The document discusses Tiltti, a Finnish project that provides peer support and information for problem gamblers. It was started in 2010 and is funded by RAY. Tiltti is part of the Finnish Blue Ribbon organization and provides individual counseling, treatment referrals, group support activities, and an open door walk-in space. Tiltti also collaborates with the Gambling Clinic to provide specialized treatment and peer support groups for those who have not engaged with other services or are at risk of dropping out of treatment. One such group is the Tuesday group, designed for people who want to quit gambling but find it difficult to start a formal therapy process.

1. Peer support and
gambling related harms
The Finnish Blue Ribbon, Tiltti
Jenni Kämppi, Project Manager
NFHK 24-26 Aug 2011, Turku, Finland

2. Tiltti – information and support
point project
started on April 2010, three employees at the moment
funded by RAY (The Finnish Slot Machine Association) (first phase
4/2010-12/2011, option until 12/2014)
one of the development projects of The Finnish Blue Ribbon
NFHK 24-26 Aug 2011, Turku, Finland

3. The Finnish Blue Ribbon
www.sininauhaliitto.fi
one of the key actors since 1993 in the Finnish field of gambling
related harms: producing material and increasing know-how
non-governmental central organization for 86 different Christian
member organizations in Finland
member organizations do welfare work with alcohol and drug
abusers
– walk-in & low threshold support centers
– residential treatment facilities and rehabilitation services
– substance abuse prevention programs
– most workers are volunteers and recovering service users,
only 1/3 are paid employees
NFHK 24-26 Aug 2011, Turku, Finland

4. Context: Gambling in Finland
STM/Toy 2007 Latest population survey,
The Finnish yearbook of gambling 2009, Huotari 2009
games are everywhere:
– almost 17 000 slot machines at about 9000 locations
– Lotto & draw games can be played at about 3200 locations
– Internet gambling opportunities are increasing fast
gambling is popular and widespread:
– annually 3,1 million Finns take part in gambling activities
– during the last 12 months 87% of respondents over 15 years of age had engaged in
gambling activities
– most common among the 25-34 and 35-49–year-olds
prevalence estimates:
– about 130 000 (3 % of the population) persons in Finland have had gambling problems
during the last 12 months
– a third of them (42 000, 1% of the population) are pathological gamblers
– capital city area: appr. 29 000 and 9600
→ public health problem
service system is scattered:
– services are hard to find, unevenly distributed and they vary locally
– outpatient treatment and counseling is provided within substance use, mental health,
health and social services
– specialized and integrative services are needed (→ Gambling Clinic started 2010)
NFHK 24-26 Aug 2011, Turku, Finland

5. Gambling clients in 2010
Rahapeliasiakkaat
Kuopion kriisikeskus
(8municipalities)
Oulun päihdepalvelut
• Possibility for specialized in gambling problem 27 clients
65 + 9 clients
• Service that has a trained in GP worker
• Inpatient treatment (red line)
National service Sosteri (Itä-Savon sairaanhoitopiiri)
Savonlinnan A-klinikkatoimi
(6municipalities)
11 clients
Turun nuorisoasema (15-24 v) (20
municipalities)
16 clients
Varkauden A-klinikka
(5 municipalities)
12 clients
Gambling Clinic Tyynelän riippuvuusklinikka
(Helsinki, Vantaa, Kauniainen) 7-10 clients
Gambling clients:
Outpatient: 68 Pelissä -hankkeen asiakastyö
Monipel: 18 39 + 5 clients
Groups: 13 Laukaan terveysasema, Jämsän A-
klinikka, Joutsan terveysasema,
Tiltti: 56 clients Keuruun päihdeklinikka.
16 clients
Peli poikki – Time to fold
Mikkelin A-klinikka
internet manual: 114 clients 21 clients
Peluuri Helpline: 1 120 calls Tuustaipaleen
Järvenpään sosiaalisairaala kuntoutumiskeskus 3
Pelivoimapiiri: 168 clients Jyränkölä, Heinola
/ Hietalinna yhteisö clients
13 clients
6 clients

6. Outpatient
Gambling Clinic treatment
Adminstration Medical treatment study (THL)
and research
Peer groups
Data collection
Evaluation
Feedback
Booking
Clients SMS support
Referral Booking messages
Referral
Referral
Information and
support point
Peli poikki Peluuri Helpline Pelivoimapiiri
eCounselling
On-line self help
On-line peer groups
manual and
therapy

7. Tiltti is an essential part of the
Gambling Clinic service entity
we provide low
treshold information
and support point
services
we develop forms of
peer support and co-
operative forms of
treatment and peer
support
NFHK 24-26 Aug 2011, Turku, Finland

8. The foundations of our work
Deaconic values: every individual is valuable and worth helping
Peer support is important and needed
Service users, peers and volunteers
working beside professionals
Service users = experts by expertice
Project employees = experts by knowledge
We help people to help themselves
NFHK 24-26 Aug 2011, Turku, Finland

9. This is what we do
Forms of individual support:
– Counselling, assistance Forms of group/peer support:
– Treatment referrals – Coffee for gamblers
– ”Open doors” walk-in – Information evenings
afternoons – (Tues)day group
– Debt counselling
NFHK 24-26 Aug 2011, Turku, Finland

10. Monday Tuesday Wednesday Thursday Friday
9-10.00 Morning yoga
& relaxation
10-
11.00
11-
12.00
12- (Tues)Day
13.00 group
13- Afternoon for
14.00 professionals
14- (1/month)
15.00
15- Open doors Open doors Open doors Open doors Open doors
16.00 15-18 15-18 15-18 15-18
16- Debt
17.00 counselling

11. Treatment and peer support in co-
operation: Why we started the…
This is not
our patient
No one can help me
to quit gambling
Out patient Tuesday
Community
social group
rehab.
therapy

12. ...Tuesday group?
We (Gambling Clinic & Tiltti) had challenging people who
– had several previous treatment & service contacs
– were not engaging/ could not engage therapy services of
Gambling Clinic
– had an obvious need for (professional and peer) support
– were at risk to be drop outs & left without proper assistance
– wanted to quit gambling and had abstinence as a goal
For them it was hard or not an option to start a therapy process and it
was even harder to become a group member − but they did it
anyway!
NFHK 24-26 Aug 2011, Turku, Finland

13. Who were they?
Group members had
• A long history of problem gambling
• Many failed attempts to quit gambling
• Several comorbidity problems
• Difficult and dissatisfying but tolerable life situations
• 2 women, 4 men
• Average age 57 years (33-75)
• Average PGSI score 16,8 (9-23)
– if scored 8 or more → problem gambling with negative
consequences and a possible loss of control; support and
treatment needed
NFHK 24-26 Aug 2011, Turku, Finland

14. And what happened?
Small streams create big rivers…
NFHK 24-26 Aug 2011, Turku, Finland

15. After 20 weekly sessions:
What was learned and achieved?
I now know how to
control my finances.
I’ve understood that My thougths I don’t gamble as much
even I need normal are not as I used to.
human contancs always on
gambling.
I no longer believe I’ve tried to think
that I CAN beat the other ways to spend
slots. You never win my time.
in the long run.
NFHK 24-26 Aug 2011, Turku, Finland

16. Abstinence as a goal?
Festina lente – make haste slowly!
NFHK 24-26 Aug 2011, Turku, Finland

17. Thank you!
Comments, contancts:
jenni.kamppi@sininauhaliitto.fi
NFHK 24-26 Aug 2011, Turku, Finland

18. Special thanks to:
Tapio Jaakkola, Gambling Clinic information
Sanni Nuutinen, Drawings
References:
(The) Finnish yearbook of Gambling 2009. Suomalaisen
rahapelaamisen vuosikirja 2009. http://www.thl.fi/thl-
client/pdfs/8ee529be-8bff-417c-bc17-f538a83f1392.
Huotari, Kari (2009): Sattumanvaraisuudesta koordinointiin.
Ongelmapelaajien tuki- ja hoitopalvelut sekä
hoitopalvelujärjestelmän kehittäminen. Terveyden ja hyvinvoinnin
laitos, Raportti 21/2009. Helsinki. http://www.thl.fi/thl-
client/pdfs/e31cd22a-74a6-4cff-a009-b9ac297b1466.
STM/Toy 2007, latest population survey (english summary):
http://info.stakes.fi/NR/rdonlyres/64AD16F8-814F-4C60-BB2C-
F4ABB007B078/0/FinnishGamblingproblemsurvey2007Englishversio
n.pdf
NFHK 24-26 Aug 2011, Turku, Finland