Telecounseling, the provision of psychological services provided via phone or video conference, may be an ideal solution for veterans in greater Minnesota who are problem gamblers and don’t have convenient access to help for their disorders. The idea for this approach was the brainchild of Roger Anton, MA, LSW, consulting therapist at the Minneapolis VA Medical Center. His proposal to make this form of counseling available to veterans is now being considered by the Minnesota Department of Health and Human Services.
A 2013 study in the American Journal on Addictions showed that veterans had a 2% lifetime prevalence rate of pathological gambling, double the 1% rate in the nation’s general population. The study also found the lifetime prevalence rate for problem gambling among veterans to be 8.8%. The concern is that many of the problem gamblers could become pathological gamblers.
Veterans with a gambling problem are identified through a screening that takes place during their course of treatment at the hospital. “I’ll see patients at an appointment or two, but once they finish their treatment at the hospital it becomes a hardship to stay in touch because many come from greater Minnesota,” says Roger.
The opportunity to have several conversations with a counselor can provide clarity about what’s going on with a problem gambler. “People with gambling concerns need to have access to someone in a therapeutic environment where they feel comfortable telling their story, expressing concerns and getting professional feedback so they can determine what their next step might be,” says Roger. “Telecounseling would be a perfect way to provide that service.”
The Veterans Health Administration serves as a model for best practices in the field of telecounseling for mental health. The VA’s Midwest Health Care Network is part of one of the largest telecounseling networks in the world. The VHA has demonstrated successful delivery of numerous treatment modalities including medication management, individual psychotherapy, group therapies, substance abuse treatment and post-traumatic stress disorder programs.
There are 14 VA community-based outpatient clinics (CBOC) in Minnesota that can be used to connect problem gamblers with counselors through phone or video conference. CBOCs have provided telecounseling services in Minnesota since 2001. The network is expanding in the northwest metro area and will eventually include 45-50 clinical sites. A state plan to expand telecounseling will address a large service gap in northern Minnesota from Hibbing to International Falls.
“I’ve worked with a number of video systems and am very impressed with how it can bring the experience right into your space,” says Roger. “It’s a wonderful medium and I know that other therapists who use online counseling have also had very good experiences.”
Telecounseling can make services available to those who otherwise wouldn’t have access. In addition to challenges posed by geographic distance and the cost of gas for long trips, patients often need someone to watch their children. “This would cut through so many obstacles to access,” says Roger.
The effort to provide problem gambling telecounseling to veterans would begin as a pilot project. “My hope is that this would be quite successful and ultimately allow other providers to offer these services. It makes a lot of sense and has the potential to reach so many more people who need help.”