Strategies For Addressing Behavioral
and Financial Issues Related to
Problem Gambling in Treatment
Gina Hutto
Esther Maddux
Handouts
• 2 case studies
– Jack and Jill (will be used to demonstrate PEFT scan)
– The High Cost of Client Secrets (will be used to demonstrate
financial consequences)
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The Departments of Life
Composition of the Metaphysical Self
PEFT Scan
A Chart of Compulsive Gambling and Recovery
Financial worksheets
– Net Worth Statement
– Paycheck Planning
– Debts/Liabilities
Entering Treatment
• Entering Treatment
– Who is client? Person with problem; significant other
– What is client’s role in family?
– Presenting issues at entry to treatment process
• Primary situation leading to mandate - is gambling primary or secondary disorder3?
• Role of gambling in client’s life
– Source of income as one’s profession
– Social or recreational activity
– Is treatment mandated by someone such as court, hospital, family member or
did client voluntarily enter?
– Source of funds for payment
• State funds (varies by state and types of gambling in state)
• Insurance
• Self-Pay
Two Issues in Treatment
• Formation of Behavioral Structuring
– Client
– Significant others
• Financial status
– Income
– Expenses
Purpose of Treatment Interventions
• Image situation to sort out specific problem
areas related to
– Formation of behavioral functioning
– Financial issues manifesting as a result of the
formation of behavioral functioning
Imaging Personal Behavior in Relation
to How We Use Money
• Managing the self in relation to how we use
money
– Behavior Scan - Image how we organize the self
– Financial Scan – Image how we use money
Imaging Personal Behavior in Relation
to How We Use Money
• Dimensions of observation
– Who is the client? –
• Person with gambling problem
• Persons impacted by the person with the gambling problem (significant other,
family members, friends, employer)
– What is the diagnostic impression – mild, moderate, severe (DSM V)?
– What level of treatment is indicated - .5, 1, 2.1, 2.5 (ASAM 2013
Level)?
– Where is treatment available? – in Georgia, outside Georgia (for
higher levels of care)
– How does the counselor assess the metaphysical and financial
functioning formation of the client and/or significant other?
– How does the client view the metaphysical and financial functioning
formation of the self or significant other?
– How do the significant others view the metaphysical and financial
functioning formation of the self or the problem gambler?
Imaging Personal Behavior in Relation
to How We Use Money
• Roles of counselor
– Establish trust with client
– Establish image of functioning pattern of client
– Present image of functioning pattern to client
– Choose and use appropriate tools and techniques
• to facilitate guiding the client in evolving his or her
personal capacity
– to release self-defeating behavioral formation
– to replace with life-enhancing behavioral formation when
responding to life opportunities
Imaging Personal Behavior in Relation
to How We Use Money
• Managing the self in relation to how we use
money
– Behavior Scan - Image how we organize the self
– Financial Scan – Image how we use money
Imaging Personal Behavior in Relation
to How We Use Money
• Managing the self in relation to how we use
money
– Behavior Scan - Image how we organize the self
• Family Genogram
– Role in family of origin
– Role in current environment
• The Departments of Life
• Composition of the Metaphysical Self
• PEFT Scan
– We pass along behavior patterns just as we pass along a money
inheritance.
– What is the dominant functioning pattern the client and the
significant other is expressing?
Behavior Scan
The Departments of Life
Physical Self
Health
Impairment
•Body
•Brain
•Biology
•Trigger Level/Cravings
Chases (6)
•Tolerance - Needs more (1)
•Withdrawal (Releasing
attachment to gambling)
•Health/Life - losses
•*Numbers indicate DSM
Diagnosis Criteria for
gambling
Non-Physical
Other
Other
Other
Self
People
Places
Things
•Mental – Preoccupied (4)
•Emotional - Restless,
irritable when cuts back
(2); Gambles when
distressed (5)
•Connectional
•Automate
•Aware/Unaware
•Willing/Not willing
•Choices
•Words – Lies (7)/Actions (Secrets)
•Consequences
•Can’t stop use/Persistent
recurrent pattern –
Repeated unsuccessful
efforts to cut back (3)
•High attempted suicide
rate
•Interpersonal – losses
•Family – Losses (8)
•Social
•Career/Occupation - Losses
(8)
•School – Losses (8)
•Recreation
•Legal
•Relies on others to
complete transactions (9)
•Home
•Work – Losses (8)
•Religious place
•Social gathering place
•Alcohol, drugs, gambling
(quantity, frequency)
•Time
•Money - losses
•Physical objects
•Car
•Work equipment
Behavior Scan
Composition of the Metaphysical Self
• How we form self when relating to people,
places, and things including money
– The healthy self
• Focus attention within
• Connect to creative source within/Join with
others
• Manage Character Operating System
• Distribute Energy
• Activate Energy
• Meet needs in a way that is satisfactory to all involved
Behavior Scan
PEFT Scan
• Observe
– Observe where presence, power, and energy are
expressed in a financial transaction
• Where naturally reside
• Where placed
– Identify the components of a financial transaction
– Observe distribution and activation pattern to
determine whose power and energy is active in each
component of the transaction
• Within the individual
• When interacting with others
Behavior Scan
PEFT Scan (Cont)
• Assess
– Where each person’s presence is active in the transaction
• Balanced – both parties are consciously engaged from beginning
to end of transaction
• Imbalanced – act separately in transaction (isolate); crossover and
cover
– Focus of attention – I/You; We
– Belief system in operation – reality, illusion, delusion
– Level of consciousness of presence that is activating –
conscious ownership or transfer; unconscious interference
or deference
– Connection of presence, power, and energy
• Include/exclude; allow/deny; attach/detach; congruence/discord
Behavior Scan
PEFT (Cont.)
• Assess
– Intensity of exchange
• With ease, gentle but firm, with force, with excessive force
(physical force , non-physical force and/or both)
– Timeline of exchange or deal
• At what point in transaction does exchange of presence
occur
– Quality of outcome
• Healthy inclusion and exclusion
– Each person’s opinion is expressed, valued, considered, and
included from beginning to end of transaction
• Unhealthy exchange (behavioral mutation)
– Separation/Enmeshment (crosses over and covers)
The Progression
Downward or Upward
• A Chart of Compulsive Gambling and Recovery
• http://www.lostbet.com/images/gambling_ch
arts1.gif
A Chart of Compulsive Gambling and
Recovery
• The Chart of Compulsive Gambling and
Recovery may be found at this website:
– http://www.lostbet.com/images/gambling_charts
1.gif
Treatment Strategies
• Develop new way of living
– Hope – there can be better life outcomes
– Accept and activate ownership of creation of what
one does from beginning to end of transactions
one step at a time
• In all departments of life including money
Imaging Personal Behavior in Relation
to How We Use Money
– Financial Scan – Image how we use money
• The Money Departments
– Net worth worksheet – the amount of money we have at any
point in time
– Paycheck planning – the amount of money we have coming in
and going out
– Debts/liabilities – the amount of money we owe, how much,
when due
The Financial Dilemma
• When do financial issues need to be addressed
– Reality – action has to be taken to pay bills; someone has to
pay them or client will not have access to that resource
– If client is not able to pay the bills (institutionalized or
incarcerated); who will pay them until client can
– Assets need to be protected so they are not unnecessarily
depleted
• Who will address financial issues
• When is client ready to address financial issues
– Healing process begins when client begins to take ownership
for filling own needs from beginning to end of transactions
rather than bargaining with someone else to do it or relying on
old behavior (gambling) as the solution for finding the way out
Financial Scan
• Tools for Conducting Financial Scan
– Net Worth Statement: Assets - Liabilities
– Cash Flow Statement: Income – Outgo
– Debt/Liabilities Inventory
The Money Departments
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Communication about money
Legal Issues
Financial records
Cash flow – income and outgo
Credit and Debt
Insurance
Savings/Investment Assets/Retirement Plan
Taxes
Estate plan
Financial Scan
• Communications about money
– Lies
– Secrets
Financial Scan
• Legal issues
– Law of Nature and Law of Land
• When law of nature is violated and there is harm to self or
others, law of land becomes involved
– If incarcerated or institutionalized, who has authority
to act on behalf of client if client is not allowed to act
for self
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Personal representative appointed by court
Power of attorney for health care
Power of attorney for finances
Living will
How are tasks completed if there is no advance directive?
Financial Scan
• Legal Issues
– Types that may occur
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Theft
Embezzlement
Writing bad checks
Prostitution to pay for habit
Bankruptcy
Financial Records
• Where are all financial documents located?
Financial Scan
• Cash flow – income and outgo
• Problem symptoms
– Always short of money even if good income
– Disappearance of cash
– Where is the stash
Financial Scan
• Income – Work related issues
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Missing work, coming in late, leaving early
Takes long lunches and breaks
Fails to finish projects properly or on time
Takes excessive interest in office pools
Borrows money from coworkers
Heavy telephone use not related to work
Uses sick days when not sick
Makes or takes gambling calls while at work
Uses computer at work to gamble
Asks for advances in pay
Caught stealing or embezzling
Takes cash advances with company credit card
Financial Scan
• Credit and Debt
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Overdue; unpaid bills
Cash advances from credit cards
Home equity loans
Increase in number of active credit cards; only able to
pay minimum due or not enough money to make
payments
– Payday loans, loans from friends or relatives or other
entities
– Bill collectors are calling, or property is being
repossessed
– Credit may be denied
Financial Scan
• Credit and Debt
– Have the client get a copy of the credit report for
each family member including children
– https://www.annualcreditreport.com/index.action
– Tool for setting up debt repayment plan
• https://powerpay.org/
– Credit Counseling
• http://www.nfcc.org or 1-800-388-2227
• www.gamblersanonymous.org or 1-626-960-3500
– GA or Gamanon
Financial Scan
• Insurance
– If there is no health insurance; if hospitalized, how
will medical bills be paid; will assets have to be
depleted; which ones and in which order
– Life insurance – who owns
• Term - no cash value; has death benefit
• Whole – cash value; has death benefit
Financial Scan
• Checking/Savings/Investment Assets/Retirement Plans;
Personal Assets
• Dilemma: can be source of money to gamble with; can
be source of money to bail out; can be source of future
financial security
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How can assets be protected before depletion
Checking accounts– Personal, business
Savings accounts; certificates of deposit
Investments
• Individual stocks and/or bonds, mutual funds, ETFs, retirement
accounts – Pension plan, 457, 403b, 401k, SEP
• College tuition
• Real estate
Financial Scan
• Checking/Savings/Investment
Assets/Retirement Plans; Personal Assets
– Money may be pulled from accounts
– Money may be used for high-risk investing or
frequent trading
– Bouncing of checks, postdating of checks
– Personal assets may be sold or pawned for cash
Financial Scan
• Taxes
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– Transactions may incur taxable consequences
– Taxes must be paid or there will be consequences
– There can be tax penalties if assets depleted from
retirement accounts and interest due on owed
amount
– There can be property liens if taxes are not paid
Financial Scan
• Estate Planning
– Advance directives needed if admitted to institution or
incarcerated in trauma state
• Power of attorney for health care
• Living will
• Power of attorney for finances
– Estate transfer techniques – Sources of concern
• By law – Joint tenancy with right of survivorship
• Wills – The Will becomes operational at death - is executor willing to
represent client?; there is a problem if client has burned bridges with
loved one
• Trust – Trust funds (taxes have to be paid; how do you negotiate old
family patterns when determining distributions and who pays taxes)
• Gift – tax consequences – can give up to $14,000 per person in 2014
• Contract – life insurance, retirement plans
Financial Behavioral Treatment Goal
• Facilitate development of ability to begin and
complete personal transactions one step at a
time in all departments of one’s life including
financial
• Start somewhere and create one success one
step at a time over and over again
• Repeat this new pattern one step at a time
when the next opportunity arises
Contact Information
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Esther M. Maddux
Ph.D., CFP®, GCAC-II, KLAC, KCGC-I
Phone: 785.215.2116
Email: emaddux101851@msn.com