Secrets Lies and Fraud Auckland Clinical Team The

Secrets, Lies and Fraud Auckland Clinical Team The Problem Gambling Foundation of New Zealand 2009

Social theory Mills. C. W. (1959) The Sociological Imagination.

Aim and Methodology Aim • Case study approach • Explore links between: – Clinical interventions with gambling affected families – Public health interventions with community agencies Method • Describe case study - gambling related fraud – Identify factors relating to: • Self control • Risk management • Relapse prevention – Legal proceedings, outcome pending, lengthy delay

Fraud & Gambling • • Overall amount fraud increased since 2006 Gambling is major motivator fraud 44% total value fraud attributed to gambling Fraud recovery 11% Down from 37% 2006 – Reduced recovery rate closely related increase gambling motivated fraud • Average value $1. 1 m per fraud • More than threefold increase since 2006 survey • Substantial economic costs for society KPMG Forensic Fraud Survey Australia & NZ 2009

Sentencing Problem Gamblers in NZ • Problem or pathological gambling is invisible as a mitigating factor in criminal sentencing • Failure to recognise gambling in sentencing decreases the likelihood of rehabilitation • Increases the likelihood of re-offending Minchin 2006 • Does not address risk management

Continuum Approach – Evidence based Intervention • Our clinical practice and intervention plans place people on a sliding scale. • People can change their gambling behaviour over time. • People are affected by the range and interaction of risk and protective factors – Individual – Social systems levels • • Couple relationships Family Community Society • Identify factors amenable to change Develop optimally effective interventions

Basic Risk and Protective Factors Model - Evidence based Source: SA Thomas and A Jackson Risk and protective factors, depression and comorbidity in problem gambling. URL http: //www. beyondblue. org. au/index. aspx? link_id=6. 718&tmp=File. Stream&fid=1041

Protective factors “Protective factors are influences that modify, stop or alter a person’s response to some hazard which predisposes the person to a maladaptive outcome. ” Rutter 1990

Risk factors “a risk factor is a variable that is associated with an increased risk of a condition. It does not suggest a causal relationship…” Thomas & Jackson 2008 Identification high risk factors leads Identification of high risk groups Target early intervention and or prevention. Interaction of risk factors important Thomas & Jackson 2008

Relative risk data PG K 10 Severe mental disorder No PG 35. 7% 1. 9% Relative risk 18. 8 WHO AUDIT hazardous alcohol use 50% Positive depression screen 71. 4% 29. 5% 2. 4 Smoke daily 57. 1% 15% 11. 5% 4. 3 3. 8 Thomas & Jackson 2007

Co morbidities that are risk factors for problem gambling • Problem gamblers have high rates of psychological disturbance, hazardous alcohol use, smoking and depression in combination with other social and family problems.

Case study • • • Gambler: female 40 years European, middle class payroll clerk, 3 years Mode: Keno @ local dairy De-facto relationship 17 yrs Partner: truck driver Two children: 18 months and 5 yr Families of origin: physical distance plus lack of support “Keeping up appearances” dominant pattern Employer – medium sized family owned company Detection – fired – made bankrupt – caveat mother’s house and partner’s cars Lengthy period waiting to be charged, then another lengthy period waiting to be sentenced.

Case study: Layers of concealment • Secretive gambler, partner knew fraud charges not about gambling. • Gambling known only to mother, sister • Fraud $400 000 – amt concealed from partner, clue from bankruptcy • Legal aid advice – Home D likely outcome. • Partner not prepared to look after dependents on own and didn’t attend court hearing. • Gambler sentenced to custodial sentence • Partner finds out about gambling after imprisonment • Where is the baby? What is happening? • After imprisonment: co owner of Company took out security over partner’s cars, tried to manoeuvre partner to take cars.

Protective factors Individual • Strong sense of capability Relationship • Stable, long term, wish to be together after shock & devastation. • Mutual love of children, positive parenting skills

Protective factors: environment • Referral for gambling assessment and counselling by legal representative. • Pre sentencing assessment & crisis management of identified risk factors • Ongoing regular counselling support • Clinical interventions that strengthened personal resiliency • Pre sentencing report for Probation services • Counselling & advocacy for partner during custodial sentence • Gambling counsellor as expert witness for High Court panel of judges • Secret disclosed - two trusted family members

Risk Factors - individual • Egotistical self belief “can beat the system” • Anti social personality • Moderate depression – Poor coping skills • Over responsible family role – husband under functioning • Cognitive defences & distortions

Risk factors - Relationship • Lack of intimacy emotional and physical (“really relating”) • Negative communication patterns – Power and control – Diminished self disclosure & openness • Fragmented self – Over responsible façade versus hidden emotional

Risk factors - environment • Legal – no money no effective representation • Court – Judge’s attitude sympathetic to defamatory statements of company – worst sentence outcome for client • Middle class family encounter with social agency systems lack flexibility for support & resource options • Result – Blind to children’s safety & care – Blind to partner’s coping skills

Risk Factor: Social Capital • Problem gamblers have low levels of social capital (Thomas and Jackson) • Social capital is evidenced by: – Level of interaction with others in the community – Quality of relationships • Examples of community involvement: Church, community groups • Examples of positive family/whanau interaction: regular social activities that support positive identification.

Continuum Approach – 12 -24 months service contact Pre sentence Period • Risk assessment & Crisis management • Development two clinical goals with broader plan support Sentence & Probation Period • Risk assessment & crisis management for partner & family • Advocacy – community agencies

Risk Management - Goals & Outcomes Goal 1 – self control • Strengthen resilience • Increase self understanding: – Hearing story – Reframing to create safety and awareness Goal 2 – relapse management – Making connections between F/T/B – Work toward self acceptance – Ability to move forward to rebuild life Risk Management ongoing clinical intervention Outcomes Diversify coping skills: • reduce impacts from risk factors – Home D not imprisonment • Increase impacts from protective factors – Ongoing commitment to improve communication and quality of openness and trust in relationship – Shared understanding of problem and improved coping skills to manage

Public Health Interventions • Reduce environmental risk factors • Increase visibility of problem gambling as a factor in social policy development in large organisations such as: • Will require developing a comprehensive education package based on the new evidence

Recommendations Service planning & funding • Closer attention needs to be paid to new approaches using risk and protective factors that allows for measurement of clinical outcomes • Evidence based approaches need to be applied to existing funding models to deliver adequate resourcing that takes into account case complexity. • As opposed to an individualised medical approach • Current electronic information systems do not capture the range of assessment and interventions we are implementing to minimise risk and maximise protective factors.

Contact details Jenny. curry@pgfnz. org. nz Cheryl. campbell@pgfnz. org. nz Michael. henderson@pgfnz. org. nz Narelle. nichelsen@pgfnz. org. nz Problem Gambling Foundation 09 368 1520 128 Khyber Pass Grafton Auckland.