Counselling techniques

Stigma and history of unsuccessful attempts to change can make it hard for clients to ask about gambling – and this makes it important for you to bring gambling up with clients.

The Motivational Interviewing approach is useful here.  

Motivational interviewing is an evidence-based approach in all addiction that avoids confrontation while helping clients think about their behaviour in an accepting and constructive manner.

Asking the question

Some guidelines

Questions relating to gambling should be included in your routine client assessment. Clients are likely to be reassured and may be relieved when you bring up gambling in a professional and non-judgemental manner.

The aim at this stage is to discover whether the client is concerned about their gambling and reassure them that this is a legitimate health issue.

Direct questioning

In primary care practice, the use of diagnostic screening tools to identify problem gambling can be problematic because of the length of the measurement tools.

It may be more useful to include a direct, concise screening question about gambling as part of your intake interview.

Direct questioning aims to:

• normalise problem gambling as a health issue
  
• introduce the topic of problem gambling in a non-confronting, non-personalised manner
  
• offer screening for problem gambling if required
  

Affected others

People affected by someone else's gambling are a much larger group than those affected directly. The Productivity Commission's report suggests there are seven to 10 times as many affected others than there are people with gambling problems. 

Affected others can be as desperate and discouraged as gamblers themselves and may be seeking help for problems as diverse as depression and anxiety, through to domestic violence.

They also may feel the stigma of gambling problems and be relieved if you show a willingness to discuss gambling with them.

All problem gambling services in Victoria offer free and confidential help to affected others.

Interviewing technique

Talking with a client about an addictive behaviour - that is, a behaviour they persevere with, despite the negative impacts on their lives - carries the risk they will justify or minimise their behaviour, making them entrenched. 

Motivational interviewing is a technique designed to:

• Enable you to talk with a client about gambling without confronting them and making them defensive
  
• Discuss gambling issues with your client in an accepting, constructive and non-confrontational manner
  
• Talk about the pros and cons of your client's gambling behaviour
  
• Examine the pros and cons of your client changing their behaviour
  
• Highlight the difference between the client's current situation and the changes they would like to make.