Exploring the Gaps in Programming for Men and Women with a Gambling Disorder in the Correctional System in Canada.

The prevalence of problem gambling in the correctional system is about 10 times higher than in the general population, but programming for gambling problems in the correctional system is scarce. Examined barriers to treatment for problem gamblers in the correctional system, sex or gender differences, and options for program design. We conducted interviews with 16 experts who had worked with problem gamblers in the correctional system and analyzed the data in terms of themes. For barriers, the experts discussed a lack of awareness about problem gambling, as well as stigmatization and lockdowns. Experts described the content of current programs as equally applicable to both men and women, but that emotional components were more important for women. Finally, the experts had mixed views on whether programming should be integrated with other programs such as substance abuse. Programming implications for this population are discussed.

Acceptability of Internet-based interventions for problem gambling: a qualitative study of focus groups with clients and clinicians.

BACKGROUND: Although Internet-based interventions (IBIs) have been around for two decades, uptake has been slow. Increasing the acceptability of IBIs among end users may increase uptake. In this study, we explored the factors that shape acceptability of IBIs for problem gambling from the perspective of clients and clinicians. Findings from this qualitative study of focus groups informed the design and implementation of an IBI for problem gambling. METHODS: Using a semi-structured interview guide, we conducted three focus groups with clients experiencing gambling problems (total n = 13) and two with clinicians providing problem gambling treatment (total n = 21). Focus groups were audio recorded, transcribed verbatim, and analyzed using a two-part inductive-deductive approach to thematic analysis. RESULTS: Although both user groups reported similar experiences, each group also had unique concerns. Clinician perspectives were more homogeneous reflective of healthcare professionals sharing the same practice and values. Clinicians were more concerned about issues relating to the dissemination of IBIs into clinical settings, including the development of policies and protocols and the implications of IBIs on the therapeutic relationship. In comparison, client narratives were more heterogeneous descriptive of diverse experiences and individual preferences, such as the availability of services on a 24-h basis. There was consensus among clients and clinicians on common factors influencing acceptability: access, usability, high quality technology, privacy and security, and the value of professional guidance. CONCLUSIONS: Acceptability is an important factor in the overall effectiveness of IBIs. Gaining an understanding of how end users perceive IBIs and why they choose to use IBIs can be instrumental in the successful and meaningful design, implementation, and evaluation of IBIs.

Lessons Learned: Implementing UK-Developed Interprofessional Simulation Training Courses in a Canadian Setting.

OBJECTIVE: In response to the need for practitioners to improve their skills in integrating mental and physical healthcare, the Centre for Addiction and Mental Health (CAMH) (Canada) invited education specialists from Maudsley Simulation (UK) to pilot two of their existing interprofessional simulation courses on the mental-physical interface in Toronto. Participants' experiences as well as the courses' educational impact were evaluated. METHODS: Participants completed pre-and post-course questionnaires, a 2-week follow-up questionnaire, and individual interviews 6 months after course completion. RESULTS: Participants (n = 23) found the courses to be relevant and applicable to their practice. Over half of the participants interviewed (8/15) reported changing their practice as a result of the course. However, concerns regarding the sociological fidelity of these courses within the Canadian context were noted. CONCLUSION: The findings support the transferability of interprofessional simulation courses developed in other countries. It is important, however, to contextualize course material to fit local healthcare systems and to ensure sociological fidelity where professional roles may vary.

A Pilot Evaluation of a Tutorial to Teach Clients and Clinicians About Gambling Game Design.

This paper describes the pilot evaluation of an Internet-based intervention, designed to teach counselors and problem gamblers about how electronic gambling machines (EGMs) work. This study evaluated the tutorial using assessment tools, such as rating scales and test of knowledge about EGMs and random chance. The study results are based on a number of samples, including problem gambling counselors (n = 25) and problem gamblers (n = 26). The interactive tutorial was positively rated by both clients and counselors. In addition, we found a significant improvement in scores on a content test about EGM games for both clients and counselors. An analysis of the specific items suggests that the effects of the tutorial were mainly on those items that were most directly related to the content of the tutorial and did not always generalize to other items. This tutorial is available for use with clients and for education counselors. The data also suggest that the tutorial is equally effective in group settings and in individual settings. These results are promising and illustrate that the tool can be used to teach counselors and clients about game design. Furthermore, research is needed to evaluate its impact on gambling behavior.

Group Treatment for Women Gamblers Using Web, Teleconference and Workbook: Effectiveness Pilot.

While the past decades have seen a dramatic increase in the number of women who gamble and develop consequent problems, treatment services are being underutilized in Ontario. This pilot study explores the feasibility of using web- and phone-based group interventions to expand services available for women who might not otherwise seek or be able to access treatment. Distinct treatment considerations for working with women, such as the value of a women's group, advantages of phone counselling, and the implementation of modern web-based services, were reviewed. The study involved a clinician-facilitated group that used teleconferencing and webinar technology (Adobe Connect) for support and discussion, and a Tutorial Workbook (TW) developed specifically to address the issues and treatment needs of women who gamble at a problematic level. A mixed method analysis used to evaluate the results suggested that the group-based teleconference/webinar approach provided a much-needed means of treatment support for women. Participants reported that the program helped them to understand their gambling triggers, to improve their awareness, to feel better about themselves, to modify their mood and anxiety levels, to feel less isolated, to address their relationships, and to feel more hopeful for the future. The Tutorial Workbook, which was used to supplement the educational component of the group interaction, was highly rated.

A Yoga Intervention for Posttraumatic Stress: A Preliminary Randomized Control Trial.

Yoga may be effective in the reduction of PTSD symptomology. The purpose of this study was to evaluate the impact of a Kundalini Yoga (KY) treatment on PTSD symptoms and overall wellbeing. To supplement the current field of inquiry, a pilot randomized control trial (RCT) was conducted comparing an 8-session KY intervention with a waitlist control group. 80 individuals with current PTSD symptoms participated. Both groups demonstrated changes in PTSD symptomology but yoga participants showed greater changes in measures of sleep, positive affect, perceived stress, anxiety, stress, and resilience. Between-groups effect sizes were small to moderate (0.09-0.25). KY may be an adjunctive or alternative intervention for PTSD. Findings indicate the need for further yoga research to better understand the mechanism of yoga in relation to mental and physical health, gender and ethnic comparisons, and short- and long-term yoga practice for psychiatric conditions.

A Yoga Intervention Program for Patients Suffering from Symptoms of Posttraumatic Stress Disorder: A Qualitative Descriptive Study.

OBJECTIVE: To understand how individuals with symptoms of posttraumatic stress disorder (PTSD) perceive a trauma-sensitive Kundalini yoga (KY) program. METHODS: Digitally recorded telephone interviews 30-60 minutes in duration were conducted with 40 individuals with PTSD participating in an 8-week KY treatment program. Interviews were transcribed verbatim and analyzed using qualitative thematic analysis techniques. RESULTS: Qualitative analysis identifies three major themes: self-observed changes, new awareness, and the yoga program itself. Findings suggest that participants noted changes in areas of health and well-being, lifestyle, psychosocial integration, and perceptions of self in relation to the world. Presented are practical suggestions for trauma-related programming. CONCLUSION: There is a need to consider alternative and potentially empowering approaches to trauma treatment. Yoga-related self-care or self-management strategies are widely accessible, are empowering, and may address the mind-body elements of PTSD.