Transcript UNDERSTANDING AND UTILIZING 12 STEP PROGRAMS

Prevention and Recovery Conference
Inspiration. Connection. Motivation.
Oklahoma City, Oklahoma
November, 2014
Prevention of Problem
Gambling: What Every
Preventionist Needs to Know
Jim Wuelfing
Owner and Principle Associate
The New England Center
[email protected]
Never underestimate the
power of a few committed
people to change the world.
Indeed, it is the only thing
that ever has.
Margaret Meade
About the Meaning and
Challenges of Prevention
Prevention
No
progress has ever been
made against any epidemic
by treating only the
casualties. We simply replace
them with more.
Prevention
Is
an active process of
changing conditions and
fostering personal attributes
that supports the well being
of people.
Challenges and Principles of
Prevention Planning
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Based prevention in tested theory, research and
data
Use a proven prevention planning model
Using multiple strategies over multiple domains
Use evidenced-based strategies
Reduce risk and enhance protective factors
Utilizing best practices
Based on Tested Theory,
Research and Data

What prevention models are you following?
– Public health model
– Environmental management
– Youth empowerment and development
– Social ecological theory

What do you know about your population?
Quality and Accuracy of Data
Luxury Car –Valid and reliable measures that
allow you to observe outcomes over time
(examples surveys)
 Sedan – Proxy measure that may or may not
be valid indicators of outcomes of interest
 Compact Car – Qualitative data such as focus
groups and people’s perception of the problem.

CSAP’s Strategic Planning
Framework

Assessment
 Capacity Building
 Planning
 Implementation
 Evaluation
 All under the umbrella of cultural
competence and sustainability
Assessment

Assessment involves using data to access:
– Problem gambling and related problems (i.e.
needs) which leads to recommendations for
state and community priorities
– Capacities and resources in existence to address
the problems and gaps in capacities
– Readiness of state and communities to act.
(Adapted from CSAP Strategic Planning Framework)
Capacity Building

Involves identifying types and levels of
resources in the prevention system and
enhancing those systems by:
–
–
–
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Workforce development
Improving data-based systems
Increasing coordination
Building community resources.
(Adapted from CSAP Strategic Planning Framework)
Planning

Includes developing a comprehensive, logical and
data driven plan to:
–
–
–
–
–
Address priority problems and issues
Decrease risk factors
Increase protective factors
Minimizes gaps in resources and capacity
Selects complementary strategies (multiple strategies
over multiple domains.
(Adapted from CSAP Strategic Planning Framework)
Implementation

Involves:
– Infrastructure development
– Implementing evidenced-based strategies.
(Adapted from CSAP Strategic Planning Framework)
Evaluation

Involves:
– Assessing technical assistance and training
efforts needed
– Policies and procedures needed to foster
positive outcomes
– Measuring positive change that occurred.
(Adapted from CSAP Strategic Planning Framework)
Six Prevention Strategies
[Center for Substance Abuse Prevention
(CSAP)]

Information Dissemination
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Prevention Education
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Alternative Activities

Community-Based Processes

Environmental Approaches

Problem Identification and Referral
Information Dissemination

Complementary to more intensive /
interactive approaches
 Includes all types of passive education
– Posters
– PSAs (print, radio, TV)
– pamphlets

Choice air times
 Target audience
 Avoid authority figures & exhortations
Prevention Education

Combine information, skills, protective
factors
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Interactive, intense, with booster sessions
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Peer-led components
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Provide social skills training & practice
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Involve parents individually & with students
Alternatives

May be more effective with high-risk youth
 Intense programs with variety
 Component of integrated comprehensive
strategy
 Community service, mentoring, recreation,
cultural activities
Community-Based Processes
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Utilize multi-agency activities & interagency
coordination
 Clear purpose, appropriate planning,
commitment to results
 Active participation by meeting members’ needs
 Leadership essential
 Appropriate roles for paid staff
 Implement proven effective strategies to achieve
outcome-based goals
 Effectiveness based on strategies not structure
Environmental Approaches

Individualized environment
– Seek to socialize, instruct, guide, & counsel to
increase their resistance to health risks
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Shared environment
– Support healthy behavior, prevent risky behavior
for all in the population
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Environmental strategies
– Price interventions, minimum -purchase-age,
deterrence, location & density, counter-ads
Problem Identification and
Referral
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Estimate accurately people who justify
intervention
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Ensures appropriate referral to meet needs

Realize relationship between substance use,
gambling and other health problems.

Risk of exposure to other risk behaviors
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Brief interventions appear promising
PREVENTION DOMAINS

Individual
 Peer
 Family
 School/work
 Community
 Society/environmental
MULTIPLE STRATEGIES
OVER MULTIPLE DOMAINS
Questions to Consider in
Selecting Strategies
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Who is the strategy targeting ?
Why are you targeting this population and what
data/information supports your targeting this
group ?
What factors is your strategy addressing ?
Why do you feel this strategy will lead to a desired
change?
Is their any evidence that indicates that this
strategy is effective ?
What change due you want to occur in this group
or population?
SAMHSA’s Emerging Evidence-Based
Continuum
New
NREPP
2005+
Little-to-No
Evidence of Effectiveness
Innovative
and/or Unproven
Evidence of Effectiveness
Based on Rigorous Evaluation
Effective*
Conditionally
Promising* Effective*
Of
Insufficient Interest*
Current
Support*
* SAMHSA/NREPP effectiveness levels
Protective and Risk
Factors
Protective and Risk Factors

Protective factors – Factors that decrease the
chances of someone (or a community) developing
health and behavioral problems are called
protective factors. Having multiple protective
factors can override risk factors.

Risk factors - Factors that increase the chances of
someone developing health and behavior problems
are called risk factors. Individuals, families and
communities which possess these factors are
considered at risk. Those that possess several are
considered high risk.
PROTECTIVE FACTORS
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A relationship with a
caring adult role model
Having an opportunity to
contribute and be seen as a
resource
Effectiveness in work,
play and relationships
Healthy expectations and
a positive outlook
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Self-esteem and an
internal locus of control
 Self-discipline
 Problem solving and
critical thinking skills
 A sense of humor
 Family cohesion
 School/community
connectedness
Protective Factors

Family connectedness
 Designing school-based prevention
programs that seek to develop student’s
attachment, trust, and identification with
larger groups (e.g., school clubs and sports
teams, Scouts or Guides).
YOUTH GAMBLING PROBLEMS: THE IDENTIFICATION OF RISK AND PROTECTIVE FACTORS:: Report to the Ontario
Problem Gambling Research Centre: Laurie Dickson, M.A.
Jeffrey L. Derevensky, Ph.D., Rina Gupta, Ph.D.
Risk Factors for Problem Gambling
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At-risk for a substance abuse problem
Having a parent, sibling, relative, friend, or
significant person with either a gambling problem or
substance use problem
Having or knowing peers with substance use
problems is a risk correlate of youth problem
gambling
Anxiety
High risk propensity
Low perception of risk regarding problem gambling
Early onset of gambling behaviour
YOUTH GAMBLING PROBLEMS: THE IDENTIFICATION OF RISK AND PROTECTIVE FACTORS::Report to the Ontario Problem
Gambling Research Centre: Laurie Dickson, M.A.
Jeffrey L. Derevensky, Ph.D., Rina Gupta, Ph.D.
High Risk Categories

Child of a compulsive
gambler
 Belief that skill is
involved
 An early big win
 Feeling that one must
chase gambling loss
with more gambling
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Early age of onset (8.5
years for pathological
gamblers; 11.5 years
for non-pathological
gamblers)
 Large first bets
 Otherwise addicted
Characteristics of Low Risk
Gambling

For fun or recreation,
never for financial
gain
 Knowledge that over
time nearly everyone
loses
 Socially with family
and friends, not alone
Limited time –
frequency and
duration
 With predetermined
limits for losses
 Acknowledging that
knowing a lot does not
make you a better
gambler
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Minimizing Your Risk
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Always bet with a predetermined amount of
money to be lost
 Never borrow money to gamble
 Never gamble illegally
 Know your personal risk factors
 Know where to get help
 Be willing to help others
Three Consistent Messages
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The choice to abstain from gambling as a lifelong
practice is a legitimate choice that many people
make.
 We want you to be legally allowed to gamble
before you do so and we do not want you to
gamble illegally ever.
 If you still choose to gamble, we want you to
know enough about gambling so that you can
lower your risk of gambling problems.
Best Practices in Prevention
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Research and Conceptual
Framework
Accuracy, Efficacy and
Credibility of Approach
Needs Assessment
Measurable Goals and
Objectives
Outcome and Process
Evaluation
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Comprehensive Approach
Integrates Overall Health
Promotion
Community Involvement
and Ownership
Long-Term Commitment
Replicability
The Connection Between
Prevention and Recovery

Both are primarily concerned with wellness
 Both focus on both building personal
recovery capital as well as community
recovery capital
 There is much overlap in the skills used by
preventionists and recovery support
personnel
 Both support a holistic approach
Prevention of Problem Gambling
on the National Level

National Council on Problem Gambling
NCPG) – Prevention Committee
– Co-chairs: Julie Hynes (OR) [email protected]
Susan McLaughlin (CT) [email protected]

NCPG Annual Conference – July 10-11,
2014, Baltimore, MD
State Efforts

Oklahoma Association on Problem and
Compulsive Gambling (www.oapcg.org)
– Wiley Harwell, Executive Director
405-801-3330
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Other State Affiliates of NCPG
– Go to www.ncpgambling.org and click “About
Us” and then “State Affiliates”
Stacked Deck

Evidenced-based curriculum for the prevention
of problem gambling among teens and young
adults.
 Created by Robert Williams, Ph.D., Alberta
Gaming Research Institute and Robert Wood,
Ph.D., University of Lethbridge, Alberta
 Teaches young people to approach life as
smart risk-takers, weighing the pros and cons
of their actions to determine the odds of
achieving positive results.
Thank you.