Presentation Transcript

1. “Problem? Who Says It Is A Problem?: African Americans and Problem Gambling—Challenges and Opportunities”

   Deborah G. Haskins, Ph.D., LCPC, NCGC-II, BACC
2. Learning Objectives Identify historical and cultural aspects of African Americans, gambling, and problem gambling. Understand key cultural values, beliefs, experiences regarding African Americans when providing problem gambling/mental health treatment and outreach. Consider cultural strengths and opportunities for negotiating relationships and outreach to African Americans.
3. First, Who Are African Americans? Depends on Who You Ask and Talk to? US Census Bureau (2010): Black or African American refers to a person having origins in any of the Black racial groups of Africa. It includes people who indicated their race(s) “Black, African-American, or Negro” or reported entries such as African-American, Kenyan, Nigerian, or Haitian. Term identifies a citizen of the U.S. with lineage that can be traced to Africa, south of the Sahara….Linked to the transatlantic slave trade and does not include White South Africans and Black people from the Caribbean or Africa who have obtained citizenship through the immigration naturalization process. Children of these parents who are born in the U.S. are usually identified as African Americans…term almost exclusively replaced the term Black in reaction by Jesse Jackson who asserted the term Black is “baseless,” whereas African American has “cultural integrity. (Hall, 2005) Key: Let the person/client self-identify—make no assumptions.
4. Current Research on African-Americans and Problem Gambling New evidence that African Americans are more likely to experience gambling-related problems than White Americans (Barry, 2011) Black respondents (96%) more likely than Whites (45%) to exhibit past-year PPG (Barry, et al., 2011) Problem gambling is more prevalent in minority communities, and African Americans… may be particularly vulnerable because of the role that some forms of gambling plays in the social life of these communities (Alegria et., al, 2009; Westermeyer, J., et al., 2005).
5. Research Females were more likely to be African-American and either retired, unemployed or otherwise outside the workforce (Ibanez, et al., 2003) Race was the most significant predictor of PG (Welte, et al., 2004) PG was more common than gambling w/o problems or social and recreational gambling (Cunningham-Williams et al., 1998) African-Americans were more likely to gamble in response to Negative Affect situations than Whites, and education was inversely associated with wagering in response to Gambling Cues (Petry, Rash, & Blanco, 2010) Adolescent gambling among an African-American urban sample was associated with substance use in both genders and lifetime conduct disorder and psychiatric symptoms in females; male gamblers had higher levels of externalizing behaviors compared to females (Martens et al., 2008)
6. Why Important for You in California? The lifetime prevalence of PPG is particularly high among African Americans and among individuals who are disabled or unemployed (although the authors noted a research limitation included the prevalence rates of PPG among African Americans was associated with a relatively large sampling error and should be treated cautiously).
7. Barriers to PPG Help Seeking in California (Volberg, Nysse, & Gerstein, 2006) Differ by gender, age, and ethnicity but common reasons for not seeking help: Not wanting to stop Shame or embarrassment Denial that gambling is causing problems Assuming treatment would not work Question: What are the barriers for African Americans here?
8. Historical/Cultural Aspects of African Americans/Gambling/Problem Gambling “Numbers running” (historical vocation) Lottery Scratch-offs Video Slot Machines located in community Casinos (women, older adults, nursing home trips) Race Tracks Sports Betting (especially among youth) Online Gambling Street Dice games Dog Fighting (Males, Youth) Card games: Pinochle, Baccarat (e.g., Gladys's Knight) Key: Is gambling viewed as a problem within this community?
9. Why Do African Americans Gamble?
10. African American Male Invisibility Syndrome—Signs & Symptoms Frustration Increased awareness of perceived slights Chronic indignation Pervasive discontent/disgruntlement Anger Immobilization or increasing inability to get things done Questioning one’s worthiness Disillusionment and confusion Feeling trapped Conflicted racial identity Internalized rage Depression Substance Abuse Loss of Hope (Franklin, 2004)
11. Key Cultural Considerations Acknowledgement of Oppression External Coping Resources Differences in Worldview Racial Identity Development (and racial saliency) Acculturation
12. Why Don’t African Americans Seek Treatment/PPG RX? Mistrust of “White” institutions dating back to slavery (Boyd-Franklin, 1998; 2005) Mistrust of Agencies which have oppressed Blacks (e.g., police, foster care systems) (Boyd-Franklin, 1998; 2005) Lack of Insurance and Finances to Pay (Boyd-Franklin, 1998, 2005; Smith, 2004; Sue & Sue, 2008) Lack of Transportation (Sue & Sue, 1999) Use of own community/cultural resources (Smith, 2004) Same reasons others don’t: STIGMA, “Not a Problem”
13. Cultural Strengths: What is Missing? Why Lack of Identifying/Incorporating Cultural Strengths? Deficit-models prominent (Helms & Cook; 1999; Sue & Sue, 2003) Treatment models (European-Americans) used as universal standard (Helms & Cook, 1999; Sue & Sue, 2003, 2008) Incompatibility of universal treatment/outreach with African-American realities and valuing “Living in the City” (Stevie Wonder) “It’s a Jungle Out There…Don’t Push Me..I’m on The Edge” (Grandmaster Flash) Practitioners’ discomfort with African-Americans (miseducation) (Helms & Cook, 1999) Practitioners’ lack of cultural broaching (Day-Vines, et al., 2007)
14. African American Cultural Strengths African self-consciousness (“Say It Loud! I’m Black and I’m Proud!”) Religious faith and spirituality (McGoldrick, Pearce & Giordano, 2005);Richard & Bergins, 2000); indigenous practices Extended Family Networks Communal valuing Reliance on community networks/relationships Resiliency (historical): Trouble Don’t Last Always
15. Opportunities for Treatment and Outreach What is Needed: New, emicculture-based paradigms for problem gambling/mental health treatment and outreach (Barry, 2010) Cultural-guidance (Tseng & Streltzer, 2004): Therapeutic interventions based on cultural insight and assessment of whether and how a client’s problems are related to cultural and/or environmental factors
16. Engaging African Americans: RX and Outreach Demonstrate comfort being-in-relationship (cultural credibility) Do groundwork to establish relationships with community for referrals/provide prevention education first Integrate cultural context and worldview into RX and outreach Address invisibility syndrome/cultural challenges in the RX plan
17. Engaging Tools/2 Be aware A-As “Don’t do groups” (challenge with 12-step rooms, lack of cultural identification w/attendees) Identify natural-cultural eco-systems: Religious/Spiritual Leaders, The “Black Church,” Families, etc. Educate/Train family/friends/laypersons on PPG: front-line assessors; See www.baylor.edu/Christianethics/ Use/Develop culturally-reflective educational/therapeutic resources: See You-Tube “African Americans and Problem Gambling” (Univ of Penn Law Class) Use bibliotherapy (and cultural literature): Many will be hesitant or won’t come at all
18. Question for Reflection and Commitment Are we willing to move outside of the safe confines of our agencies/organizations to build, establish, collaborate with persons/community resources serving African Americans already?
19. Questions/Comments
20. Selected References Adell, S. A. (2010). Confessions of a slot machine queen: A memoir. Madison, WS: Eugenia Books. Alegria, A.A., Petry, N. M., Hasin, D.S., Liu, S.M., Grant, B.F., & Blanco, C. (2009). Disordered gambling among racial and ethnic groups in the US: results from the national epidemiological survey on alcohol and related conditions, CNS Spectrums, 14, 132-142. Barry, D. T. (2011). “New Research on Minorities and Gambling.” Gambling Disorders 360. http://blog.ncrg.org/blog/2010. Boyd-Franklin, N. (2005). (2nd Ed.). Black families in therapy: Understanding the African American experience. NY: The Guilford Press. Day-Vines, N. L., Wood, S. M., Grothaus, T., Craigen, L., Holman, A., Dotson-Blake, K., & Douglas, M. J. (2007). Broaching the subjects of race, ethnicity, and culture during the counseling process. Journal of Counseling & Development, 85, 401-409. Franklin, A. (2004). From brotherhood to manhood: How Black men rescue their relationships and dreams from the invisibility syndrome. NJ: Wiley Publishers, Inc. Hall, L. E. (2005). Dictionary of multicultural psychology: Issues, terms, and concepts. CA: SAGE Publications, Inc. Haskins, D. (2011). “Congregational ministry to problem gamblers.” In R. B. Kruschwitz (Eds.), The gambling culture. TX: Baylor University. Martins, S. S., Storr, C. L., Ialongo, N. S., & Chilcoat, H. D. (2008). Gender differences in mental health characteristics and gambling among African-American adolescent gamblers. American Journal of Addictions, 17, 126-134. McGoldrick, M., Giordano, J., & Garcia-Preto, N. (2005). (3rd Ed.). Ethnicity and family therapy. NY: The Guilford Press. Petry, N., Rash, C. J., & Blanco, C. (2010). The inventory of gambling situations in problem and pathological gamblers seeking alcohol and drug abuse treatment. Experimental and Clinical Psychopharmacology, 18, 530-538. Volberg, R.. A., Nysse-Carris, K. L., & Gerstein, D. R. (2006). 2006 California problem gambling prevalence survey. CA: NORC. Westermeyer, J., et al. (2005). Lifetime prevalence of pathological gambling among American Indian and Hispanic American veterans. American Journal of Public Health, 95, 860-866.