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Gambling, Gaming & Technology Use
Knowledge Exchange


Fall 2018 Edition

Feature Article:
Latest Research on Gambling and Older Adults

Older Adults and Gambling

The newly released Journal of Gambling Issues (JGI) issue no. 39 features a special section on the latest findings related to gambling in older adults. Comprising six original research articles focused on research conducted in the past five years, this special section covers topics such as prevalence rates of gambling and problem gambling, gambling behaviours, and best practices for prevention and treatment of problem gambling in adults aged 55 or older.

Approximately 4.3% of older adults are at risk of developing gambling problems, and 2.1% have a gambling problem.1 Although this is lower than the general population, research has shown that older adults are more likely to experience gambling-related harms.2, 3 To date, gambling prevention and treatment strategies have not been extensively studied in this population.

Interdisciplinary research team

A multidisciplinary research team summarized and broadened the current state of knowledge in this area by researching and writing five articles in this JGI special section. Team members spanned many organizations, including the Institute for Mental Health Policy Research at the Centre for Addiction and Mental Health (CAMH), Gambling Research Exchange Ontario (GREO), Healthy Horizons Consulting, the Responsible Gambling Council, the Centre for Urban Health Solutions at St. Michael’s Hospital and the Peel Addiction Assessment and Referral Centre, among others. The research collaborative was spearheaded by Dr. John McCready of Healthy Horizons Consulting and was funded by GREO and the Ontario Ministry of Health and Long-Term Care.

Best practices for prevention and treatment

To ensure development of relevant best-practice guidelines, the working groups on these projects implemented feedback from key-informant interviews with knowledge users and service providers as well as from the full research team and knowledge brokers.4

The resulting best practice guide for the prevention of problem gambling in older adults highlighted the importance of providing:

  1. entertainment alternatives for seniors
  2. proper education about attitudes, risk factors, safe gambling practices and how gambling works
  3. on-site support.4

Other best practices highlighted the importance of considering development and implementation, information delivery and location, format for information delivery, style or language, target audience, and gambling policy and staff training, for new prevention initiatives.4

The resulting publication detailing the best practices for treatment of older adults discussed the importance of service providers offering:

  1. person-centred care (e.g., focusing on the whole person and respecting the client’s autonomy)
  2. family-focused care (e.g., involving family members in care where appropriate)
  3. screening and assessment (e.g., screening all older adults for problem gambling, and tailoring screening and assessment to the needs of older adults)
  4. secondary prevention and early intervention (e.g., providing brief interventions when gambling problems are identified as low to moderate)
  5. tertiary prevention and specialized treatment (e.g., assessing older adults with moderate to severe gambling problems using a trauma-informed, holistic approach and creating appropriate treatment plans)
  6. ongoing support and recovery resources (e.g., providing ongoing support during recovery based on the client’s goals and needs).5

Both these publications as well as the other articles featured in the newly released JGI special section take steps toward improving our understanding of gambling problems in older adults so that we can provide the best possible care despite the paucity of research currently available. Dr. McCready believes that “with support and collaboration from our research team members, GREO and the CAMH Provincial System Support Program (PSSP), we hope the next steps will include the development and implementation of a strategic dissemination plan that will draw attention to gambling and the growing older-adult population and enhance best practices, programs, policies and research for the prevention and treatment of problem gambling among older adults.”

Read the latest issue, no. 39, and the special section on older adults and gambling here.


2018 Provincial Problem Gambling and Behavioural Addictions Forum

This year’s Provincial Problem Gambling and Behavioural Addictions Forum took place on June 18 and 19 in Ottawa, Ontario. Our forum was attended by mental health and addictions service providers from across Ontario, who came to learn about a variety of topics related to gambling, gaming and technology use. Some highlights and images from the forum appear below.

Dr. Michael Cheng (pictured left) gave an informative talk on strategies to help families disconnect from things, activities and people that are harmful in their lives and provided guidelines for (re)building attachments with youth experiencing problem technology use.

His talk was followed by Jake and Elaine Uskoski, who shared their personal stories about gaming and the recovery process.

Forum 2018
Image from left to right: Dr. Michael Cheng, Elaine Uskoski, Jake Uskoski, Colleen Tessier and Lisa Pont.

Sarah Waldman and Matthew Tsuda gave a well-received overview presentation, Behavioural Addictions 101, to an audience of mental health and addictions service providers.

Behavioural Addictions 101
Image from left to right: Sarah Waldman and Matthew Tsuda giving their Behavioural Addictions 101 talk.

Sarah List from the Ontario Lottery and Gaming Corporation (OLG) talked about the latest updates during our 2018 roundtable provinicial update. Presenters participating in the provincial update included representatives from CAMH, GREO, OLG, ConnexOntario and YMCA.

Provincial Update
Image: Sarah List from the OLG shares updates during the 2018 roundtable provincial update.

We also heard talks from keynote speakers Dr. Colleen Carney (Cognitive-Behavioural Therapy for Insomnia) and Mary Ann Carmichael (Trauma and Shame) and participated in many informative breakout sessions on a variety of topics related to problem gambling, gaming and technology use. Thanks to everyone who joined us!

You can access all available PowerPoint presentations on our website here.

Q & A with Gundel Lake, Amethyst Women's Addiction Centre

Amethyst Women's Addiction Centre logo

Tell us about the Amethyst Women’s Addiction Centre and the problem gambling services Amethyst provides.

Amethyst Women’s Addiction Centre is a day-treatment addiction service that provides programming for women 18 years of age and older who have concerns about their substance use, problem gambling or other behavioural addictions. Amethyst was founded almost 40 years ago when a group of community members realized that traditional addiction services didn’t always meet women’s needs. As a result, services were established based on the philosophy that women’s experiences of addiction cannot be separated from the context of women’s lives, including the context of gender-based oppression and discrimination, and gender-based violence.

What are some of the challenges faced by women with gambling problems?

Women who have gambling problems face many issues, but some of the most predominant are listed below:

  • One issue is that women’s “problem” gambling doesn’t always look like problem gambling. In other words, women tend to spend less money, in part because women typically have access to less money. It is important not to make assumptions about the scope of the problem based on finances alone. Sometimes women’s gambling gets minimized because the financial implications seem less consequential. Further, because women still tend to be primarily responsible for caretaking in society, women can often maintain their roles as caretakers even while gambling; in other words, while women may problem gamble, it may not interfere with day-to-day life in the same way it does for men who aren’t expected to maintain caretaking duties.
  • Women often face harsher social consequences because of their gambling problems. Male partners tend to leave relationships more quickly as a result of women’s problem gambling, and other family members tend to be more critical and judgmental toward women’s problem gambling, resulting in significant social isolation. If there is legal involvement, women also tend to receive harsher sentences than men.
  • Because women’s problem gambling tends to happen on a smaller scale and perhaps with fewer recognized consequences, women’s gambling does tend to be more invisible. As a result, programming often does not recognize the ways in which gender shapes women’s experiences differently. As such, women might feel alienated from and misunderstood by traditional programming. Women often gamble to manage an emotional experience, and all too often, part of that emotional experience includes trauma as the result of violence. When this is not recognized or acknowledged, we run the risk of deepening women’s shame and reinforcing the impacts of the violence they have experienced.

What are some important tips for clinicians who see women with gambling problems in their practice?

There are several important things clinicians can remember when working with women who problem gamble. The first tip is to assume that everyone has experienced trauma and that the gambling is in some way an attempt at managing that experience. Of course, not everyone has experienced trauma, but the vast majority of women who problem gamble have, and this approach is part of trauma-informed practice. It doesn’t harm anyone to make this assumption, but it can be harmful when trauma is not acknowledged as part of the picture.

Also important is to offer women choice in programming. There are valid reasons why women may be unable to participate in various treatment options. For example, employment obligations (especially in the context of being the sole breadwinner) and caretaking duties can prevent women from participating in residential programming, even when that is indicated by a clinical assessment. Group programming may also be indicated; however, for many women, co-ed group settings feel too unsafe and too unpredictable because of their past trauma. As clinicians, we may be quick to judge this “resistance” as denial or lack of cooperation, but it is also possible that women are trying their best to manage trauma symptoms that emerge as they address their gambling issues. In the same way, then, while Gambler’s Anonymous (GA) is life saving for many, it may not be the right fit for some, particularly because it is co-ed and does not acknowledge the context in which women turn to gambling in the first place. GA should be offered as one choice in a menu of tools but never required or expected.

Finally, it is also important in working with women to keep the idea of safety at the centre of this work. For many women, lack of safety is a recurrent theme in their lives. When we focus on safety in women’s lives, it is possible to reduce harm overall, even that associated with problem gambling. But when we focus solely on gambling, overall safety is not necessarily established, and lack of safety (e.g., physical, emotional, mental and financial in both historical and current contexts) is typically a theme in women’s problem gambling.

For more information about Amethyst Women’s Addiction Centre, click here.


Inventory of Gambling Situations mobile app available now

Introducing the new Inventory of Gambling Situations (IGS) app. Launched in mid-September, this app provides a mobile-friendly version of the IGS, asking clients with problem gambling or suspected gambling problems about their past-year gambling frequency in 63 different situations that may put them at risk. Its goal is to determine the risk of excessive gambling in each of these situations and identify the client’s profile of high-risk situations or triggers. The app is currently available for download on mobile phones or tablets through the Apple Store and Google Play Store.

Want to learn more about the IGS? Read about key concepts and practice tips and complete the online version of the IGS here. You can also register for our upcoming webinar, “Relapse Prevention and the Inventory of Gambling Situations,” November 14, 2018, from 12 noon to 1:00 p.m. EST here.

Monitor Your Gambling & Urges mobile app update

We have just launched the latest version of the Monitor Your Gambling & Urges (MYGU) app on both the Apple and Google Play Stores. With a new sleek look, this app will help your clients track their urges and triggers for gambling right when they happen using their mobile phones or tablets.

Do your clients prefer to track their urges and triggers on their computers? If so, they can always access the online version at

Human trafficking course now online

EENet is pleased to announce the release of a new course on human trafficking. Developed by EENet with the support of Aboriginal Engagement and Outreach at CAMH, this online, self-directed course is aimed at mental health and addictions service providers across Ontario. This free online course will help you learn to recognize and respond to the needs of human trafficking survivors.

Learn more here.

Gambling, Gaming and Technology Use community of interest

Gambling, Gaming and Technology Use has just launched a community of interest on EENet Connect to help mental health and addictions service providers stay on top of emerging trends and share knowledge. We encourage you to join the community today by:

  1. registering for the EENet Connect online community at
  2. once logged in, selecting the “Groups” tab from the green menu and searching for “Gambling, Gaming & Technology Use Community of Interest”
  3. selecting “Join This Group.”

Already a member? Provide us with your feedback about our community of interest here.

World Health Organization’s inclusion of “gaming disorder” in the ICD-11

On June 18, the World Health Organization (WHO) released the International Classification of Diseases 11 (ICD-11), which now includes gaming disorder under the category of “Disorders Due to Addictive Behaviours.”

Read our trainer-therapist Lisa Pont’s blog on why she is pleased about the decision while she also addresses some of the controversies.

And don’t miss the CBC interview with mother and son Elaine and Jake Uskoski―guest speakers at our 2018 provincial forum―as they discuss their lived experience with gaming disorder. professionals website

Looking for the latest evidence-informed practices to help your clients with problem gambling, gaming and technology use? Look no further than Our professionals website provides you with evidence-informed clinical best practices, clinical simulation videos, client handouts, infographics for your presentations, and upcoming trainings and resources as well as research from the JGI and CAMH.

One of our latest evidence-informed practice sections focuses on the mental status examination, detailing important key concepts, the latest research, tips and resources for your clinical practice as well as handouts for your clients.

Visit today!

Blog on vocational goals and recovery

What role does vocation play in problem gambling recovery? Have you wanted to offer vocational services at your practice but didn’t know where to start? Matthew Tsuda, occupational therapist and educator at Gambling, Gaming and Technology Use, talks about his experience with providing vocational services and the role that vocation plays in problem gambling recovery. Read his blog here.

You can also view our monthly blog series here.

Save the date for AMHO’s community of practice meeting and AGM—November 5 and 6

Addictions and Mental Health Ontario will be holding its annual general meeting and community of practice meeting on November 5 and 6, 2018, at the Radisson Admiral Hotel in Toronto. Join peers and leaders from community mental health and addictions agencies in a discussion around current trends, issues and more. Stay tuned to for registration information.

What’s in a name? Gambling, Gaming and Technology Use Knowledge Exchange

Our team has a new name! The Problem Gambling Institute of Ontario has officially changed its name to the Gambling, Gaming and Technology Use Knowledge Exchange. We have changed our name to reflect our mandate of helping to build a better mental health and addictions system in Ontario by providing training and education, developing digital tools and resources, and facilitating knowledge sharing.

Gambling, Gaming and Technology Use is part of the Provincial System Support Program at CAMH.

Learn more about our name change.

​Research U​​​pdates​​Research

CAMH Research Updates

Effects of disulfiram on choice behavior in a rodent gambling task: Association with catecholamine levels. Patricia Di Ciano, Daniel F. Manvich, Abhiram Pushparaj, Andrew Gappasov, Ellen J. Hess, David Weinshenker & Bernard Le Foll*. (2018). Psychopharmacology, 235 (1), 23–35.

*denotes researcher from the CAMH

Journal of Gambling Issues - No. 39

Special section: Gambling and older adults—Research and practice

Literature Review: Gambling disorder in the college student-athlete population: An overview. Donald E. Nowak, Jr.

Article: Don’t talk to them, they will not understand: How poker players experience criticism and stigma. Olav Niri Talberg.

Article: Cheating and stealing to finance gambling: Analysis of screening data from a problem gambling self-help program. Kalle Lind, Juha Kääriäinen.

Article: Les joueurs pathologiques en traitement sont-ils un groupe homogène? Différences selon la concomitance d’un trouble d’utilisation d’une substance. Francine Ferland, Nadine Blanchette-Martin, Annie-Claude Savard, Émilie Vézina, Andrée-Anne Légaré, Alexandra Champagne, Haniel Baillargeon-Lemieux, Isabelle Giroux, Pascal Garceau.

Brief Report: Financially focused self-concept is associated with etiological and maintenance factors of gambling disorder among non-problem gamblers. Nassim Tabri, Michael J.A. Wohl, Richard T. Wood, Kahlil Philander.

Trainings & WebinarsTrainings and Webinars

Visit the training page to register or find out more information about any of the events below.

In-Person Training

  • Have you completed Phase One? Then sign up for Introduction to Problem Gambling: Phase Two—Interactive and Applied Training for Addiction and Mental Health Service Providers to complete your certification! | October 25 and 26, 2018, in Toronto
  • [Full, but wait-list available] Introduction to Problem Gambling: Phase One | November 5 to December 10, 2018, online
  • [Full, but wait-list available] Problem Technology Use: An Introduction | November 19 to December 11, 2018, online


  • Relapse Prevention and Inventory of Gambling Situations | November 14, 2018
  • Recent Evidence on Internet Gambling in Ontario | November 28, 2018
  • X Reality Therapy: Current Use of Technology to Assist in Treating Trauma-Related Disorders | December 4, 2018
  • Poverty and Gambling | January 9, 2019
  • E-therapy for Problem Gambling | January 30, 2019
  • Vicarious Virtual Vulnerabilities: Addressing Staff Needs and Support When Dealing with Clients with Tech-Trauma Related Issues | February 5, 2019
  • Medication and Problem Gambling Treatment: Understanding Uses, Benefits and Side Effects | February 22, 2019
  • Promoting Engagement in Healthy, Meaningful Activities as Alternatives to Problematic Behaviours | March 13, 2019
  • Northwestern Ontario Wellness: Integrating Research, Treatment, and Prevention During Gambling Expansion | March 27, 2019

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