Compulsive Gambling in Michigan …

         Compulsive Gambling in Michigan
                          Focus Groups

                David Hartmann and Thomas Van Valey

                     Following the initial design of the project, one of the first
                     steps in data collection was a series of focus groups.
                     These were held with people having specific types of
                     interest in the topic (e.g., individuals self-identified as
                     compulsive gamblers or as spouses of compulsive
                     gamblers, employees of the state criminal justice system,
                     university students, and health care providers). These focus
                     groups were held on four separate dates at four locations:

                     1.     November 20, 1996, in Detroit, MI at the Novi Hilton
                     2.     January 15, 1997, in Lansing, MI at the State Police
                            Barracks
                     3.     January 22, 1997, in Kalamazoo, MI at Western
                            Michigan University
                     4.     February 4, 1997, in Grand Rapids, MI at the WMU
                            Grand Rapids Regional Center

                     Dave Hartmann and Tom Van Valey both
                     conducted/observed the first focus group in Detroit. It
                     included six individuals self-identified as compulsive
                     gamblers or as spouses of compulsive gamblers, plus one
                     health care provider. Dave Hartmann managed the Lansing
                     group, which included six State Police officers (Mark
                     Hoffman observed). Dave Hartmann and Tom Van Valey
                     conducted the third group, in Kalamazoo, with five students
                     from Western Michigan University (there were also two
                     observers: Carol Groves from the Kercher Center for Social
                     Research and Arlen Gullickson from The Evaluation Center).
                     Dave Hartmann carried out the fourth group with five Grand
                     Rapids-area health care providers.

                     As do most focus groups, the session began with a few
 The Detroit         minutes of introductions. The participants "told their
Focus Group­         stories," then responded to a series of issues that were
                     raised.     The first issue was types of gambling.
 Compulsive
                     "Recreational gamblers" were identified first. These are the
  Gamblers           people who will gamble every now and then, without getting
Tom Van Valey        hooked on it. "It's like somebody that takes a drink once in
                     a while." Participants also indicated that this form of


                                  36
gambling most likely makes up a large part of all gambling.
Within the broad category of problem gambling the
participants clearly distinguished between the "binge
gamblers" and the "compulsive gamblers."           As one
participant put it, ". . . some people are binge gamblers.
They only gamble when they go on vacation, and they only
go on vacation once a year, whereas I was the kind of
compulsive gambler who gambled every day."

There was also some discussion of "pathological gamblers,"
those people who will break the law to gamble or to support
their gambling. There appeared to be consensus that these
were the people with the most serious problem.

The next issue had to do with the range of activities on
which people bet. The participants quickly listed a wide
range: horse racing, lottery, casino, bingo, dice, bowling,
after hours clubs (poker), office pools, liars poker, machines
(both legal and illegal), sports, fantasy football (or baseball,
or hockey, etc.), numbers, pull tabs, and bets with bookies
(which themselves might cover a wide range), betting on the
Internet. They even included the stock market.

In addition to the kinds of activities, the participants readily
identified certain types of gambling with characteristics of
the gamblers. For example, primarily female-oriented forms
of gambling are bingo and slot machines, while male-
oriented forms would include the use of bookies and sports
betting. They thought that pools and casino gambling
(primarily because of the ease of access), in contrast, were
more or less generic, applying to males and females alike.
There was also some discussion that gambling is inversely
related to the social status of the individual. Nevertheless,
they were also able to identify the forms of gambling that
were the most popular: pools, sports betting, and lotteries.

There was also some discussion about the difference
between betting based on some skill or knowledge (e.g.,
poker or horse racing) and betting based on luck (e.g.,
lottery and machines). While the participants agreed that
there was a difference, they also indicated that gamblers
often delude themselves into thinking that their betting is
based more on skill than luck. Indeed, in this context, the
notion of "a system" was introduced as the gambler's way
to improve his/her odds. The participants agreed that

             37
gamblers with a system were more likely to be problem
gamblers than those without such systems. By the same
token, gamblers who lie about their gambling (i.e., about
how much they win or lose, about whether they gamble or
not, or even about what they had for lunch) are more likely
to be problem gamblers.

When asked about the reasons for gambling, the
participants were able to identify several: to relieve
depression, for the action or the "high," for the challenge, to
alter one's mood, to get extra money, to prove something
about yourself, for the social component, for competition, for
entertainment. "I define it as a disease of more­that if one
is good, two is better, and three is better yet." Along a
similar line, some of the kinds of things that encourage
people to gamble include easy credit, ease of filing for
bankruptcy, state support of gambling (e.g., lotteries),
support of gambling by other institutions such as the church
(or MacDonald's), moral acceptance of gambling, the value
placed on instant gratification, peer pressure, the media,
ease of access, improved technology. A major issue was
the encouragement of gambling by the gambling
establishments themselves (including the state). It is simply
part of today's society. As one participant put it, "Most
gamblers that I knew held jobs, had families; they weren't
doing gambling­they were just regular people . . . they were
intelligent, and they were . . . looking to enhance their
income, and without paying tax on this enhancement."

When asked about the possibility of stages in the gambling
process, the participants were quick to point out that the
process begins with social and recreational gambling. At
some point, perhaps associated with a big win, an analysis
stage occurs next (when the gambler is trying to rationalize
the process).       This is often followed by a stage
characterized by anger or desperation (because the
gambler is committing substantial portions of his/her
resources). Next is compulsion and then bottoming out.
Denial is also part of it. After all of these comes the
process of recovery, and the gambler is often forced into it
(by a friend, family member, employer, or other). Very few
realize that they need help all by themselves.

Some of the consequences of compulsive gambling noted
include marital/family problems, employment problems, legal

             38
problems, financial problems; even health can be an issue.
Indeed, it appears that multiple problems are likely,
especially among those people who have been compulsive
gamblers for a long period of time. Self-destructiveness is
at the extreme.

When asked where gamblers go for help, Gamblers
Anonymous was mentioned by several participants, along
with the Veterans Administration, other treatment centers,
and state and national councils (like the Michigan Council on
Problem Gambling). Common referral sources were family
members, churches, therapists, a gambler's telephone hot
line, even regular medical doctors.

In this same vein, the participants clearly indicated that there
is a need for more treatment programs and facilities that
focus on problem gambling as well as more people trained
to deal with problem gambling (along with other kinds of
addictive behaviors). One participant was quite graphic
about the need for treatment in the context of explosive
growth:

       . . . you're putting in all these casinos
       everywhere, and everybody looks at the up
       side. But out of all those casinos, there's still
       gonna be that 1 or 2 percent of people that
       get hooked, and they're gonna be walking
       around with nothing. They're gonna be
       devastated. And the only way it's gonna hit
       the forefront is gonna be like an O.J. thing.
       There's gonna have to be something like this
       crazy dude walkin' around with his gun and
       shootin' people. It's gonna have to be a
       compulsive gambler that goes completely nuts
       before somebody says, 'Hey, maybe we
       ought to put in a treatment center for these
       guys.'


The introduction for the student group made it clear that the
point of view of younger people was important because
anecdotal evidence indicates that people begin gambling
before they are 21 years old. Thus, the first topic of
discussion was the types of gambling that are important to
college students. The participants quickly identified casino

             39
  The Kalamazoo       gambling (in Mt. Pleasant), presenting it primarily as a social
  Focus Group­        activity. " . . . it's just like the place to go, you know;
                      possibly pick up some women or whatever, and just go and
University Students
                      have fun." In addition, they identified the lottery, sports
   Tom Van Valey
                      gambling, card games, and pools (e.g., the Super Bowl and
                      the basketball championships) as popular types of gambling.
                      As one student put it, "It's huge. I mean, it's unbelievable
                      how many different pools­even at high school. I mean,
                      there are huge, huge pools for the NCAA tournament. And,
                      I mean, starting at­even at such a young age as 14 up
                      through 18 in high school . . ."

                      When asked about the connection between gambling and
                      drinking, the students reported that the two often occur
                      together, although there was some support for the position
                      that drinking was the more important social activity for most
                      students. They also indicated that there appears to be a
                      trend for people to start gambling at younger ages (5th and
                      6th grades). When asked why, they pointed to the
                      proliferation of electronic games and computers, the access
                      to gambling activities (like the NCAA pools), the legalization
                      of gambling, and the fact that young people see so many
                      adults routinely involved in it.

                      With respect to motivating factors, the participants
                      suggested that novelty is one important element, especially
                      for casino gambling, but it wears off. They also indicated
                      that among college students, some people gamble to relieve
                      depression or to feel good about themselves. Greed and
                      the "thrill" of winning were also major motivating factors­the
                      possibility of actually winning a large amount of money.
                      Along with the social aspects of gambling (gambling is a
                      way to be "cool"; it is a symbol of adulthood, the fame and
                      status associated with winning), the possibility of winning a
                      lot of money seems to be particularly attractive to young
                      people, even though most of them do not gamble much
                      money at any one time. "Everyone wants the Big Pot­to
                      change your life." Other motivations for gambling included
                      the competitiveness among college students and the
                      excitement associated with it, especially if you are winning.

                      With respect to the kinds of people that engage in different
                      kinds of gambling, the students indicated that, in addition to
                      college students, casino gambling appears to draw from all
                      segments of society, especially the older generations.

                                   40
                    However, they also noted that there appears to be a clear
                    gender difference in other forms of gambling, such as sports
                    betting.

                    In trying to summarize, one of the students said, "There is
                    no solution to gambling. . . . gambling is only one of many
                    options that are available to the college student. Just like
                    alcohol, it is a part of college life. However, there doesn't
                    seem to be as strong a support structure for gambling as
                    there is for alcohol." The sentiment that gambling was an
                    important issue was clear. The students indicated that
                    people do need to become aware of gambling, because it
                    can produce problems as serious as alcohol (although lots
                    of people do not seem to realize it). As gambling becomes
                    more common, though, more people are likely to become
                    aware of the potential problems. Therefore, like alcohol,
                    problem gambling will be increasingly recognized and
                    treated.

                    This focus group was conducted on January 15, 1997, at
                    the State Police Headquarters in Lansing, Michigan.
                    Participating detectives were from the Criminal Investigation
                    Division, and most were assigned to the Organized Crime
                    Team. Because their professional experience focused
                    heavily on particular aspects of gambling in Michigan, a
                    modified protocol was used for this group.               Our
                    concentration was on the nature, extent, and repercussions
State Police        of illegal gambling, especially those linked to organized
Focus Group         crime.     There was less emphasis on the personal
David J. Hartmann   experience of gambling (attractions, life cycle of gambling)
                    and more on the negative impacts of gambling that would
                    involve interventions on the part of law enforcement or other
                    parts of the criminal justice system.

                    We opened the group by asking about the range of gambling
                    activities that participants were professionally concerned
                    with. The working definition of relevant gambling activity for
                    these men revolves around the idea of organization as a
                    business. Although there are exceptions, as one respondent
                    put it, "Organized conspiracy is our criteria." A second
                    joined in, "Another thing is the continuing criminal enterprise,
                    that they don't just do it as a one-time or a two-time thing.
                    They continue the enterprise just for that purpose. . . . the
                    people we target, that is their source of income."



                                 41
As in the other groups, a discussion of types of gambling
ensued, again with the special restriction that we would
discuss the types of gambling they most often see as
leading to legal interventions. Sports betting was mentioned
most often and was the basis for the majority of anecdotes.
Illegal numbers was also mentioned. Numbers was thought
to compete with the legal lottery games in Michigan, and
one respondent remarked that he thought numbers activity
had actually expanded with the growth of the lottery. Better
odds and the ability to make small bets were thought to be
attractions of the numbers racket. An additional factor may
be the tradition of play in some areas of the state­one
participant talked about "generation after generation
following numbers." The legitimization of the winning number
through use of the legal lottery numbers may also be an
inducement for expanded popularity.

But if numbers play is a recognized illegal activity, it is not
one that attracts a large share of official attention. One
respondent said, " A bigger issue than that (untaxed
income), particularly in a numbers situation­'cause no one
really attaches a lot of importance to illegal numbers in
Michigan­is the amount of revenue they suck out of a
community or out of an area on a weekly basis."

Another illegal gambling activity that the police often deal
with is video poker. This was believed to be a widespread
activity wherein the machines are marked "for amusement
only," but bar owners and other proprietors do pay off to
known patrons. The distributor of the games and the
proprietor generally split profits.     The complexity of
identifying and proving that the operation is illegal was
stressed. "Well, the problem is­the experience that we've
had, it's run the gamut. You have some distributors that
distribute other vending equipment such as jukeboxes and an
array of things, and the video poker may just be one part of
their operation or equipment they supply. I think we can
almost universally say that when those distributors of video
poker machines start installing and they have a multitude of
different accounts around the state, they will tell them right
up front, "You can use this game legitimately or you can use
it as a gambling device and make all kinds of money, where
you will not make that money if you stick to legitimate
purposes."



             42
A final set of gambling activities, the 800 number betting
lines to overseas locations, gives a flavor of the
sophistication of the operations the police must cope with
and the jurisdictional complexity of the necessary
approaches. Federal, state, and even international levels
are involved. One respondent pointed out that these
problems are getting even tougher as the technology
changes. "Especially as they start dealing with computers
and the Internet. I mean, you try and figure out where these
accounts are and how­you know, who's involved. I mean,
they can be in any number of countries, any number of
states. You know, it's gonna make it all that much more
difficult."

The group then discussed the types of people who have
gambling problems and concluded that all types are
involved. Several comments suggested that gambling is
reaching into more and more parts of the social
environment. The following quote is instructive. "A definite
percentage are women. You see all through the state.
There are a lot of sports bars, and we've had a lot of
gambling there. It either starts there or takes off because
of­you know, they've got 20 TVs, different games going on,
all talking sports. Sports bars have generated a lot of
interest in sports gambling."

The discussion continued that there is a range of "low level"
or "recreational betting" such as on poker machines in bars,
or a neighborhood with a tradition of numbers playing, or
working class participation in parlay cards at work or
lodges. While people may lose money they can ill afford to,
the betting tends to be smaller. "Then you go up to the
sports betting that some of the guys are involved with and
they're structured. You're talking about big dollar bets. A
lot of losses. A lot of professional people in there that have
the ability to place large bets and then some
nonprofessionals that don't have it, and they usually get hurt
pretty bad. And that's probably when they start coming to
us, when they've got a really big tab."

The next topic was the effects of gambling. Again, most
examples and experience were drawn from sports betting.
For example, "They (sports bettors) get so deeply in debt
that they can't pay. And you have situations where they've
been threatened and they don't have any alternative but to

             43
come to us. I guess from my experience, we've dealt with
people who've paid thousands and thousands of dollars in
gambling debts and they still owe thousands and can't pay
it. It affects their family, it affects their job."

When pressed for the nature of the effects, a participant
said, "(There was an individual who lost) I'd say at least
$100,000 or more than that over probably a 4-year period.
It totally consumed his life. . . . It bankrupted him." Another
continued, "I can give another example. The guy already
went to prison and came out. This guy worked for . . . his
brother's business. He was the comptroller and was in a
position to have control of the money. He siphoned out
$565,000 and spent almost virtually all that money on
gambling­sports gambling in this case. So, in that case, he
almost killed his brother's business. It's taken 7 years to
replace that money. It was a very successful business, but
was hanging on by a thread until they finally replaced those
monies. So that affected­it almost wiped out­he had like 40
employees that would have lost their jobs."

Another participant continued about a man with a minimum
wage job who ran up significant gambling debts (again, on
sports) and was ". . . encouraged by the bookie to do
whatever it takes to get the money. One of the suggestions
was to commit insurance fraud. . . There's another
example. We've done investigations in the past on groups
of individuals who travel all over the country and do breaking
and entering and those types of things. And their weekend
activity­when they come back to Michigan, and they finally
go to a casino and that's where they spent their (money)."

So if illegal gambling activities are the focus of law
enforcement, the legal-illegal distinction becomes less
important when the effects of gambling are discussed. Law
enforcement officers see and deal with effects on families,
on business, and on crime to pay for gambling. The types
of gambling include, but are not limited to sports betting with
both legal and illegal types being mentioned.             One
participant summed up the problem very well. "I sit here
thinking, you know, where are we going? We're gonna have
a lot of legitimized gambling, not only in Michigan but, you
know, the surrounding states. And then we have the illegal
part. But the bottom line is that people are going to get into
debt." Another continued, "There was a man down in Texas

             44
that was robbing banks . . . The reason he was robbing
those banks was because he had a gambling debt. Now the
last sentence (of the news story) didn't say "illegal gambling"
or "legal gambling" or whatever, you know. A Livonia police
officer was robbing a bank. Another gentleman, a
prosecutor, who was very well thought of­but he embezzled
$140,000 and ended up shooting himself in a motel room.
These are stories within the last couple of months. . . . We
all think that it's a victimless crime. But not only the
family . . . "

The increase in legal gambling was certainly thought to
contribute to the opportunity for problems. A related
problem is the possibility that there is a growing tolerance
for gambling behavior, even that with negative effects. One
officer remarked that they try to prosecute cases with
obvious victims because of the notion that gambling itself,
even illegal, is tolerable. One officer said, "What really put
the foothold is the darn lottery. And now, to confound the
problem, are the casinos­especially the deal in Detroit."
Another continued, "And that's the problem we have to
confront when we take cases to court. That's the first thing
that comes up from the defense. The state gambles, so­."
When the moderator pressed the point, saying, "Certainly
judges aren't receptive to that argument. Juries, yeah, that
I could see," the participant answered, "You get both.
Judges are people too. You've gotta convince them as
well. They might have their neighborhood card game that
they go to as well. And they sit there and say, `Well, gee.
That's rather hypocritical if I'm going to sentence somebody
who enjoys another form of gambling.'"

Several participants suggested that the state's role in
gambling also suggests a state responsibility. "The state
has got their foot in the door here with the start of the lottery
and now these casinos are gonna be all over. I think that
the state, by legalizing it, has really created a lot of
problems for people in the state of Michigan." Again, the
law enforcement perspective is tightly focused on criminal
implications. The discussion continued, "Let 'em go to
Canada. You'll find that prostitution will pop up around the
casinos. You'll find narcotics will be in the back door. You'll
find loan sharks or whatever. You'll find all kinds of illegal
activity. We've already experienced some at Mount
Pleasant, all these things I've just mentioned." Another

             45
officer concurred, saying, "That will be a major concern, a
problem, to keep organized crime out of these casinos. You
know, keep 'em legitimate."

That same issue of state responsibility led to a discussion of
resources to help problem gamblers. As a whole,
participants were not aware of many places they could turn
for information or to refer people to. Law enforcement
regularly deals with people with significant problems, so a
referral network would be a welcome resource. As one
participant put it, "I was sitting here thinking that the whole
bottom line was that where does the gambler seek help and
what time in his life does he seek help." Another continued,
"I wouldn't know right now where exactly to send
somebody."

This gap is starting to be addressed, but the progress has
been slow. One officer said, "We've got a meeting coming
up where the fellow that does our substance abuse (training)
is just going to be going to a school for gambling addiction,
going to a seminar or something. So we've got him
incorporated to come in and do that presentation to our
folks. But that's a first. I mean, we haven't been exposed
to that."

At this point in the group, the moderator introduced a person
who is helping to organize and inform on the issue of helping
resources for gambling problems. This individual briefly
described the hopes and plans of this effort. The group was
very receptive to the idea of a referral network and
applauded the idea of working with judges to get help for
problem gamblers. The alternative is continued recidivism,
from their perspective. "And we have seen that happen
(without treatment). Bail him out. He's into a loan shark.
He's in big trouble. We bust the loan shark. And a year
later he's calling us back, saying, `I'm in trouble again.'"
Another officer suggested that law enforcement has tended
not to focus on the gambler at all. They simply use the
gambler as a witness or a tool to go after extortion or other
criminal activity. This leaves the gambler with the same
problem and the same propensity to again get in trouble.
"The gambler himself tends to get looked at as the victim
and not [as] the person who's responsible."




             46
Programs involving education, treatment, and even the
equivalent of Employee Assistance Programs at businesses
like casinos were held up as models to pursue. The whole
treatment perspective was a welcome new insight to many
of the group members, and a willingness to work on
referrals was present.

Especially since budget restrictions often signal a reduced
law enforcement presence on nonviolent crimes, addressing
root causes is a necessary approach. The moderator
summarized, "That's interesting. The resources are cutting
back; it's becoming a low priority. The culture is saying
maybe it's not so bad and at the same time gambling is
growing by leaps and bounds."             A group member
responded, "That's exactly it. I mean, we go to the
legislature to justify our budget . . . We've gotta persuade
the legislators that this is a problem. This is something, you
know, that the State Police should be involved in."

That idea of documenting the case for resources brought up
a discussion of the need for a better understanding of the
links of gambling to other crimes. While officers see the link
routinely, systematic research and documentation, as in the
substance abuse field, is lacking.

A final summary to the range of issues discussed was made
at closing by one participant. The issues of problems,
changing culture of legitimation, and lack of treatment and
referral resources were summarized. "I think we're in a
great period of change for this state with this new situation
(of legal gambling), and we're gonna face a lot of problems.
And if we have to meet `em, everybody has to be educated.
. . . If somebody came to me and said, `I need help. I've got
this situation,' I want to be able to say, `Okay. Here's a
number that you can call.'"

We are deeply indebted to these officers and to the
participants in the other focus groups. Through their honest
and thoughtful discussion, we have gained needed insight
into the scope and nature of gambling in Michigan.

This focus group was conducted on February 4, 1997, in
Grand Rapids, Michigan. Since all participants were from
the Grand Rapids area, issues surrounding regional variation
were not addressed. Also, because these professionals

             47
                    were in private practice, they tended to see a middle to
                    upper class client base; so again, issues of generalizability
                    are significant. As with the state police group, because
                    therapists have a particular professional involvement with
                    gambling, the protocol was modified to reflect their
                    emphasis. We hoped to address issues of the nature of
                    gambling problems, patterns of presentation and recovery,
                    and types of resources available to assist problem
                    gamblers. We expected a more psychological rather than
                    social forces perspective to dominate and consequently
                    asked specifically about those perspectives.

                    As with the other groups, we opened by asking about the
                    range of gambling activities that participants were
                    professionally concerned with. A significant difference in
                    perspective from the gamblers group became evident.
                    While the gamblers group tended to define themselves and
                    their problem around gambling, the therapists tended to see
                    gambling as one of several manifestations of a deeper
                    underlying issue such as a manic-depressive diagnosis,
                    obsessive/compulsive characteristics, or simply one of a
Therapist and       broad range of addictive behaviors. Most of their clients
Counselors          present a range of problems including substance abuse, and
                    gambling is considered to be a secondary or tertiary
Focus Group
                    problem. This perspective dominates among the therapists
David J. Hartmann
                    and is either present or becomes accepted by their clients.
                    One participant said, "In my experience, none of the people
                    I've worked with that actually did have a gambling problem
                    ever presented that as the presenting problem." Two other
                    participants agreed.

                    When asked if at least some of their clients are more
                    concerned about their gambling than other problems, the
                    two therapists who answered said no. When asked about
                    individuals who do define their problem as a gambling
                    problem, one said, "I don't think those people make it to
                    therapists." Another continued, "I think they might see that
                    as their primary problem because that's what got them into
                    trouble. Whereas therapists often say `Is this a symptom of
                    something else,' they don't want to hear that and so you see
                    'em one time and then they're out the door." There appears
                    to be a conflicting perspectives problem that might prevent
                    proper assistance for some clients. The moderator
                    suggested that a closer working relationship with groups
                    that accept the fundamental rather than symptomatic

                                 48
importance of gambling problems might be possible (e.g.,
Gamblers Anonymous or the Michigan Council on Problem
Gambling). A participant remarked, "I don't think it's
happening. I've never gotten a referral from them­from GA
to the therapist, I mean. It's like the infancy of AA where
they would never use a therapist. I've gotten more support
from that now." Several then commented on the traditional
lack of coordination between self-help groups and
therapists. A potential class bias was also mentioned for the
lack of referrals and coordinated work. "I think­you know,
because we're in private practice and we're probably getting
at least working class and upper middle class people­."
The implication is that people with different income and
education levels may also have different orientations to
professional help.

Another part of the issue may be the notion of a "billable
diagnosis." Some of the GA participants had remarked
about lack of insurance coverage. Here, a therapist said, "I
think we have to be really clear about that because there
are some insurance companies that won't pay for a
diagnosis." Another continued, ". . . even for substance
abuse." And another, ". . . behavioral problems."

This discussion led to a worry that it is indeed difficult to
know how many people actually have a diagnosable
gambling problem. "But looking at this, it's really hard to get
a figure on what we have in terms of­the figure of problem
gambling." There was some murmuring of agreement with
that statement so the moderator asked about the South
Oaks, the DSM-IV, and other screens. A relative lack of
familiarity with standardized screening instruments was
admitted, though discussion quickly established that the
DSM-IV diagnostic criteria were well known and used in
practice.

Perhaps because of the middle class nature of the clientele,
most of the clients tended to gamble in casinos, although
one participant had clients who bet with bookies. Significant
problems tend to be associated with running up debt and
interfering with family and job responsibilities. One
participant said, "In most of the cases, even at the end, it's
just like the denial with an alcoholic. It was never seen as
a problem until either the money ran out or it caused some
other problems."

             49
Michigan-based casinos were seen as an increasing venue
for these problem gamblers although, again, many of the
wealthier ones could also go to Las Vegas or Atlantic City
if local options were unavailable. For others, however, "I
think what's especially­I would call them more working class
people. They seem to really think that this (a local casino)
is a­they can do this in a weekend." Another continued, "As
a matter of fact­or a day. I know people who do day trips,
I mean with a group of couples. I mean it's really
becoming­it's like a social event. For many people it's not
problematic." But for others it is. "I've noticed with clients
that they're not as impressed with the exterior and all the
amenities (of the casino). What they're impressed with is
their credit line." Another added, later in the session, "I think
it's undeniable­I've lived here all my life. It's undeniable that
more people that I know gamble now because of the
proximity of casinos. That is an undisputable fact."

The social legitimacy of gambling was also perceived to be
changing. "The casinos give it legitimacy to the family
system. So a lot of people can go for the fun and
entertainment . . . and that would not have been true with
the bookies going in and playing on the sports or more of
the hide-away things." This has also led to a broader cross-
section of gamblers as opportunity increases and social
stigma declines.

One of the dimensions we wanted to explore with therapists
was the issue of motivation to gamble­what brings people
to gambling? Because of their professional training,
therapists were particularly attuned to this dimension. Not
surprisingly, motivations for gambling were thought to be
diverse. For example, "I think they come into it (gambling)
with a certain set of dynamics which it does something to
help them feel more adequate, more in control, that sort of
thing." Another continued, "It's pretty wide, especially for
the non (nonproblem gambler)­like where it's not a family
history of it or it's not a cultural thing in the family. The
people­I mean, I've known people, have dealt with people
who kinda began innocently. I mean, their family didn't do
it. . . . I mean they did it for fun. You know, it became a
social thing, then it became a hobby, then it became a real
interest, then it became a habit . . . ."




             50
The impact of casinos on decreasing social stigma and
making gambling accessible to a broader clientele was
stressed. One participant said, "I think with women, the
casinos have given them another place to be social."
Another continued, "It's easier to go into a casino versus
going into a bar alone." And a third, "So for women, in
terms of the prevalence of that gaining for women, I think it's
just a more socially acceptable place to go. They can do
entertainment for a number of hours, sometimes gain money
and sometimes lose money, and I think this just started that
way."

The links of accessability and acceptability to eventual
problem gambling were also stressed. "Maybe it starts with
a kind of interest or hobby, and then it becomes a pattern,
and then it becomes maybe a sense of wanting social
connections. . . . They make it very convenient. I mean,
we're talking about these hotels. One of the things you can
do­if you drink in these casinos and you don't have to drive
back to your hotel because they offer one-stop shopping."
Another continued, "Yes. The longer you stay­well, a
woman I know who goes with a group­and I'm sure she
would never think of it as a problem for her. She goes with
a group and she really likes to stand at the slot machines.
Well, her husband gets tired. He goes back to the hotel.
And she doesn't have to be concerned about drinking or her
safety. It's very conducive. It's seductive." Another, "That's
a good word for it."

In addition to these paths into gambling, participants
stressed that the chasing of losses becomes a motivation at
some point for a great many gamblers. One summarized,
"Sure. Chase winnings or chase losses. I mean, it's kind of
a fine line, you know, as far as the motivation or the
compulsion to keep winning and keep winning, or, `I've gotta
gain it back. I've gotta gain it back.' I mean, compulsion is
driving in either one of these scenarios." Another continues,
"It's a life of its own. Chasing the gains they made, but
they're also chasing the loss of that; but it was never their
money."       When asked what they are chasing, one
responded, "The arousal. The excitement, yeah. That's the
addiction." Another continued, "That's the addiction, yeah.
Sometimes the money becomes secondary to the arousal
and the excitement." It is important to realize that this
description closely parallels that of the problem gamblers

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themselves in our focus group.      This notion of the
compulsion and the chase are clearly central to the
experience of problem gambling for many people.

Also like the gamblers and the police groups, the therapists
note that a problem is often defined only when someone
else complains or an obvious deficit in family or job or health
occurs. "When it becomes a problem in everyday life.
When it affects relationships, when it affects work, when it
affects function." Another added, "In terms of functioning it
would be in terms of the total preoccupation."

The next topic concerned the motivation to change on the
part of the gambler. The therapists again stressed that they
did not generally see the client who recognized his problem
and was bottomed out and ready to change. The cycle of
deceit and family problems and debt and illegal activity
discussed by both the gamblers group and the police group
was not a presenting scenario with the clients of these
therapists. They talked more about straining of the social
networks rather than breakdowns. One must wonder if
these clients are indeed different or simply at an earlier
stage of the more serious pattern. One therapist said, "I've
never had a gambler bottom out much. They seem­they've
gotten close . . . but then they pull back for awhile. . . ."
Again, as opposed to the model of the increasingly isolated
problem gambler, two therapists described a very social and
interactive pattern. "There's a gregariousness about a lot of
them. They're very social­you know, some of them. I'm
just thinking of a lot of these people who are­it's a group .
. . it's not like the drinkers who can sit in their room alone
and drink themselves into oblivion. You can't do this with
gambling 'cause more often than not you're gonna be out
with people. It's just slightly different. I mean, you can be
alone and still be in a group and be isolated. But so much
of it's got a social connection to it." Another continued, "And
I wonder if that isn't one of the dynamics about it. It seems
like a lot of these gamblers, when they win they've gotta tell
someone. They've gotta show somebody what they've won.
So maybe that's a piece of it."

Among solutions discussed were education and prevention
efforts such as we now sponsor for substance abuse.
There was wide agreement on the appropriateness of an
information-based approach to young people. There was

             52
some worry about allowing the government that sponsors
and supports gambling to also be in charge of forming the
antigambling or (at least) the gambling information message.
The difficulty of forming the message at all was stressed.
One participant said, "I want to say one more thing about
education. Keep in mind that this is a state that has never
been able to agree on curriculum per se. I mean, we can't
even decide on what should be taught in grade three and
come to an agreement.            I always thought it was
multiplication tables, but no. So what is there to say? If we
can't even agree on basic core curriculum, we could never
agree on what to say about gambling. I think prevention
could really work in helping people make choices, but we
can't do that anymore. . . . And as long as we've got an
instant gratification society­is it (the prevention message)
gonna do any good? I don't know."

Others thought prevention was certainly worth a try. "It may
stop the progression. And because we know that a lot of
this­the onset is insidious. It's slowly over time. There are
the warning signs. There are the things that could be
problems, that could signal trouble. It may cause some
people before they're in that total compulsive thing and that
arousal to say, `Wait, you know, I do see some of this.'"
Another, "Or even the checklist (of symptoms) available
somewhere or published somewhere.                Just as an
awareness, you know." And another, "I kind of agree . . . in
that the government or the casino operators
corporation­you know, but there is some responsibility that
lies there for basic education, for basic­you know, like `This
could be problematic and here are some signs that it might
be.'"

In summarizing their thoughts, one therapist returned to the
theme of complex motivations but a definite, identifiable
contributing factor in state sponsorship of gambling and the
legitimation of the activity. "I just think one of the critical
pieces that I'm hearing and saying, which we touched on it
before­we call it a collusion effect or a contagion effect, or
whatever. But here I see it growing stronger and stronger
that there is a social aspect of this, where it's a legitimate,
fun, group thing to do. Entertainment is growing and
growing. That is going to­my clinical intuition is that that is
gonna heighten the incidence of people who normally would



             53
                    not be problem gamblers to be taken down that insidious
                    path where they become problem gamblers."

                    In sum, the therapists group saw problem gambling as a
                    significant and growing problem in Michigan. They tended
                    to see root causes in increasing acceptance and social
                    legitimation of gambling as well as easier access for
                    traditionally excluded groups like women. Problem gambling
                    itself, however, was generally seen as a manifestation of a
                    deeper disorder that requires identification and treatment.
                    Approaches to addressing these issues must involve
                    awareness, education, and a strong prevention message.

                    As we expected and hoped, the four focus groups
                    evidenced a variety of backgrounds and opinions with regard
                    to gambling in Michigan. The strength of the focus group
                    approach is that we could look for and tease out those
                    differences, in light of the known experiences of the
                    participants. The perceptions and insights of a group of
                    college students, a group of therapists, a group of State
                    Police officers, and a group of recovering gamblers and
                    family members would not have come out in a general
                    population survey. Yet each of these groups had much to
                    tell us about gambling. We are grateful to these individuals
                    for the time they gave us and even more so for the wisdom
Focus Groups        they shared.
  Summary
                    Specifically, the problem gamblers group showed a
David J. Hartmann
                    remarkable ability to express the plight of the gambler and
                    the family, job, and health problems related to the
                    pathology. These individuals tend to see the problem as a
                    disease requiring treatment, social support, and abstinence.
                    Stages of the problem and the need to honestly desire help
                    were stressed. Family members shared this disease model
                    and the need for helping resources in the state.

                    The student group had less direct experience with significant
                    gambling problems, but were aware of very young people
                    entering into the early stages of gambling participation.
                    While this particular group did not have many personal
                    problems or know many associates with problems, they did
                    describe a culture of acceptance of gambling and the
                    socialization around it. The legal-illegal distinction was not
                    stressed, since many saw a tacit acceptance of gambling as
                    a whole in their environment.

                                 54
The State Police group focused on the interactions of law
enforcement with gambling. The distinction of legal and
illegal gambling was quite important to these men when it
came to the types of gambling they tend to scrutinize. But
that distinction was far less important when it came to the
legal implications of gambling problems. Gambling debt and
the pursuit of winning lead to family, job, and crime problems
both as victims (of extortion, for example) and as
perpetrators (to secure funds to pay debts or gamble
anew). From the perspective of these officers, all types of
gambling are linked in contributing to an environment where
gambling-related problems, especially those involving
criminal activity, will become an increasingly significant
problem in Michigan.

The therapist and counselor group also saw problem
gambling as a significant and growing problem in Michigan.
They tended to see root causes in increasing acceptance
and social legitimation of gambling as well as easier access
for traditionally excluded groups like women. Problem
gambling itself, however, was generally seen as a
manifestation of a deeper disorder that requires
identification and treatment. Approaches to addressing
these issues must involve awareness, education, and a
strong prevention message.

In sum, members of these groups told us that (1) gambling
is a significant and growing problem in Michigan, although its
size is unclear; (2) problem gambling is a disease requiring
prevention, treatment, social support, and abstinence; (3)
control of gambling-related problems is becoming more
difficult, due to gambling's increased social legitimacy, public
acceptance, and technological sophistication (e.g., off-shore
phone lines and Internet opportunities); (4) the state is
compounding the problem through its sponsorship of the
lottery and casinos; (5) more women and young people are
gambling because of socially acceptable opportunities such
as casinos; (6) there is some help for problem gamblers, but
not enough. More should be done in the areas of education
and prevention as well as in establishing a referral network
of helping resources; (7) illegal gambling and excessive
gambling are not victimless. They lead to debt, bankruptcy,
crime, poor support of families, and poor job performance;
(8) problem gambling is often a manifestation of some



             55
deeper psychological problem; and (9) support groups and
many therapists still do not work well together.

All the groups added to our understanding in particular
ways, as discussed above. They all tended to agree on
certain points as well: that access to gambling is easier,
that social approval of gambling is perceived to be
increasing, that there is insufficient understanding of the
problems associated with gambling, that among those
problems are disruptive effects on individual health and well-
being and on families and workplaces, that criminal
involvement may be related to gambling in ways we are not
fully able to document, and that necessary remedial actions
will include a widening net of services and referrals for
problem gamblers and a clear and strong educational
program.




             56