Integrating SBIRT for Problem Gambling into Credit Counseling Settings

Background: Screening and Brief Intervention and Referral to Treatment (SBIRT) is a promising approach for intervening with individuals at risk of problem gambling. The stigma felt with problem gambling may impede treatment seeking in this population, even as individuals with problem gambling suffer serious consequences, including significant debt and bankruptcy. Financial risk is a core feature of problem gambling and is responsible for much of the ruin that besets gamblers and their families.

Credit counseling is a natural setting for reaching out to people who are struggling financially due to gambling and may be a prime area for screening and intervention. Gambling behaviors may be central to some clients’ credit problems; yet the financial service industry has not developed standardized methods for screening and responding to gambling problems among clients of credit counseling. The current study tests the feasibility of training credit counselors to screen for gambling risk within credit counseling assessments. This study is the first to examine the rate of problem gambling behaviors among clients who seek credit counseling.

Methods: The researchers collaborated with a national consumer credit counseling agency that serves a large population of low-to-moderate income adults and families nationwide. The researchers trained credit counselor employees to use the Brief Biosocial Gambling Screen (Gebauer et al. 2010), a four-item measure, to screen for at-risk gambling behavior as part of their overall assessment among individuals requesting credit counseling. De-identified data collected by the credit-counseling agency was shared with the researchers.

Results: During the first month of data collection, 336 callers were screened. Among all callers, 18.2% endorsed gambling five or more times in any year of their lives, and 3.6% of the sample were screened positively as at-risk gamblers. Consistent with the literature on gambling, at-risk gamblers were slightly (p<.06) more likely to be male than female.

Implications: Results show that standardized screening for problem gambling can successfully be integrated into the credit counseling assessment process. Data support the hypothesis that among callers for credit counseling services, rates for problem gambling are similar to national rates, and among callers who endorse the first question on the screen related to lifetime gambling behavior, they have higher than national rates for problem gambling. The presenters will discuss how the relationship between the University and credit-counseling agency formed and how trust was built to develop a method for introducing SBIRT interventions into a new, non-health-focused setting. Responses and reactions from the credit counselors will be shared for illustration, in addition to the quantitative results and next steps for expanding the project to include a standardized, brief intervention that would follow a positive screen for problem gambling. This paper will demonstrate how introducing SBIRT into a new setting helps to identify needs and problems that otherwise might be overlooked and unaddressed.

Reference:

Gebauer, L., LaBrie, R., & Shaffer, H. G. (2010). Optimizing DSM-IV-TR Classification Accuracy: A brief biosocial screen for detecting current gambling disorders among gamblers in the general household population. Canadian Journal of Psychiatry, 55(2), 82-90.