Luck and Fate: Cultural, Social and Psychological Characteristics of Asian Gamblers

1. Luck and Fate: Cultural, Social and
Psychological Characteristics of
Asian Gamblers
Timothy Fong MD
UCLA Gambling Studies Program
New Horizons in Responsible Gambling
Conference
Vancouver, BC
February 2017

2. Objectives
• Discuss cultural attitudes and risk factors
regarding gambling among Asian Americans
• Discuss the impact of assimilation and
acculturation on gambling behavior and attitudes
towards treatment
• Identify culturally competent prevention,
intervention, and treatment programs for Asian
Americans

3. Definitions

4. Asian Pacific Islander
• A person with origins in any of the original
peoples of the Far East, Southeast Asia,
South Asia or the Pacific Island

5. Asian American
• Asian American Pacific Islander
• Asian American
• Asian Pacific American
• Asian or Pacific Islander
– ~5% US Population
– ~13% California
Asian Canadian
~26% British Columbia

6. Asian Canadian Population
• South Asian
• Southeast Asian
• Chinese
• Filipino
• Korean
• Japanese

7. APIs are Heterogeneous
Different languages & dialects
Different historical & trauma background
Different immigration histories
Different living, clothing & customs
Different family structure, inter-personal
relationships
Different cultural values
Different substance abuse preferences

8. Asians and Gambling

10. Stories from California
• BJL, a divorced Korean American from Fontana,
owed $200,000 in gambling debts in 2006. He
killed his 5-year-old daughter and then himself.
• TN, the Cambodian doughnut king of California,
gambled away his empire and, by 2005, wound
up living on the porch of a friend's trailer.
• KX, a Hmong father in North Sacramento,
argued with his wife over his gambling, shot
himself in the head and killed five of his seven
children in 1999.

11. California 2005-2016
• 2005 UGSP Founded
• 2007 Calls from API Non-Profits,
Conference presentations, letters to
legislature, meetings, grass-roots events
• 2007 First grants to examine API
Gambling
• 2009 CALGETS begins operations

12. Gambling Expansion in Asia
• Macau: No. 1 gaming market since 2006
• Singapore: Dropped its gambling ban
Opened Integrated Resorts 2009
• South Korea: >17 casinos;
• Taiwan and Japan: Considering allowing
casinos.
• The Philippines: Manila Bay

13. One Chinese proverb
demonstrates the culture’s
acceptance of gambling, at
the same time signaling a
warning to those who
overindulge: “A little gambling
is soothing and relaxing;
heavy gambling could affect

14. Asian Culture and Gambling
• Gambling has been a part of society
from the early Asian history (3,000
B.C.)
• Gambling as a part of social/family life
• New Year’s celebration and funerals
•

15. Cultural factors that
promote gambling
–Acceptable way to make money
–Inquire about one’s destiny
–“Honoring the Gods”
•Losses are sacrifice
–Equate gambling with self-worth

16. Cultural factors that
promote gambling
– Emphasis on numbers that have
power over life events
– Heavy peer involvement
– Gambling is family entertainment
– Gambling as a rite of passage
– Superstitions

17. Perceptions about Gambling
Chinese Western
Make money Entertainment
An investment
A harmless activity Involves risk
Limited sense of risk

18. Nancy Petry Study 2002
• Study on 96 Cambodian, Laotian and
Vietnamese refugees
–59% identified as pathological
gamblers. (1.5% California rate)
–95 % reported gambling in the
previous year, and 93% reported
gambling in the previous two

19. California Prevalence Study
(2006)
• Asians (504)
– Low response rate (47% overall, less APIs)
– 7% of survey sample
– Mostly English (1% translated)
– Problem Gambling: 2.3%
– Pathological Gambling 0.7%

20. Genes or Environment or
Something Else
• When national prevalence rates were
examined in countries such as Taiwan,
Hong Kong, and Korea, it was found that
the rates of problem and pathological
gambling were consistent from those
found in European and New World
countries (Taiwan – 5%, Hong Kong –
1.5%, and Korea – 1%).

21. Immigration?
• Asian immigrants in western countries
often yield much higher rates of problems.
– Montreal Chinese 5%
– Calgary, 8%
– Sydney, 8%.

22. Why Immigration?
• “Personality traits that make them greater
risk takers. Immigration for most involves
taking some risks . . Therefore. . .”
• To date there is no conclusive data to
show that Asian immigrants as a whole
exhibit personality traits that are correlated
to problem gambling.

23. Immigration
• The experience of immigration – including
any experience of trauma and subsequent
stresses of adaptation contribute to
greater likelihood of problem gambling.
– Loss
– Loneliness / isolation
– Status seeking

24. What about the gaming
industry?
• Gambling establishments frequently
shuttle potential patrons from communities
with large Asian populations (Chinatown,
Koreatown, etc.) to their facilities.
• Bilingual staff in order to increase comfort
and ease of their Asian patrons.
• Targeted events, lounges, facilities, offers

25. Prevalence of Asian Gambling
in Casinos

26. Results
Gender N=180
Male 75%
Females 25%
Ethnicity
Asians 37%
Chinese, Filipino, Korean,
Japanese
Non-Asians 63%

27. Results
Screening Score APIs Non-APIs
SOGS >5 42% 36%
NODS >5 35% 26%

28. PG Alliance San Jose
Community Survey 2011
• Gender:
– Male-574 (40%),
– Female-828 (57%), N/A 61 (3%)
• Race:
– Vietnamese-374 (27%),
– Filipino-201 (14%),
– Chinese-145 (10%),

29. Results
• PG Prevalence (%)
• San Jose (Gen Pop)
– At Risk: 6.5
– Problem 2.4
– Pathological 1.4
• San Jose (API)
– At Risk: 6.5

30. Help Seeking Behaviors & Barriers
(PG Alliance San Jose Community Survey
2011)
• APIs reported > non-APIs
– Very Difficult to talk about
– I Would not discuss my problems
• Barriers to Treatment
– No Money
– Shame
– No idea where to go

31. Community Awareness
• 84% said PG is an addiction
• 40% had not heard of treatment resources
• Likely sources
– Media
– Friends / Family
– Helpline

32. APIs and Treatment

33. Barriers to Treatment
• Underestimation of the extent of the problem
– Lower does not mean zero
• Lack of dependable statistics & research data
– Lack of funding, dedicated resources
• Underutilization of treatment services (delaying
or not seeking treatment)
– shame
– stigma

34. Barriers to Treatment
• Lack of cultural & language appropriate
treatment programs
• Lack of evidence based practice
• Myth Debunked:
– Treatment retention, duration and outcome
similar for API vs. Non-API

35. California Gambling Education
and Treatment Services
(CALGETS)
problemgambling.ca.gov

36. Treatment Options
• Prevention
• Self-help
• Telephone Interventions
– Helpline services
• Office-based treatment
• Group treatment
• Intensive Outpatient

37. Gambling Helplines

38. Problem Gambling
Telephone Interventions (PGTI)
• 1-800-GAMBLER
• 1-888-968-7888 (Chinese Languages)
• Free (or no cost)
• Weekly sessions over the phone
• Staffed by trained therapists
• Problem Gamblers and Affected Individuals
• Helpline staff fielded 187 calls for 2015
• 24 / 7

39. 1-888-968-7888
• Dedicated, Asian Language Helpline
• Separate from 1-800-GAMBLER
• Helpline staff fielded 187 calls for 2015
• 24 / 7
• Media sources: #1 referral
– Radio , Print, Internet
• Referred by human ~15%

40. Gamblers
• 40% male
– married, 36-45 years old, Cantonese-
speaking, and residing in the San Francisco
Bay Area (where helpline is headquartered).
– Gambler callers most often reported strained
family relations and finances as the most
negative impacts to their lives.

41. Venue for Gambling
• 60% Card Rooms
• 30% Tribal Casinos
• 10% Internet
– What happened to underground gambling?

42. AI API Callers
• “Affected individual” callers
– female, married, age 26-45, Cantonese-
speaking and calling from the San Francisco
Bay Area or San Gabriel Valley area.
– Affected individuals were most often the friend
or spouse of a problem gambler, or child

43. Freedom From
Problem Gambling Workbook

44. Available Languages for WB
Arabic Hmong Russian
Armenian Japanese Samoan
Cambodian Korean Spanish
Chinese Laotian Tagalog
English Lu Mien Thai
Farsi Punjab Vietnamese

45. Where to Get the Workbook
California Department of
Public Health
Office of Problem Gambling
www.problemgambling.ca.gov

46. Cultural Issues in Office
Based Treatment

47. Cultural Issues
• API PG
– redeem losses, peer influence, thrill,
emotional problems, stress and boredom
• (Teo et al. 2007)
– claim that they are winning even when they
are losing a lot of money.
– illusion of control than the Caucasians
• (Loo et al. 2008

48. Impact of Family on GD
• Familial socialization may have impacted
Chinese gamblers’ familiarity with and
preference for certain forms of gambling
and may have passed on the values and
beliefs about gambling to the next
generation (Loo et al. 2008).
• Second, Chinese families has a strong

49. Cultural Influences
• Collectivistic (Goodwin and Tang 1996)
mindset leads to strong sense of guilt and
shame because they have brought
disgrace to their families and have let their
families down.
• less likely to seek outside or professional
help than other cultural groups despite

50. Treatment Principles

51. Prevention Ideas
• Effective early intervention strategies
much address the culture of acceptance,
in order to reshape social norms and
learned behaviors
– Teaching the odds
– Building up coping skills
– Demystifying gambling as a sport

52. Prevention Ideas
• Strengthening family and community can
be a powerful tool to help Asian gamblers.
Service providers working with Asian
gamblers often have to act as a liaison,
linking gamblers to other services such as
ESL classes, job training, public benefits
assistance, and financial counseling.

53. What Clinicians Can Do
• Willing to work with client who are not ready for
total abstinence; need a longer time of
engagement; to start with, cut down use
• Avoid traditional reflective, non-directive
approach
• Focus on external stresses in the early stage,
offer crisis intervention & tangible help
• Respect family secrets and confidentiality
• Accommodate client’s work & family

54. What Clinicians Can Do
• Proficient in client’s language/dialect,
using interpreter only as last resort
• Avoid extensive questioning, assessment
& evaluation; clarify and explain all
procedures
• Help client develop measurable and
tangible short-term treatment goals
• Receptive to Somatic Approach &

55. Focus on the Family
• In many Asian traditions, it is natural for
family and community members to help
one another – by lending money for debt
relief, vouching for a loan, etc.
• Asian families may have to get assistance
in setting firm boundaries, avoiding
codependency, and encouraging

56. Make Treatment Acceptable
• St. Mary’s Center in San Francisco,
framed services in the context of a
teahouse.
• Clients are invited over to “chat over tea”
rather than for “counseling”.
• Services called “improving finances”

57. Thoughts on GA
• Gamblers Anonymous – a voluntary, 12‐
step support group for gamblers currently
only has one Asian language meeting in‐
the entire state of California.
• Unknown effectiveness and even less
availability
• One-on-one “mentorship” more powerful

58. Medication Principles
• Target co-occurring disorders
• No data on API-specific responses
• Concepts of medications to impact
behaviors is tough to grasp
• Therapeutic power of the pill

59. Eastern Treatment Options
• Acupuncture
– Used to be part of residential treatment
programs
– No clear data
• Eastern philosophies of balance,
restoration
– Flushing out negative energy

60. Fables of Fortune (South Philly)

61. Innovative Ideas
• Partner with casino buses / tour junkets
• Create more online tools / apps for APIs
• Tie-in with API dining establishments
• Partnerships with churches
• Establish community “warning networks”
• Encourage casinos to play more active
role in outreach

62. Q and A

63. Contact Information
Timothy Fong MD
310-825-4845
tfong@mednet.ucla.edu
www.uclagamblingprogram.org