What I Learned About Gambling on Summer Vacation

This July, I attended the 30th National Conference on Problem Gambling in Tarrytown, New York. The title of the annual conference this year was “30 Years: Proud of Our Past, Planning Our Future.” New York was selected because 30 years ago this was the site for the National Council on Problem Gambling’s first conference.

Over 500 participants participated, including researchers, educators, therapists, gamblers, and family members. There were participants from all over the world including the Netherlands, Australia, Taiwan, and the U.K.  The two days were filled with lectures, workshops, and Professional Educational Development (PED) talks. Within the conference structure, tracks were available for therapy, prevention, and research as well as for those in recovery.

I enjoyed the meals (they were even able to accommodate my gluten free needs) and the snacks during breaks.  All events were held at the Westchester Marriott, which is located in the Lower Hudson Valley right off the Hudson River.

Kathryn Elliott-Hudson with Dr. Chuck Maurer

Kathryn Elliott-Hudson with Dr. Chuck Maurer

Fellow Therapists at NCPG Conference

Kathryn Elliott-Hudson with Jenny McIver (GA) and Catalina Christophe (AZ)

All the presentations I attended were stellar, but I had a few favorites:

  • “Developments in Treatment” by Mark Potenza, M.D., Yale University psychiatrist and researcher, whose focus was on the challenges of getting people with gambling problems into treatment and “identifying which treatments might work best for whom.”
  • Gender Differences in Treatment-Seeking British Pathological Gamblers by Henrietta Bowden-Jones, M.D., who developed the first national problem gambling clinic in the U.K.
  • Richard Rosenthal, M.D., founder of the gambling treatment program in UCLA, who presented a talk on how problem gambling became accepted as a disease in the medical world back in 1980.  His topic, “The Inclusion of Problem Gambling in the DSM-III” (the Diagnostic and Statistical Manual), was based on papers from the archives of the American Psychiatric Association and NCPG as well as his own documents and interviews with several members of the committee, in addition to his experience as a member of the DSM-IV IDNEC committee.
  • Longtime NCPG member and former board member Don Feeney of the Minnesota Lottery presented a fantastic PED talk, “Generations in Gambling.” His focus was on whether treatment developed for Baby Boomers is appropriate for Millennials, those born 1982 to 2004. Although the talk was brief, we were left with questions about accommodating the differences between the generations: what are the differences in their ideas and beliefs about gambling and in their gambling behavior? For instance, the Millennials grew up in an era of acceptance for gambling after lotteries opened the door; Baby Boomers had to be sold on it, literally.
  • Roberta Broughton from Ontario presented a workshop with focus on women and group work, two topics that are of particular interest to me.  Her topic was titled “Treatment of Female Gamblers: A Workbook and Webinar Effectiveness Pilot.” Roberta has designed a five-unit workbook focusing on issues presented by women gamblers. The workbook is designed to increase resilience and teach skills necessary for sustained recovery.
  • Dr. Heather Chapman, director of the Louis Stokes Hospital Gamblers Recovery Program (Brecksville, Ohio), discussed client reluctance and GA. As an aside, Brecksville was the first hospital to treat gamblers—ever—in 1972. For those of you who have questioned GA’s effectiveness or validity, Dr. Chapman said that GA continues to be underutilized, despite suggestions by therapists and others that GA is a helpful adjunct in the recovery process. I believe that a 12-step program is essential. Treatment is short-term, but the disease is always going to be there, and one needs as much ammunition as possible to keep the disease at bay. Where else in society besides GA can one get ongoing reinforcement and understanding about a disease that is “cunning, baffling and powerful”?

Why Attend a Gambling Conference

All of these topics allow me to be more sensitive to my clients’ needs. The field is changing as gambling has become more prevalent and the means of gambling more sophisticated.  We as therapists must continue to avail ourselves of opportunities that enhance our knowledge and allow us to share ideas so that we can best support those whose gambling has gone way beyond a social level in addition to those affected by their gambling.

I’m already looking forward to the 31st National Conference on Problem Gambling in Portland, Oregon, where the topic will be Listening, Learning, Leading, all of which I hope to do next July.  Until then, I will implement new information in individual and group sessions.

NCPG Executive Director Keith Whyte and Barbara Rollins

Kathryn Elliott-Hudson with National Council on Problem Gambling Executive Director Keith Whyte and Barbara Rollins

5th International Gambling Conference Highlights

Kathryn Elliott-Hudson presenting at the 5th Annual Gambling Conference

Kathryn Elliott-Hudson with co-presenters Dr. Phillip Townshend and Matthew McMillan at the 5th International Gambling Conference

I was invited to present at the 5th International Gambling Conference in Auckland, New Zealand, February 19-21, 2014. I’ll share some of the highlights of this conference, whose goal was to examine “how positive change can be brought about through research, policy, and practice.”

On February 20, I had the privilege of presenting, along with Matthew McMillan and Dr. Phillip Townshend. Our topic was “Working Toward Best Practice: Reflections from the Northern and Southern Hemispheres.” My portion of the presentation was focused on gambling in Arizona, which included information about the Office of Problem Gambling, the Treatment Assistance Program, and an historical perspective of gambling in this state. The presentation was well received, and I fielded quite a few questions during the Q&A and later at lunch.

The conference, an educational and cultural experience, was held at Auckland University of Technology (AUT), City Campus Conference Center, which was completed just in time for the conference.  It was hosted by Hapai Te Hauora Tapui Maori Public Health, the Gambling and Addictions Research Centre at AUT, and the Problem Gambling Foundation of New Zealand (PGF).

Approximately 300 people representing fifteen countries attended. I was one of three U.S. presenters. Newly retired Judge Mark Farrell, a friend of mine, delivered the keynote “Therapeutic Justice: The World’s First Gambling Treatment Court” about the criminal and civil treatment court he founded in Amherst, NY in 1996.

Another keynote of particular interest was delivered by Professor Gerda Reith of the University of Glasgow on “Mobile and Social Gambling: Key Trends and Challenges for Research.” I also enjoyed the workshop “Web-Based Counseling for Problem Gambling” presented by Simone Rodda from Turning Point Alcohol and Drug Centre in Victoria, Australia.

Because the focus of the conference was on technology, each attendee received an Android tablet with a preloaded conference app so that we could view the program, information about the keynote speakers, presenter abstracts and bios, and maps of the venue. Despite a wonderful how-to video, there were many laughs as we struggled to learn to use our devices, and a call was sent out to any nearby five-year-olds who could possibly help us.

On the cultural side, the welcome powhiri was a one-time experience for a manuhiri (visitor). It was their way of officially welcoming us to Aotearoa/New Zealand and to the conference. This event took place at the sacred place or Marae, and each morning there was some sort of ritual except for one morning when we had the Pacific Welcome, songs and dance of other Pacific islands such as Tonga, Fiji, and Samoa.

A Maori expression appeared with the conference logo: Ma te korero ka mohio, Ma te mohio ka marama, Ma te marama ka matau, Ma te matau ka ora. It means: Through discussion comes understanding, through understanding comes light, through light comes wisdom, through wisdom comes wellbeing. I left the conference with a new appreciation for the potential application of technology in the counseling setting.

It is possible that the presentations will become available online in the near future, and if so, I will publish an update to this post.


Review of Bill Lee’s Born to Lose

I just finished rereading Born to Lose: Memoirs of a Compulsive Gambler by Bill Lee. I was so compelled by his story that I was unable to put the book down after planning to read just a few pages. The next thing I knew it was 2:00 a.m.  Reading the book a second time was just as riveting. Bill Lee’s childhood—even before he was born—was filled with many jaw-dropping moments. He describes his descent into hell in a graphic and poignant way.

The book is the story of addiction told from the perspective of a male action gambler. Bill Lee was born in San Francisco’s Chinatown, where he was exposed at an early age to the gambling culture. The author speaks of early indoctrination and acceptance of gambling within his community.

“My history of gambling really began before I was born,” Lee says in the book. He was born into a culture in which it was not unheard of to lose fortunes and even one’s children to gambling. He talks about a generational influence as he was a third generation gambler. He believes that he is one of those unfortunate individuals who is predisposed to gambling and that all it took was exposure, and he was off and running.

Although he spent time in Vegas, the action primarily takes place in his hometown, but his story could have happened anywhere.  Gambling is about time, money and most importantly, availability.

He eventually finds recovery through the Twelve Step program and shares his challenges in accepting his disease and the structure of the Twelve Steps. At the time of the book’s writing, Lee had a 40-year history of gambling followed by 15 years of involvement with GA.

There is a ray of sunshine in reading the book as Lee shares his experience, strength and hope. He seems to have held off his demons one day at a time and credits GA. Before he surrendered to GA, he relapsed and questioned GA traditions and procedures, but in the end he came to praise the gift that he had been given.

Lee is a writer by profession and has been featured on several television shows. His memoir was published in 2005 by Hazelden Publishing, which “provides products and services to help people recognize, understand, and overcome addiction.”

Born to Lose is available in paperback and a Kindle version by following this link to Amazon.

Book Cover: Born to Lose by Bill Lee

Remembering Joanna Franklin

Last week I had my bi-monthly breakfast with two of my colleagues who are also working with gamblers. The main topic of conversation was the sudden passing of our beloved colleague, mentor and friend, Joanna Franklin, on Saturday, October 5. We each talked about how we met Joanna and the impact she had on our lives.

I first met Joanna in the spring of 1997. She had come to Michigan to train those of us who were interested in working with problem gamblers. Our training was held in an office building near the soon-to-be Greektown Casino in Detroit’s Trapper’s Alley and sponsored by the now-defunct Michigan Council on Problem Gambling. My initial plan was to attend to see if there was something to benefit the program I was working in at a local hospital. At the time, I loved my work in chemical dependency. I loved my clients and colleagues.  However, that day in 1997 would mark a new beginning for me.

After Joanna was introduced by the executive director of the council, she stepped forward, her gaze sweeping the room, and said that gambling was “in one word, magic.” Gambling for the gambler, she said, was “magic” because it solved so many things, at least prior to the addiction manifesting itself. She talked about the impact of gambling, time that can never be recaptured, the financial and emotional toll on the individual and families. By the end of the morning session, I knew that somehow my career path would shift in a significant way. This, I knew, was to be the icing on the cake.

Joanna continued to work with us throughout 1997, providing education, inspiration and very practical support. She brought in other experts to expand our knowledge base, and she was always available to answer questions and validate the baby steps that we took on our road to becoming nationally certified gambling counselors.

It was Joanna who encouraged me to start a women’s group as part of my private practice. Joanna later told me that mine was one of the first, if not the first, group for women gamblers in the United States. She encouraged me to explore how women would better benefit from help within the treatment delivery system. I was inspired to look for any and all references and resources to be a more effective counselor. The early literature tended to focus on the issues of a predominantly male gambling population. Joanna encouraged me to talk to others about  working with women gamblers and explore techniques that would benefit their unique needs.

After my move to Arizona in 2003, our relationship shifted from a less direct mentorship as I began to gain more confidence. We always managed to connect each year at the National Conference on Problem Gambling, and she was always supportive and validated my growth, commitment and special interest in women gamblers. In Seattle this past July after exchanging our usual hugs she asked about my practice and my future plans. As always, I checked in to see what was happening with her in Maryland, and she talked about her daughter Heather, whom I had met at several conferences, a new grandchild, and of course, her husband Carl.  When we parted I said, “See you next year in Orlando.”

According to Keith Whyte, NCPG president, “Joanna trained thousands and thousands of counselors and helped set high standards for the profession through her work on certification.” She designed and delivered clinical training programs in 45 states, 10 Canadian provinces, among 31 tribes and in 9 other countries.

I know the world is a better place for Joanna Franklin having been here, in particular for those individuals and families who have been impacted by problem gambling, and for all who met her, her genuine caring and love for people. She was one of the most significant influences on the work I do today.

Thank you, Joanna. What a legacy to leave—a job well done.

After the Phone Call

Making the call for help is not a decision that is made lightly. It is a rare individual who is not anxious about picking up the phone and making that all-important call. Without a doubt, showing up for the first appointment may be equally anxiety provoking. However, if a client knows what to expect at the first session, this may help alleviate fear and anxiety.

During that initial call a question I’m often asked is, “What’s the cost of treatment?”  As a TAP provider, I can access monies allocated to the Office of Problem Gambling to support our treatment efforts. No one is ever turned away, and co-pays are based on one’s ability to pay, indebtedness, and need.  During the first appointment, I evaluate a client’s financial status and suggest an affordable co-pay.

The assessment or intake process normally takes 90 minutes. The goals of the assessment are for connection, disclosure, paperwork, and interpretation/planning. I encourage clients to come to their session at least 15 to 30 minutes beforehand to complete their paperwork so that they can spend the bulk of their first session sharing their gambling history and what they would like to accomplish in recovery.

In the connection stage of the first appointment, the goal is for the client to get to know the therapist and vice versa. During the disclosure phase, the focus is on the client telling his/her story. The information gathered is designed to formulate a plan of action.

During disclosure, I’m looking for what the client is seeking, his/her gambling history, and consequences.  This is the time during the assessment that I introduce the concept of gambling as a disease.

Paperwork consists of documents required by the state of Arizona’s Board of Behavioral Health, the Office of Problem Gambling, and HIPPAA as well as those documents required by the therapist. The issue of confidentiality is addressed.

The interpretation stage focuses on assessing what it is the client wants to achieve in therapy and prioritizes the client’s needs and assesses their support system. If there are medical concerns, I stress the need for an appointment with the primary care physician.

By the end of the session, we have an initial treatment plan, which will be our roadmap for next four to five weeks. The client receives an Informed Consent document to take home. We set a standing appointment. Standing appointments are very important for the client to begin the process of putting structure and accountability in his/her life.

Sometimes the client is accompanied to the first session by a friend or a loved one. Occasionally that individual is eager to share the impact of the addiction on their life or on the family system. When this occurs, I allow a small amount of disclosure and encourage that individual to seek his/her own appointment, or I refer them to Gam-Anon.

After this first appointment, clients are normally seen on a weekly basis. That’s when the real work begins, but it all starts with that phone call and first appointment.

Holiday Survival for Those in Recovery

The Most Wonderful Time of the Year?

For the past few weeks this holiday classic has been playing in my head. It’s the Most Wonderful Time of the Year  Perhaps this was triggered by a client’s recent comments  lamenting the start of the holiday season.

“I hate this time of year,” she said, “Absolutely hate it! There’s no joy in it for me.”

She went on to describe past losses, a history of family discord, and “burned bridges.” To make matters worse, the winter holidays were to be a series of firsts for her—first Thanksgiving, first Christmas, first New Year’s—without gambling or participating in an act of addiction and she didn’t know “how to do sober.”

This certainly didn’t sound like the most wonderful time of year for her, I observed.

The “Perfect” Holiday

Without a doubt, this time of year puts undue stress on us all. In recent years all of us have been subjected to increased media hype, often starting as early as September. We succumb to the lure of advertising, resulting in unreasonable expectations for ourselves and for others.

The media floods us with images of glamour and perfection. The gifts are elegantly wrapped. The table is impeccably set, and the turkey’s cooked perfectly. The scene is complete with smiling faces projecting contentment and happiness.

Sometimes, consciously and most certainly unconsciously, we compare our lives and our situations with these ideal images of the holiday. No wonder we come up lacking! Who can compete with staged sets, enhanced food photography techniques, and airbrushed models paid to look happy and festive?

Perfect Holiday Food

Enhanced food photography makes life look perfect. But real life doesn’t always look this way.

All year long we’ve been chasing our tails. Add in the pace of the winter holidays, and we go into overdrive to keep up with the demands on our time. For those who aren’t dealing with addiction, there’s intense pressure during the “most wonderful time of the year.” And for those who are fighting an addiction, the pressure is even worse if they are not prepared or aware of the pitfalls of the holidays.

Is there anything you can do to accentuate the positive and minimize the negative influences of the holidays? Absolutely! I like to call them “The Three G’s”: Give of Yourself, Give to Yourself, and Guilt-free Gift Giving.

Holiday Survival Tips for Those in Recovery

Give of Yourself
The most important thing to remember is not to isolate, which actually makes the problem worse. The best way to get outside of yourself is to think about and do for others.

Within the recovery community itself, you can always help with setting up or cleaning up after meetings, talking to the newcomer, and sharing your strength and hope. Volunteer for tasks through Intergroup.

In the community, there’s an abundance of volunteer opportunities. Food banks and food kitchens are always in need of extra hands. Organizations such as the Humane Society and animal shelters welcome volunteer help throughout the year. You could volunteer to work with seniors or youth or any charitable organization that interests you.

However, if you decide that you really want to have your own pity party, set a timer for 15 minutes and indulge yourself. But when the timer goes off, get up and move on with life by thinking about someone else besides you.

Give to Yourself
▪   Try diversion/distraction techniques such as watching movies or reading a fast-paced non-work-related book. Laughter is the best medicine any time of year, so watching comedies is not only a great diversion but it will get you laughing.  Visit your public library. The price is right to check out selections from their huge selection of books, DVDs, and music.

▪  There are some other things you can do that are inexpensive or free. Go for a walk or hike. Ride a bicycle. Grab your camera and see the world in a new way even if it’s only in your neighborhood. Check the newspaper entertainment magazines for free or low cost concerts, exhibits, and other activities in the community.

▪   Get out and socialize. Take a risk and ask someone out for coffee.  If talking is difficult for you, start by genuinely listening to others. If you have not been particularly social due to the impact of your addiction and you are afraid to take a risk, remember that others may be equally nervous about connecting as well. Ironically I find that gamblers are risk-avoidant when it comes to trying new activities and connecting with others. But when actively gambling, gamblers are incredible risk takers.

Guilt-Free Gift Giving
About those gifts. There’s a tendency for all of us to overspend at Christmas time, and all spending rules fly out the window. Even those who have a solid spending plan in place may make small compromises here and there.Remorse is at an all-time high in January when the bills come due.

A gambler may engage in overspending as a way to soothe those pangs of guilt about past spending to fund the gambling. Those in early recovery are particularly vulnerable as gift giving may be viewed by the gambler as an opportunity to make amends to significant others.

Guilt-free or Guilty Giving?

Spending is at an all-time high during the holidays. But gift giving is not a way to make amends for those in recovery.

▪   Set a realistic budget and stick to it. You may need help from a sponsor or a therapist to help you evaluate if you’re staying within your means. The slogan “Keep It Simple” means just that. Gifts most remembered are those from the heart.  And your new way of life is the best gift of all.

Maybe you’re like my client and doubting that it’s the most wonderful time of the year. The goal is to create wonderful moments for oneself—not an entire holiday season, not a picture-perfect family scene, not a dinner table laden with the finest. But wonderful moments.

Be like a child stringing pieces of popcorn to decorate the Christmas tree: string those moments together and you will have one day at a time.  And that will definitely be wonderful!

Recovery is a Gift

Your new way of life is the best gift of all.




Typical Clients in Gambling Treatment

There’s no typical client that I see in gambling treatment. They’re from all walks of life and socioeconomic status.  Men and women. Young and old.

My oldest client was in their early 80s. The average age of the clients I work with is late 40s.  Having worked in a university town, I have had students in their late teens and early 20s engage in treatment.

When I first started, I saw more men. Over the years, the number of women who present for treatment has grown and now equals the male gamblers I see in treatment.

It doesn’t matter who you are or where you live. Addiction does not discriminate and is an equal opportunity destroyer.

Gambling Treatment in Mesa-Chandler

When you’re ready for help to stop gambling, gambling treatment is a phone call away.  I am one of five providers for the State of Arizona’s Office of Problem Gambling Treatment Assistance Program (TAP) in Mesa. My Mesa-Chandler office, south of the 60 and a short distance from the 101, is easily accessible to all areas of the East Valley. I am one of the few therapists in the Southeast Valley participating in the TAP Program for Problem Gambling.

Where the need for gambling treatment starts

Gambling addiction is an equal opportunity destroyer

My mission is to provide the highest quality gambling treatment to problem gamblers and those affected by someone’s gambling. Please call me today so that together we can cross the bridge from gambling addiction to recovery.


Compulsive Gambling Insights


I have a unique perspective on the various issues that accompany compulsive gambling after 16 years of working with problem gamblers and their families.

With the explosion of casinos, gambling is the new kid on the block. So is gambling addiction. Currently there’s limited public awareness of compulsive gambling and gambling addiction. In certain areas of the country there’s limited access to gambling treatment and not enough advocates for prevention and treatment.

On the plus side, I have seen improvement in the quality and amount of available services for those who have gambling problems. Research into the cause of gambling addiction is in the early stages.

Today, most states have funds available for problem gambling hotlines, treatment and prevention. Initial awareness of problem gambling and the need for treatment was brought to the forefront by grassroot organizations most often created by those who were in recovery from gambling addiction.

From Addictions Specialist to Gambling Treatment Specialist

My own journey as a gambling treatment specialist began in 1996 after years of working with chemical dependency, adult children of alcoholics and recovering adolescents. That year, a proposition had been passed that mandated treatment in conjunction with the establishment of three land-based casinos within the city of Detroit. The State of Michigan advertised for therapists interested in working with gamblers.

After a year of training and supervision, in 1998 I received my certification as a Nationally Certified Gambling Counselor I (NCGCI) and was one of the first therapists on the state panel. Until my relocation to Arizona in 2003, I treated gamblers in the St. Joseph Mercy Hospital System and in my private practice in Ann Arbor. After I relocated to Arizona in 2003, I continued my work with compulsive gamblers and their families. I received my certification as a Nationally Certified Gambling Counselor II (NCGCII).

I learned a lot in those early years, and I am so grateful to my clients who provided insights into compulsive gambling that one could not get from a textbook or from the excellent workshops that I attended during and after my training. I am thankful for the support of my personal mentor, Dr. Lori Rugle, and to Joanna Franklin, NCGC-II, BACC and Deborah Haskins, NCGC-II, BACC who are all pioneers in the field of gambling addiction. They encouraged me to stretch and grow.

Most of all, I owe a debt of gratitude to my clients who have allowed me into their lives, one day at a time.