
• current location of family members
• alliances, loyalties and close relationships
• conflicted and distant relationships
• role models.

Genograms are accessible to clients of all culture, ages and literacy abilities.

Assessing for physical and psychological health
When meeting with any family members, it is critical to assess for violence. While there is limited research data on the subject of violence in the relationship of the problem gambler, clinical knowledge and experience suggest that threats and assaultive behaviours develop in a family under such stress. Problem gambling has been identified following convictions for spousal violence. The children may feel the brunt of an angry and frustrated parent.

Family members may be embarrassed and shamed by the effects of the gambling and are reluctant to expose yet another “family secret.” The clinician may wish to first ask how tension and anger are expressed at home. Inquire about any history of violence in the family. If there is any indication of violence, or the threat of violence, establish safety precautions for the family. Inform the spouse, or family member, of local shelters and other services for victims of violence. In a small agency, the counsellor may be meeting with both the spouse and the gambler individually. Be clear regarding the boundaries of confidentiality and duty to warn.

Lorenz & Yaffe (1988) surveyed 215 female spouses of members of Gamblers Anonymous. They reported that “...spouses of compulsive gamblers experience physical disorders from living under conditions of stress brought on by the compulsive gambling behaviour.” Those conditions ranged from headaches and stomach problems to feelings of depression and thoughts of suicide. 35% of the respondents had sought help at mental health agencies. Of those, 92% “were emphatic in stating that a qualified mental health therapist who has not received specific training in gambling counselling cannot really understand the problems created by pathological gambling.”

Assess for the physical and emotional problems.What medications is the spouse prescribed? Complete a brief assessment of the alcohol and drug use of the spouse, for she may have been coping with substance abuse.

Legal Implications for Couples

The spouse may be a partner in a family business. The gambler may have accessed business funds in an attempt to chase gambling losses. Is the spouse aware of legal implications should the business fail? While she may not have been active in the business, she may be liable. In order to protect herself from financial liability she can seek paper proof, perhaps from the business accountant or lawyer, regarding her status. She is wise not to accept the gambler’s statements alone.

Family members are frequently unaware of the illegal acts committed against them. Research by Lesieur (1987) and Blaszczynski et al. (1989) documents illegal acts committed by the problem gambler in a desperate attempt to access money to remain in the action. Gamblers have remortgaged the family home by forging the spouse’s signature on the application. Gamblers have applied for credit cards in their spouse’s name. They have cashed their children’s educational funds and taken money from an elderly parent too frightened to refuse. Problem gamblers have stolen cash from the family and have feigned a robbery in order to pawn family possessions. If the crime is discovered, the gambler may repent and promise not to gamble. The family member, out of shame or a desire to believe the gambling will end, usually will not press charges. Typically, the pattern continues.

Inquire about the possibility of crimes committed against the family. Often the fact that the counsellor raises the subject gives permission for the spouse to discuss such events. Family members may have ignored or denied missing money, unexplained debits etc. Advise family members of their legal rights and responsibilities. They may decide, after weighing costs and benefits, to meet with a lawyer or press charges.

The spouse may state that she is unable to afford legal advice. The Law Society of Upper Canada operates the Lawyer Referral Service, which offers a half-hour free confidential consultation, which can be provided in languages other than English and French. The client will be given the name and the telephone number of a lawyer who is willing to discuss her situation. The time allotted is meant to outline the legal question to the lawyer and to learn how long the legal work might take, and how much it might cost. Some questions will be asked to establish the situation. Consultation can be provided over the telephone.

Lawyer Referral Service
Telephone 1-800-268-8326
Website: http://www.lsuc.on.ca/public/a/finding/lrs/

Financial Considerations for Couples

Not all families of problem gamblers experience financial problems. There are gamblers who continue to win, and gamblers whose wealth can absorb the losses. However, the vast majority of gamblers and their families seek counselling as a result of a financial crisis. Before working with the families of problem gamblers, the clinician is encouraged to identify his or her own values, beliefs and expectations about gambling, leisure, luck and money. For further reading on money matters in marital relationships, refer to books by Ramsey (1998) and Mellan (1994).

Problem gambling counsellors are not usually trained financial advisers. Clarify the limits of your knowledge with your clients. Have information and referral numbers available. However, while you are not a financial professional you can assist the spouse in preparing a financial audit. (For more information about preparing financial audits, see Section “Finances and the Gambling Client,”).

When a relationship is based on trust and shared responsibility, a casual method of budgeting will work for a couple. However, a trusting and busy spouse offers the desperate gambler an easy smokescreen behind which to hide unpaid bills and mounting debts. The financial assessment is completed for the purpose of having the spouse recall all assets and debts known to her. Ask the spouse to:

• List all credit cards, including gas cards and store cards. Confirm the amount owed.
• Are utilities paid?
• Are bank loans (mortgage, student loans, car loans, etc.) up to date?
• What is the status of all bank accounts, including children’s accounts?
• What is the status of RRSPs, retirement savings, insurance plans, bonds and company shares?

Depending on the complexity of family assets, listing financial liabilities and accounts can be a daunting task. And the spouse may find that her reward for doing so is to discover that the financial situation of the family is worse than she believed. The client may need support to follow through.

Family members who share property together with the gambler, or have co-signed a loan, etc. should be encouraged to clarify their financial responsibilities with the lending institution. The spouse may want to cancel all her credit cards on which the gambler’s name appears and apply for a new card in her name alone. Spouses, especially, ought to be discouraged from signing any document until they have sought professional advice from a lawyer, a credit counsellor or bankruptcy trustee.

Is the spouse ready to ask friends and family if the gambler has borrowed money? Frequently the spouse discovers that there have been earlier bailouts. Encourage the family to disclose previous bailouts. Debts may have been “covered up” or the gambler “bailed out.” These behaviours can be identified, not as “enabling” (which seems judgmental and has negative connotations) but as ineffective, for the gambling is permitted to continue without consequence for the gambler. Concepts of family intervention developed in the substance abuse field are transferable to families of problem gamblers (Heineman, revised 1996).

For referral to credit counselling services nearest you, contact:

The Ontario Association of Credit Counselling Services
P.O. Box 189 Grimsby on L3M 4G3
(905) 945-5644
Telephone 1-888-746-3328
Website: http://www.oaccs.com/

All services are free and counselling may be offered by telephone.

There are many examples of legal and financial complications. For instance, the husband’s disability pension is the sole income of the married couple. He is a gambler and there is no money for basic necessities. The spouse asks for advice.

Clarify your clinical situation with the Federal Government Income Security Program 1-800-277-9914.

Intimacy

As the gambling increases, emotional and physical distance between the gambler and spouse increases and frequently the sexual relationship is diminished.

Gamblers have said “[gambling] It’s better than sex.” The spouse may withhold sex out of hurt and anger. Gamblers have complained that: “Ever since she found out about [the gambling debts] she won’t have sex with me.” Partners have stated that they cannot be intimate with someone who has deeply betrayed them. Also, there is a concern that “if he or she could lie about the gambling, has he or she been lying about other things as well?” Sex is also used as barter in a relationship. For example: “If we have sex I know he won’t say anything about me going to bingo. So I get out of bed and go to the 1 a.m. game.”

Lorenz and Yaffee (1988) report that “55% of the respondents believed that they could have benefited from sexual counselling.” These researchers suggest that poor communication and low self-esteem even prior to the gambling may have contributed to the unsatisfactory sexual relationships of the couples.

During your work with the couple, you may ask: “How satisfying is your sexual relationship?” “How important is it to you now to establish (re-establish) a satisfying sexual relationship?” A scaled response (e.g., 1…5) will inform you of the level of sexual satisfaction in the relationship and its priority for the partners.

Improving the sexual relationship is not usually a priority in the early stages of counselling. However, as the couple works to restore the total relationship, including communication, trust and a balance in issues of power and control, they will seek to restore emotional and physical expression into their relationship. In a treatment setting it is not uncommon to discover that the gambler — and the spouse — are prescribed antidepressants. A side effect of the antidepressant may be a change in sexual function. Consider the impact of this on the couple.

Steinberg (1993) describes the deficits in emotional intimacy and sexuality in the gambler’s relationships. His extensive experience with couples is evident in his suggestions for treatment strategies. If it is established that there is no risk of violence, working with the couple may reduce the risk of misinterpretation and begin to move them toward a shared vision of recovery.  

Children and Parents of Problem Gamblers

Developing Treatment Programs for Family Members

The Genogram

Bibliography