Is Gambling Help Online attracting a new cohort of treatment seekers?
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Is Gambling Help Online attracting a new cohort of treatment seekers?

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Ms Simone Rodda, Coordinator, Gambling Programs (including Gambling Help Online), Turning Point

Ms Simone Rodda, Coordinator, Gambling Programs (including Gambling Help Online), Turning Point

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  • What we will cover: Reminder of what the program is Overview of top line numbers accessing the program Results of a study into who is using the service initial data from Study 2 on help seeking experiences and client satisfaction Qualitative responses on why clients are using/would refer to program
  • Also, Kathleen latage, Renata Vergara and the Counsellors providing the services In addition, Larissa Strong and her team at DoJ have contributed to and managed all aspects of this program.
  • Our team of trained counsellors respond to more than 90,000 telephone calls a year 24 hours a day as well as provide support and referrals online Staffed by a multidisciplinary team of approximately 50 professional counsellors. Over the past ten years we have responded to over 100,000 calls from people concerned about a gambling problem Gambling Helpline services (Vic, Qld, Tas, NT) Just under 20,000 calls a year, stable over past 18 months Appointment based telephone counselling program Running for three years. Branded Ready to Change, assessment plus 4-6 semi-structured program (Vic, Tas), with a work book developed that includes some of david hodgins self-help tools Gambling Help Online (national) An initiative of the Ministerial Council on Gambling (MCG) and is funded as part of an agreement between all State and Territory Governments and the Australian Government
  • We built a program with multiple components. There are self-assessment pages to measure risk of a problem, money spent and a descriptor of signs of a problem. Within the website there are 30,000 words of content written by our counsellors. This includes self-help information on how to cut down or quit and an interactive quiz on faulty cognitions that develop around winning. As part of the development we conducted focus groups across Australia and content such as managing finances was derived from these groups. Each jurisdiction signed off on the content and provided local service information housed on specific state information pages.
  • We were contracted to provide both live chat and email counselling. In an attempt to attract more treatment seekers we differentiated these service by branding email as support and advertise it within the website as got a question get an answer or tell someone about your plans.   Both live chat and email support can be accessed via the home page by clicking start online counselling now. A client completes a short demographic questionnaire and gambling assessment and then proceeds to an online chat window.    
  • Immediate No appointment Available 24/7 Usually different counsellor each time Not the same as internet therapy – self-help with or without therapist assistance It works similarly to instant messaging where counsellor and client type in a secure environment. While there are no physical cues, the speed of typing, errors in text, punctuation and smoothness of session provide information. A client who has recently gambled will often type quickly and not wait for a response from the counsellor. There will be short incomplete sentences without punctuation and full of typos. The amount of content covered in an online session is about half of that in a face-to-face or telephone session, so we use push-page technology to introduce previously developed content which then becomes a source of discussion within the counselling session.
  • 9am-5pm – 30.8% 5pm-9pm – 43.8% Weekends – 25.4%
  • Different distribution than Helplines 9am-5pm – 30.8% 5pm-9pm – 43.8% Weekends – 25.4%
  • 24% of visitors return to the site Views from mobiles 13% Good referrals from Ebay
  • The available data suggests that only five per cent of all visits came from outside metropolitan areas. The map above shows the location of people who accessed the GHO site.
  • High rates of viewing during business hours corresponds to emails sent – time intensive activities – chat occurring at a different time (evenings)
  • 3 calls a month over 33 months – follow-up with Doj presentation on online marketing and promotion through google ad words, facebook etc
  • Advertising promoted the free online counselling services, self-help tools and email support available through the gambling help online website. The strapline read ‘Click, Chat, Change: 24/7 Online Live Counselling. Self Help Tools and Email Support’. The advertising also promoted the 1800 858 858 number as a secondary message.
  • Gamblers using chat are more often male with a significantly higher proportion of males from NSW and a significantly lower proportion of males from Qld. The highest proportion within the four age groups was the under 30’s. There were jurisdictional differences across age with NSW having a significantly higher proportion of under 30s. There was also a higher proportion of gamblers aged 30-39 from Victoria 31% vs 26% for the national sample. A difference was also found for queensland gamblers against the national dataset. Qld callers over 50 were significantly over represented 24% compared to 13%
  • An age by gender interaction was found with significant difference found between males and females aged under 30, 40-49 and over 50. The under 30 chat clients were significantly more likely to be male and over 40 and 50 significantly more likely to be female.
  • Gamblers using chat are more often EGM gamblers with 4% sports betting, 8% casino gambling, 14% wagering. There was a significant difference between gambling chat clients from Victoria with higher levels of wagering as their primary gambling concern (18.5 compared to 14%) WA wagering 4 or Casino 2, EGM2 Higher proportion of Asian background in NSW (21% compared to 10% nationally) 15-29 men significantly lower pgsi scores than over 50 No difference for females across age groups Range 3-27, 5 scored less than 8, 695 were over 8 no difference across states 41% of over 50s contacted during business hours. This is significantly higher than the total sample contact during business hours (29%)
  • Over the first 15 months there were 247 unique email requests Gamblers, CSO, Professionals, Students, Venues 919 email interactions Fewer clients than Chat (15%) Higher proportion from Tasmania (35%) a Lower proportion from South Australia (2%)** First email contact during BH (51%) Higher proportion during BH than Chat * Proportion of females accessing chat was 42% - sig difference between email and chat
  • Similar to the chat picture with more pronounced differences by gender
  • Higher proportion of Asian background NSW (11/30) 27% vs 10% of national sample No difference for email Pgsi score by age or gender PGSI range 0-27, one client scored 0 and all others scored more than 9
  • Surprises from first study.. Differences across jurisdictions High PGSI scores Uptake of email Age by gender interactions Compared with Helplines, significantly higher usage outside BH Levels of distress higher Lack of anonymity around email, low uptake in counselling online
  • Where people said that they had previously spoken to a counsellor, the most common method was face-to-face. Interestingly, the rest of the population of previous treatment seekers stated that their treatment was distance based as via telephone or online through GHO or another website. This suggests that peoples views of what constitutes counselling may be shifting.
  • 112 females 208 males – 61% of people seeking help for the first time are aged between 20-29
  • 32% less than one year when isolated to new clients
  • Sig difference on new vs current and new versus previous
  • Ready – sig difference between new and previous versus current Able – sig difference between new and previous – previous sig less confident in resisting an urge to gamble Willing – no difference
  • Easy to access without interruption or questioning from anyone around Easier to communicate – feel more free to express what I wanted to Why would they recommend – A good medium to start the process of giving up and possible transition on to face to face if needed. It's easy to be honest about feelings when anonymous. It is very difficult to talk about the extent that problem gambling affects all areas of life. On-line appears less judgemental and the option is always there to switch off and run away if need be. It calms you down
  • Numbers Confidence? Second quote also said there is no tension or embarrassment Immediate Accessible Just easier “ After being at the pokies for 4 hours today and losing the majority of my money, I didn't know what else to do, I thought it might give me a different outlook to what I've recieved in the past, and to be honest its been better this time round, more informatvie – 40-45 female, metro melb Previous – 3 horses, 2 casino 2 cards rest EGM – no sports bet
  • Current and previous counselling all via telephone or online
  • How are these new treatment seekers affected by the gambling problem? The following questions may help you determine if someone else's gambling is affecting you in some way. In the last three months, how often: PG Sig Others Impact Screen (M=12.4, SD=4.2, Range 0-18), implications for interventions Response format : Not at all Rarely Sometimes Often
  • My reasons were we do not have a land-line and the cost of a 1800 call on my mobile would be excessive.
  • No sig difference
  • Sig difference by gender – males more often prefer online versus females Significant difference in first contact and previous for preference for online counselling
  • Self-screening and assessment Personalised feedback better than assessment only Use with Motivational Interviewing to shift readiness to change Personalised feedback from a ‘person’ better than text or images Information, score, personalised feedback
  • Moderated forums Peer-to-peer and/or therapist driven moderated or un-moderated (active seeders) Users can lurk or sign up to post Outcomes Better if discussing program content rather than problem symptoms Useful adjunct to online/offline treatment programs.
  • Wireless and Mobile Technology Reminders (e.g., app, med) Motivational messages and relapse prevention (NZ smoking cessation) Use to pull (rather than push) information (Swiss alcohol consumption study) Smart phone application (Murdoch mood, alcohol, cannabis monitoring)
  • Assessment, MI, CBT Typically 4-6 sessions delivered online With or without therapist assistance Comparable outcomes at 12-months compared with face-to-face treatments Adjunct to other treatments Self-guided modules do not change according to the client presentation.
  • Approximately 16% of total clients accessing either online counselling option are family and friends of gamblers. Significant others are most often female across chat or the email support program. Higher proportion of females compared to gamblers using chat *** or email ** 18/20 partners using email for EGM concerns No difference by jurisdiction Compared to gamblers, higher rates of CSO’s using Email for EGM related problems Higher rates using chat during business hours 42 vs 29 Lower rates of chat in evening periods (34.4% vs 46.1%) PG Sig Others Impact Screen (M=12.4, SD=4.2) Higher proportion than gamblers using chat during business hours ** Approximately 15% of total clients accessing either online counselling option are family and friends of gamblers.. Higher proportion of females compared to gamblers using chat *** or email ** 18/20 partners using email for EGM concerns No difference by jurisdiction Compared to gamblers, higher rates of CSO’s using Email for EGM related problems Higher rates using chat during business hours 42 vs 29 Lower rates of chat in evening periods (34.4% vs 46.1%) PG Sig Others Impact Screen (M=12.4, SD=4.2), implications for interventions

Is Gambling Help Online attracting a new cohort of treatment seekers? Is Gambling Help Online attracting a new cohort of treatment seekers? Presentation Transcript

  • Ms Simone Rodda Coordinator, Gambling Programs (including Gambling Help Online) Turning Point
  • Gambling Help Online is an initiative of the Ministerial Council on Gambling (MCG) and is funded as part of an agreement between all State and Territory Governments and the Australian Government Is Gambling Help Online attracting a new cohort of treatment seekers? Simone Rodda May 2011
    • Acknowledgements
    • Mr Orson Rapose (Systems Manager, Turning Point)
    • Dr Nicki Dowling (PGRTC, Melbourne University)
    • Prof Alun Jackson (PGRTC, Melbourne University)
    • Prof Dan Lubman (Director Turning Point & Professor of Addiction Studies, Monash University)
    • Ms Val Markovska (Gambling Project Officer, Turning Point)
  • Turning Point Telephone and online services
    • Gambling Helpline services
    • Gambler’s Help Line (Victoria)
      • Appointment based short term counselling program for gamblers (Victoria)
    • Gambling Helpline (Queensland)
    • Gambling Helpline (Tasmania)
    • Gambling Helpline (Northern Territory)
    • Alcohol and Drug Helpline services
    • DirectLine (Victoria)*
    • Drug Diversion Line (Victoria)*
    • Disposal Helpline (Victoria)*
    • Family Drug Helpline (Victoria)
    • YSAS Line (Victoria)
    • ADIS (Tasmania)
    • ADIS (Northern Territory)
    • Online counselling and support
    • CounsellingOnline (national)
    • Just Ask Us (national)
    • Gambling Help Online (national)
    • Professional Consultation Services
    • DACAS (Victoria)*
    • DACAS (Tasmania)
    • DACAS (Northern Territory)
    • E-counselling generally involves the provision of advice and support via textual communications relayed back and forth between a therapist and consumer, usually in real time… it (usually) mimics the face-to-face supportive counselling approach for assistance with generic psychological issues.
    • Abbott, J.M., B. Klein, and L. Ciechomski (2008)
  • Program objectives
    • Attract a new cohort of clients who may not otherwise access face-to-face services
    • Extend the availability of counselling and support by addressing issues around remoteness, anonymity and after-hours availability
      • Websites
      • Service sector
      • Exclusions
      • Referral
    State Information
      • Risk
      • Money
      • Cognitions
      • Signs
      • Readiness
      • Strategies
      • Helping others
    Introductory content
      • Anytime, anywhere
      • 24/7 text based counselling
    Live Counselling
      • Q&A
      • Tell someone
      • Self-directed
    Email Support
  • Are there particular sports that you follow? Making which ever sport I was watching a lot more meaningful and also the rush you get from winning What did you originally enjoy about the gambling? To start with I just bet on Australian sports then I found the online sports gambling forums and started betting USA sports. I almost bet $400 on baseball 5 minutes before I logged on here. 10:15 AM 10:09 AM 10:12 AM 10:06 AM
  • Gambling Help Online : Contacts across services (Sept 09-Mar 11)
    • Since the launch on 31/8/09:
    • Gambling Help Online website been visited 45,767 times by 36950 Visitors
    • Provided counselling to 1,663 via live chat
      • Gamblers, CSO, Professionals, Students, Venues
    • Provided support to 304 via email
      • Generated 1072 contacts between counsellor and client
  • Gambling Help Online Live Counselling - Chat (Sept 09-Mar 11)
    • Average contact duration was 42 minutes
    • Sixty-one per cent accessed anonymously
    • Metro (79%) Rural (21%)
    • Most contacts received after hours
      • 9am-5pm – 30.8%
      • 5pm-9pm – 43.8%
      • Weekends – 25.4%
  • Client contact – time of day; Chat vs Victorian GHL ( July 10-Mar 11 )
  • Website activity (Sept 09-Mar 11)
    • The average page views were four pages per visit
    • Average time on site of 4 minutes and 20 seconds
    Page viewed Number Home page 30912 Anonymous counselling 10462 Online counselling - landing page 8612 Gambling calculator 4721 Risk assessment 2990 How the pokies work 2446 Dispelling myths 2222
  • GHO visitor location by IP address (source: google analytics)
  • GHO page views by time of day (Sept 09 - May 11)
    • A stop-smoking telephone help line that nobody called: The importance of marketing.
    • Glasgow et al., 2003
  • Gambling Help Online
  • National Communications Plan
    • The Gambling Help Online National Communications Plan was developed in consultation with all jurisdictions in early 2010.
    • It aimed to raise awareness of the new service and drive traffic to the site.
    • It identified two primary audiences:
      • Problem gamblers and their significant others (family and friends)
      • Referring health professionals.
      • *The gaming industry is also targeted through jurisdictional stakeholder relations
    • The Communications Plan provides a four-tiered framework to promoting the service:
      • Targeted one-off national promotion,
      • Activities as part of the agreement with Turning Point,
      • Jurisdictional responsibilities, and
      • Longer term maintenance activities.
  • Targeted one-off national promotion
    • The Gambling Help Online National Campaign built on Victoria’s existing strategy and the key messages already in the marketplace.
    • Advertising was undertaken between April and August 2010.
    • This media buy included online advertising on four websites (Bigpond Sports, Ninemsn Sports, Facebook and Ebay) as well as in electronic newsletters of professional body publications such as the Royal Australian College of General Practitioners (RACGP) and the Australian Association of Social Workers (AASW).
    • Over 2 million impressions were served to 872,738 unique users with each unique user having the chance to see the ad at least twice.
  • Online advertising
  • Professional body publications
    • In addition to the online advertising, advertising was undertaken in 42 professional body publications including but not limited to:
      • Inpsych - National Bulletin - Counselling Australia
      • Club News - Club Link - Club Insight
  • In-gaming venue advertising
    • In Victoria, we also placed creative in bathrooms of gaming venues. This included making take away cards available.
    In-gaming advertising appeared between Feb - July 2010 and Nov 2010 to Feb 2011 In excess of 597,637 of these cards have been picked up by people in gaming venues.
  • Ongoing promotion
    • Gambling Help Online continues to be promoted through all Victorian problem gambling advertising.
    • This means this is included on all television advertising, press advertising and online advertising.
    • We continue to target advertising to each audience by reviewing segmentation research (which provides an understanding of demographics, gambling behaviour, etc), media consumption information (provided by our media agency).
    • With our online advertising, we review what sites our target audiences are using (e.g. Ebay, Facebook), we ensure advertising is featured on sporting sites at key times (e.g. AFL), we target Victorian users of international gambling sites, we undertake in app advertising (e.g. Footy Tips), we target Victorians that have signed up to gambling mailing lists and we undertake search engine marketing.
    • Who is using this service?
      • Gamblers using chat are more often:
      • Male (58%)
        • Higher proportion of males from NSW (69%) ***
        • Lower proportion of males from QLD (41%) ***
    • Aged under 30 (44 percent)
        • Higher proportion under 30 from NSW (52%) **
        • Higher proportion between 30-39 from VIC (31%) **
        • Higher proportion over 50 from QLD (24%) ***
    Gambler Profile: n=700 Online counselling (Chat) ** p <.01, *** p <.001
  • Gambler Profile: Age by Gender (Chat) *** *** p <.001 *** ***
    • Gamblers using chat are more often:
    • Gambling on EGM’s (70%)
      • Higher proportion of wagering from Victoria ** & WA a
    • Australian (69%)
      • Higher proportion of Asian background from NSW ***
    • Problem gamblers (PGSI: M =21.4, SD =4.2)
      • Females significantly higher than males*
    • Contacting evenings (46%) and weekends (25%)
      • Higher proportion of over 50’s during BH*
    Gambler Profile: n=700 Online counselling (Chat) * p <.05, ** p <.01, *** p <.001, a sample not sufficient for sig test
  • Gambler Profile: Email Support ( n =120)
    • Gamblers using Email are more often:
    • Female (53%)
      • Higher proportion of females using email compared with Chat*
    • Even distribution across age groups
      • Higher proportion males aged <30 ** & 30-39 *
      • Higher proportion females aged 40-49 * & >50 ***
    * p <.05, ** p <.01, *** p <.001
  • Gambler Profile: Age by Gender (Email Support) * * *** * p <.05, ** p <.01, *** p <.001
  • Gambler Profile: Email Support ( n =120)
    • Gamblers using Email are more often:
    • Gambling on EGM’s (72%)
    • Australian (68%)
      • Higher proportion of Asian background NSW*
    • Problem Gamblers (PGSI: M =20.6, SD =4.7)
      • No difference by age or gender
    * p <.05
    • Are we attracting a new cohort of gamblers seeking support?
  • Live chat treatment seeking status – Gamblers only (n=458)
  • Current and previous treatment seeking behaviour (n=148)
  • New treatment seekers: Age by Gender (n=319) *** * p <.05, ** p <.01, *** p <.001 ***
  • Duration of gambling problem (n=434)
  • Average PGSI by whether sought treatment before (n=448) * p <.05, ** p <.01, *** p <.001 ***
  • Readiness to Change short screen (adapted from Miller & Rollnick, 2002)
    • How important is it for you that you limit/stop your gambling? On a scale of 0 to 10, where 0 is not at all important, and 10 is extremely important, where would you say you are?
    • How confident are you that you could deal with an unexpected urge to gamble?
    • Where does limiting/stopping gambling fit on your list of priorities?
  • Readiness and confidence to change gambling behaviour (n=446) * p <.05, ** p <.01, *** p <.001 *** *
  • Pre-post change in readiness, confidence and distress (n=87) * p <.05, ** p <.01, *** p <.001 *** ***
  • Level of distress by self-identified ethnicity (UN categories); (n=501)
  • Why choosing online? New treatment seekers
    • Online is accessible and isn't too shocking to begin with. Embarrassed about the problem, I like the anonymity of online for the moment
    • (Male, 25-29, Metro NSW)
      • it was a decision that I was comfortable to do as it is my first time to do anything about the gambling problem that has affected me for 10 years
      • (female, 44-45 regional QLD)
    • A sense of anonymous. Convenience also
    • (Male, 30-34, Indigenous)
  • Why choosing online? Previous treatment seekers
    • I needed to talk to someone about places to go for face to face help
    • (Female, 20-24, EGM, chat from this site)
    • I felt more comfortable and relaxed as I was able to have some time to give thought to where I was having a problem. Sometimes when I am face to face with a person my thoughts tend to vanish
    • (female, 45-49, EGM, Vic metro, face-to-face)
    • Are we attracting a new cohort of family and friends seeking support?
  • Relationship to gambler, by gender Women (n=289) Men (n=332) Total (n=621) n % n % n % Self 201 69.6% 315 94.9% 516 83.1% Partner 63 21.7% 3 0.9% 66 10.6% Son/Daughter 13 4.5% 5 1.5% 18 2.9% Parent 6 2.1% 2 0.6% 8 1.3% Sibling 4 1.4% 5 1.5% 9 1.4% Friend 2 0.7% 2 0.6% 4 0.6%
  • Treatment seeking experiences: Significant Others (n=96)
  • The Problem Gambling Significant Other Impact Scale (PG-SOIS)
    •  
    • Have you or your family experienced f inancial hardship as a result of the other person’s gambling?
    • Have you experienced feelings of sadness, anxiety, stress or anger due to the other person’s gambling?
    • Has the quality of your relationship with the other person been affected by his/her gambling?
    • Has your or your family’s social life been affected by the other person’s gambling?
    • Has your ability to work or study been affected by the other person’s gambling?
    • Has your physical health been affected by the other person’s gambling?
  • Impact of gambling on significant other (measured by PG-SOIS, n=96)
  • Why choosing online? Significant others accessing support
    • Easy to access without interruption or questioning from anyone around (Female partner 30-34, ACT)
    • If you are comfortable with online communication, it is less confronting than actually talking to someone.
    • (Male partner 40-45, regional Vic)
    • Is online help seeking a client preference?
  • Preferred method of help seeking: age by gender (n=87)
  • Client help seeking preferences: Who prefers online? (n=87) * p <.05, ** p <.01, *** p <.001 *
  • Why clients would recommend the service?
    • Because it helped me (24 comments)
    • It’s a good place to start, an easy first step (16 comments)
    • It’s confidential, you can be anonymous (15 comments)
    • You can talk to someone immediately (5 comments)
    • It helps you be honest about your problem (7 comments)
    • It’s convenient, easy to access, easy to use (5 comments)
    • Good way of learning about resources, other ways of finding help (4 comments)
    • You can write or say what you think freely (4 comments)
    • You can transition to face to face if you need to (3 comments)
    • You can go at your own pace (1 comment)
    • How do we engage another 10% of website visitors in an intervention?
  • Emerging trends Personalised feedback
  • Emerging trends Forums and message boards
  • Emerging trends Peer-to-peer moderated
  • Emerging trends Mobile phone integration
  • Emerging trends Self-guided modules
  •  
    • http://www.thefuntheory.com/piano-staircase
    • Easy to use in comfort of home, safe, less confrontational
    • (Female, 25-29, EGM’s, Metro Vic)
    • www.gamblinghelponline.org.au
  • Significant Other Profile: Chat and Email ( n =157)
    • Approximately 16% of online clients are Significant Others. They are more often:
    • Female (73%)
      • Higher proportion than chat**
    • Aged <30 (47%)
    • Concerned about EGM gambling (66%)
      • 18/20 partners using email for EGM concerns a
    • Contacting during business hours
    ** p <.01, a sample not sufficient for sig test