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		[This article prints out to about 31 pages.] Change and continuity in a help-seeking problem gambling population: A five-year record*   Alun C. Jackson, The University of Melbourne and University of Melbourne/La Trobe University Gambling Research Program, Melbourne, Victoria, Australia E-mail: aluncj@unimelb.edu.au Shane A. Thomas, La Trobe University and University of Melbourne/La Trobe University Gambling Research Program, Melbourne, Victoria, Australia Tangerine A. Holt, Monash University, Victoria, Australia Neil Thomason, The University of Melbourne, Melbourne, Victoria, Australia Abstract This paper provides an overview of some trends among problem gamblers seeking help through the BreakEven/Gambler's Help problem gambling counselling services in Victoria, Australia, between July 1995 and June 2000. Data presented are drawn from details collected on clients at registration, assessment, and all other client contacts to form a Problem Gambling Services minimum data set (MDS). Analysis of the MDS shows a number of noteworthy trends towards continuity or change. A major element of continuity is the ability of the service to attract women, who constitute around 50% of the clients for the period. Major changes include the increasing trend towards presentation of clients at an earlier stage in their "career" as problem gamblers. Also identified is persistence or change in client characteristics, such as gender differences in gambling activity and problem type and level. In addition, a range of other factors are explored, such as level of debt and its associated characteristics, the characteristics of people committing crimes to finance their gambling, and the differences between people presenting for counselling and problem gamblers in the community. Key words: problem gambling, help-seeking, gambling-specific services

		Introduction The purpose of this paper is to provide an overview of some trends among problem gamblers who sought counselling from the specialist BreakEven/Gambler's Help problem gambling counselling services in Victoria, Australia, between 1 July 1995 and 30 June 2000 (the latest date for which data were available at the time of writing). As part of the standard operating procedures of the BreakEven/ Gambler's Help problem gambling counselling services, data about clients are collected at registration and assessment and at each client contact. Counsellors record this information on forms during (or immediately after) contact with clients. These forms constitute the Problem Gambling Services minimum data set (MDS). The MDS was established and implemented in 1995, and revised in 1998, to provide information for a range of purposes, including individual case management, service planning, and analysis of gambling impacts. The Problem Gambling Research Program at the University of Melbourne provided annual reports between 1996 and 2001 based on analysis of the MDS, which were published by the Victorian Department of Community Services (Jackson, Thomason, Ryan, & Smith, 1996; Jackson et al., 1997; 1999a; 1999b; Jackson, Thomas, Thomason, Holt, & McCormack, 2000c; Jackson, Thomas, Ross, & Kearney, 2001).1 The scope of gambling in Victoria Currently about 80% of Victorians gamble in any year, with figures ranging from a low of 75% in 1992, the year that electronic gaming machines (EGMs) or "pokies" were introduced, to a high of 87% in 1996 (Roy Morgan Research, 2000). Participation in EGM play in the adult population has varied between a low of 13% in 1992 (representing only three months of availability when the survey was conducted) to a high of 15% in 1994, coinciding with the establishment of a temporary casino in June of that year, with participation rates for 1998 and 1999 being quite stable at 13% and 12%, respectively (Roy Morgan Research, 1999, 2000; Market Solutions, 1997). Participation rates in EGM play for those who gambled show a similar pattern, with 20% participation in 1992, 41% in 1994, 31% in 1998, and 30% in 1999 (Roy Morgan Research, 2000). The introduction of the permanent casino at Crown Entertainment Complex in 1997 did not see any real change in the participation levels of EGM play. There are 30,000 licensed EGMs in the state of Victoria: 2,500 located in Crown Casino and 27,500 in other venues, with half of these 27,500 in hotels and half in licensed clubs (Auditor-General of Victoria, 1996, p. 14). Noncasino EGMs are operated by a government-mandated privately operated duopoly (Tattersall & Tabcorp) operating under a licence that runs for 20 years from 1992. They operate these EGMs from 544 venues run by 470 separately licensed companies. In 1992, 3,349 EGMs were available, operating from 45 venues. This represented 12.2% of the potential total of 27,500. By 1995, when the BreakEven/Gambler's Help program was established, 20,834 EGMs were available, representing over 75% of the potential total. Annual growth between 1996 and 1999 averaged 6% of the potential total, ranging from 9% growth in 1996 to 1% growth in 1999. In this sense, the market was a reasonably mature one in terms of EGM opportunity by the time the counselling service was introduced. In terms of other gambling opportunities, Tattersall's have operated lotteries in the state under licence since 1954, progressively adding new products (Lotto, Keno, Club Keno, Internet lotteries). Racing is catered for by three major metropolitan tracks and a range of rural racecourses, although declining attendance following the introduction of offcourse totalisers in 1961 through the Victorian Totalisator Agency Board (TAB) led to the closure of at least 34 racecourses between 1960 and 1983. The state-government-run TAB was privatised in 1994 with the formation of Tabcorp Holdings Limited. In 1999, 48% of all adults who had gambled on EGMs in the previous 12 months were men, while 52% were women. These figures were reversed for those who gambled on EGMs regularly (at least monthly), of whom 52% were men and 48% were women. While gambling participation rates in general, and EGM participation rates in particular, show a spike in 1994 and a levelling out in 1998 and 1999, expenditure rates show a steady increase over this period. There are a number of ways to look at this. Victorians' expenditure (loss) on EGMs outside the casino went from AUS $13 million per week in 1993–1994 to AUS $37 million per week in 1998–1999.2 Expressed as a loss per week for adult Victorians, this represented AUS $8.64 in 1993 and AUS $18.90 in 1999 (Roy Morgan Research, 2000). Expressed as a proportion of household disposable income (HDI), there was modest growth in total gambling expenditure between 1972–1973 and the early 1990s (about 1.3% of HDI), then a very sharp growth to 3.49% by 1997–1998. Racing expenditure has shown a steady decline in the same period, from just under 1% to 0.6% of HDI (Tasmanian Gaming Commission, 2001). Gambling revenue is now the second highest source of Victorian State Government revenue after Payroll Tax and Stamp Duty, and now surpasses Liquor, Tobacco, and Petrol Taxes combined. Total revenue from gaming increased from AUS $0.4 billion in 1992–1993 to AUS $1.04 billion in 1996–1997 to over AUS $1.4 billion in 1998–1999, with EGMs contributing 62% of these taxes. Revenue from gambling now contributes 16% of the state's income, compared with 8.5% in 1982, and is used to pay for many basic services, such as health, education, and recreation. For further details on these issues of expenditure and taxation, see Smith (1998); Productivity Commission (1999); McMillen, Jackson, Johnson, O'Hara, & Woolley (1999); Tasmanian Gaming Commission (2001); and Hayward & Kliger (2002). Problem Gambling Services strategy The 1991 Victorian Gaming Machine Control Act and its 1996 amendments provided for the establishment of the Community Support Fund (CSF). This legislation requires that 8.3% of daily net cash balances from EGMs in hotels be paid into the fund. Clubs are exempt on the basis that their profits are supposedly disbursed to the community through their club membership. In 1993, two years after EGM legalisation came into effect and one year after EGMs were introduced, the Problem Gambling Services Strategy (PGSS) was implemented by the Victorian State Government with a total budgetary commitment of AUS $61 million to 2001 funded through the CSF. Gambler's Help, known until November 2000 as BreakEven, was established under the PGSS as a specialised statewide problem gambling counselling initiative. In addition to funding Gambler's Help, the PGSS provides a range of other community and client services, including community education and mass media campaigns; regional gaming liaison and community education officers under the Department of Human Services; Gambler's Helpline, a free, 24-hour telephone counselling and referral service; and a research program to provide information regarding problem gambling in the community and inform appropriate service responses. A number of family service agencies are partially funded through the PGSS to provide counselling and other forms of assistance, such as material aid, to clients with gambling-related problems, in addition to the primary BreakEven/Gambler's Help service. Unfortunately, there is no requirement that these agencies collect uniform data on their clients. In a statewide survey of 121 of these family service agencies, most (89.3%) indicated that some people were using their services for gambling-related problems. For 15% of these agencies, clients with gambling-related problems made up 20% or more of their clientele; however, less than half of the agencies surveyed (43.1%) had data collection systems that enabled identification of gambling-related problems (Jackson et al., 2000a). Lacking the firm data from these agencies to provide a more complete picture of help-seeking, this paper will consider only those people with gambling problems who presented to BreakEven/Gambler's Help. Gambler's Help client trends Overall patterns of use of Gambler's Help During the period from the time the BreakEven/Gambler's Help program started in 1995 and the year 2000, 12,500 people sought counselling assistance, with numbers doubling every year for the first three years. It is important to note that these data are population data; that is, they include the entire population of presentations to Gambler's Help services. Over this five-year period, between 75 and 80% of people presented for help with their own gambling behaviour; the rest presented for help in relation to someone else's gambling. While the numbers of males and females presenting to address their own gambling issues are almost identical, and have remained so for the five-year period under review, females are more than twice as likely as males to present due to concerns arising from the impact of another person's gambling, most notably their partner (x2 = 298, df = 1, p < .001). A more detailed description of partner presentations is discussed elsewhere (Crisp, Thomas, Jackson, & Thomason, 2001b). These data contrast with results of a recent Ontario study where the ratio of male to female clients dealing with their own gambling problem was 1.9:1, although the proportion of people presenting for help with their own problems or the gambling problems of family/significant others is similar (73.5% and 22.8%, respectively) (Rush & Moxam, 2001). The male-to-female ratio of Gambler's Help clients also contrasts sharply with that of a recent study of callers to a Gambling Helpline in New England (62.1% male vs. 37.9% female) (Potenza, Steinberg, McLaughlin, Rounsaville, & O'Malley, 2001). While the proportion of clients who present because of the gambling of others has more than doubled from 11.9% in 1995–1996 to 24.8% in 1999–2000, the more remarkable change reported in Table 1 is the sheer increase in client numbers, such that in 1997–1998 almost as many individuals attended Gambler's Help services as in the previous two years combined. This may reflect the large increase in Gambler's Help locations from 30 sites in 1996–1997 to approximately 100 in 1998–1999. In 1998–1999, registrations plateaued, but further growth occurred in the following year, 1999–2000. Table 1 New clients: Client status by sex by year of registration     Client status Year of registration   Self-identified gambling problem Partner Other Total 1999–2000 Male 1310 133 94 1537 Female 1287 357 235 1879 1998–1999 Male 1112 122 66 1300 Female 1197 272 131 1600 1997–1998 Male 1223 129 64 1416 Female 1233 307 129 1669 1996–1997 Male 813 46 24 883 Female 694 140 70 904 1995–1996 Male 581 37 5 623 Female 560 88 24 672 Problem gambling client characteristics Previous studies (e.g., Ciarrochi & Richardson, 1989; Taber, McCormick, Russo, Adkins, & Ramirez, 1987) have shown that a "usual" problem gambler profile is an unmarried male under 30 years of age, and these studies have found the following cohorts to be overrepresented among problem and pathological gamblers: male, non-Caucasian, not married (Abbot & Volberg, 1996; Volberg, 1994; Volberg & Steadman, 1989), under 30 years of age, unemployed (Abbot & Volberg, 1996), and having a lower level of education (Volberg, 1994; Volberg & Steadman, 1989). The demographic profile of BreakEven/Gambler's Help clients reporting as problem gamblers is analysed herein and creates a somewhat different picture than the studies cited above or the profile of problem gamblers not in counselling as identified by the Productivity Commission National Survey (Productivity Commission, 1999). Although more likely to be unemployed than the Victorian population overall (x2 = 12.3, df = 1, p < .001), BreakEven/Gambler's Help clients who are problem gamblers differ from their overseas counterparts in being relatively older (in their 30s) and relatively more likely to be female than male. Research data from service agencies in other Australian jurisdictions where EGMs are readily accessible, such as the states of Queensland and South Australia, show, as in Victoria, an almost equal distribution of males and females in their problem gambler client populations (Dickerson, McMillen, Hallebone, Volberg, & Woolley, 1997). A number of factors need to be considered when accounting for this gender finding, particularly the difference in help-seeking behaviour between males and females. It is a general finding in other health and human service contexts that females tend to have a greater propensity for help-seeking than males (Cockerham, 1997; Australian Institute of Health and Welfare, 1996). Furthermore, although it may generally be a long time before an individual develops gambling-related difficulties with a newly legalised form of gambling, there is some evidence that suggests that female players in particular may seek help within one to two years of beginning to gamble on a new product (Dickerson et al., 1997). Female clients presenting to BreakEven/Gambler's Help agencies in the second year of operation of the program (July 1996 to June 1997) differed significantly from the male clients in a number of characteristics. Many of these differences persist. When compared to males, females were likely to be older (39.6 years vs. 36.1 years of age), born in Australia (79.4% vs. 74.7%, x2 = 10.9, df = 1, p < .001), married (42.8% vs. 30.2%, x2 = 41.8, df = 1, p < .001), living with family (78.9% vs. 61.5%, x2 = 369.1, df = 1, p < .001), and having dependent children (48.4% vs. 35.7%, x2= 57.0, df = 1, p < .001). Despite having similar personal annual incomes (U = 255,151.5, Z = –.493, n.s.), female gamblers reported average debts (AUS $7,342) of less than half of that owed by male gamblers (AUS $19,091) (F(1,616) = 12.11, p < .001). Age structure of the help-seeking group As Table 2 indicates, females who presented to resolve problems associated with their own gambling were older than their male counterparts; however, the overall age profile of clients with gambling problems was similar throughout the five-year period. In 1999–2000, problem gamblers are slightly overrepresented in the 20–29 (20.7% compared with 19.5% of all Victorians), 30–39 (30.6% compared with 20.2%), 40–49 (27.5% compared with 18.4%), and 50–59 (13.4% compared with 12.7%) age groups when compared with the age distribution of Victorians aged 15 and over in the 1996 Census. They are underrepresented in the under-20 (1.2% compared with 9.0%) and over-60 (5.5% compared with 20.2%) age groupings. Table 2 New clients: Problem gamblers: Sex by age by year of registration       Age cohort (years) Year Sex   <20 20–29 30–39 40–49 50–59 60+ Total 99–00 Male N 25 313 431 322 136 57 1284   Female N 6 210 344 373 230 82 1245   Persons N 31 523 775 695 366 139 2529     % 1.2 20.7 30.6 27.5 14.5 5.5 100.0                     98–99 Male N 17 304 386 246 108 38 1099   Female N 7 224 348 319 196 76 1170   Persons N 24 528 734 565 304 114 2269     % 1.1 23.3 32.3 24.9 13.4 5.0 100.0                     97–98 Male N 12 305 384 276 97 37 1111   Female N 8 202 316 344 164 54 1088   Persons N 20 507 700 620 261 91 2199     % 0.9 23.1 31.8 28.2 11.9 4.1 100.0                     96–97 Male N 8 227 290 174 72 16 787   Female N 5 123 205 195 95 27 650   Persons N 13 350 495 369 167 43 1437     % 0.9 24.4 34.4 25.7 11.6 3.0 100.0                     95–96 Male N 4 126 192 136 60 15 533   Female N 5 84 151 141 78 39 498   Persons N 9 210 343 277 138 54 1031     % 0.9 20.4 33.3 26.9 13.4 5.2 100.0 Like the BreakEven/Gambler’s Help client data, two Productivity Commission national samples (problem gamblers and data on people in counselling at agencies specialising in problem gambling counselling) reported a different age profile from adult Victorians in the 1996 Census (Productivity Commission, 1999). None of these gambling groupings appear to be representative of the general adult population in Victoria. Relative to the Productivity Commission samples, the BreakEven/ Gambler’s Help program reported greater numbers of younger clients (25–34 years old) in counselling, whereas the national sample reported more people in counselling for problem gambling in most of the older age categories. Do BreakEven/Gambler’s Help clients reflect the age structure of problem gamblers? The Productivity Commission survey identified the under-25 age group as the largest group of problem gamblers. Apart from the 65–69 age group, which constitutes only 4% of problem gamblers, it is this under-25 group that is the least represented in counselling in Victoria, with only about one third of the potential numbers in counselling over the years 1999–2000 and 2000–2001. Marital status In 1999–2000, almost half (48.0%) of all problem gamblers were married (legally or de facto), and a quarter (26.2%) indicated that they had never married (see Table 3). However, there were considerable differences between the sexes with respect to marital status. Male problem gamblers (35.3%) were twice as likely never to have married as their female counterparts (16.9%, x2 = 112.0, df = 1, p < .001), who were more likely to be widowed, divorced, or legally married. More females reported divorced or separated status than males. A comparison of the marital status of problem gamblers with that of Victoria’s general population based on the 1996 Population Census suggests problem gamblers are less likely to be married (37.3%) than the general population aged 15 and over (53.5%). However, the census data did not include a category for de facto marriages, which 10.7% of problem gamblers indicated was their marital status. This may account for some of the apparent differences. Problem gamblers reported higher rates for divorce (13.7% vs. 5.8%) and separation (9.5% vs. 3.2%) than the overall population of Victoria aged 15 and over. Table 3 New Clients: Problem gamblers: Marital status by sex, 1999–2000   N % Marital status Male Female Persons   Married 423 529 952 37.3 Never married 457 212 669 26.2 Divorced 134 215 349 13.7 De facto 129 143 272 10.7 Separated but not divorced 134 109 243 9.5 Widowed 17 49 66 2.6 Total 1294 1257 2551 100.0 Household and family structure The living arrangements of problem gamblers presenting to BreakEven/Gambler’s Help services changed over the five years (see Table 4). Females presenting in 1999–2000 were more likely to be living in a single-parent family than in the other years. With the exception of 1997–1998, female clients were less likely to be living with a partner, which was also true of their male counterparts. Increasingly, both sexes report living arrangements other than by themselves or with family. Table 4 New clients: Problem gamblers: Living arrangement by sex by year of registration   Living arrangement   Family/ couple One-parent family Lone-person household Other Total 99–00 Male 582 46 245 413 1286 Female 672 215 172 208 1267 98–99 Male 484 33 226 358 1101 Female 644 202 161 169 1176 97–98 Male 580 17 243 361 1201 Female 699 212 166 144 1221 96–97 Male 476 14 213 94 797 Female 470 70 110 34 684 95–96 Male 477 14 213 94 798 Female 470 70 110 34 684 Ethnic background In a pattern highly consistent over the entire 1995–2000 period, approximately one quarter of clients presenting in 1999–2000 (23.6%) were born overseas, representing a wide range of countries. This is broadly consistent with Australian Bureau of Statistics (ABS) 1996 Population Census data, which found that 27.5% of Victorians were not Australian born. However, the rates of problem gambling in some ethnic groups studied in the Victorian Casino and Gaming Authority-funded study of the impact of gambling on specific ethnic groups (Thomas & Yamine, 2000) were found to be much higher than for other groups. One might expect much higher rates of presentation to BreakEven/Gambler’s Help within these groups than those found in the MDS data. As shown in Table 5, over half of Gambler’s Help clients born overseas (56.6%) were born in Europe. Table 5 New clients: Birthplace   Persons Birthplace N % Australia 2639 76.4 Europe and the former USSR 415 12.0 Southeast Asia 164 4.7 Middle East and North Africa 67 1.9 New Zealand 56 1.6 Africa (excluding North Africa) 34 1.0 Northeast Asia 30 0.9 Southern Asia 22 0.6 South America, Central America, and the Caribbean 14 0.4 Other Oceania and Antarctica 9 0.3 North America 5 0.1 Total 3455 100.0 Labour force status Table 6 reveals that almost three quarters (73.0%) of problem gamblers presenting for help in 1999–2000 were part of the labour force; they were either employed or looking for work. As in Australian society more generally, the labour force participation rate within the study sample is higher among males than females. However, the unemployment rate of 16.6% among Gambler’s Help clients was more than double that for all Victorians aged 15 and over (7.3% (ABS, September 1999), x2 = 387.0, df = 1, p < .001). Table 6 New clients 1999–2000: Problem gamblers: Labour force status by sex   Male Female Persons Employed full-time 695 368 1063 Employed part-time 157 317 474 Unemployed 191 115 306 Unemployment rate 18.3% 14.4% 16.6% Not in the labour force 230 450 680 Participation rate 81.9% 64.0% 73.0% Table 7 shows that the labour force participation rate for problem gamblers increased between 1996 and 2000, and at 73.0% for the 1999–2000 year was considerably higher than 62.9%, the census figure for all Victorians aged 15 and over as at August 1999 (ABS, 1999). This suggests that problem gamblers have higher rates of both employment and unemployment than the overall population of Victoria. This may be a reflection of the fact that people with gambling problems are predominantly of workforce age (15–64 years). Table 7 New clients: Problem gamblers: Labour force status by year of registration   99–00 98–99 97–98 96–97 95–96 Employed 1537 1307 1447 778 628 Unemployed 306 319 295 135 90 Unemployment rate 16.6% 19.6% 16.9% 14.8% 12.5% Not in the labour force 680 625 681 569 402 Participation rate 73.0% 72.2% 71.9% 61.6% 64.1% As can be seen from Table 8, employed problem gamblers who presented for counselling in 1999–2000 reported holding a wide range of jobs. When compared to all employed people aged 15 and over in Victoria, the occupational categories of problem gamblers were very similar. The exceptions were that problem gamblers were underrepresented among professionals (9.6% vs. 19.0% of all Victorians) and overrepresented among labourers and related workers (15.9% vs. 9.7%) (ABS, 1999). Table 8 New clients 1999–2000: Occupation by sex   N % Occupation Male Female Persons   Manager/administrator 117 53 170 7.9 Professional 100 106 206 9.6 Associate/Paraprofessional 126 116 242 11.3 Tradesperson 255 36 291 13.6 Clerical or service worker 201 468 669 31.2 Production or transport worker 149 74 223 10.4 Labourer or related worker 232 109 341 15.9 Total 1180 962 2142 100.0 Income The self-reported individual income of problem gamblers is not confined to a particular income level and varies considerably from less than AUS $120 to over AUS $1,500 per week; however, over half (53.5%) of the clients reported weekly incomes of less than AUS $400. This is explained by the fact that 34.5% of the problem gamblers were in receipt of pensions and benefits. A further 23.3% of problem gamblers reported weekly incomes of between AUS $400 and AUS $599. Lower income figures among the female clients were not unexpected: they reflect the situation in the wider community. For example, in May 1998, the ABS reported that the average weekly earnings for male employees were AUS $730 versus AUS $484 for females. Further details of income reported by problem gamblers are presented in Table 9. It should be noted, however, that income figures do not account for variations such as whether net or gross income was reported or whether mandatory deductions (e.g., Child Support payments) are counted in gross amounts, and so on. The income distribution of problem gamblers is quite similar to that of all Victorians aged 15 and over from the 1996 Population Census figures, as shown in Table 9. Table 9 New clients 1999–2000: Individual income by sex   N % Income Male Female Persons   $1500/wk or more (>$78,000/a) 43 9 52 2.3 $800–$1,499/wk ($41,600–$77,999/a) 151 51 202 8.9 $600–$799/wk ($31,200–$41,599/a) 182 91 273 12.0 $400–$599/wk ($20,800–$31,119/a) 284 248 532 23.3 $200–$399/wk ($10,400–$20,799/a) 204 353 557 24.4 $120–$199/wk ($6,240–$10,399/a) 249 232 481 21.1 Less than $120/wk (less than $6,240/a) 63 119 182 8.0 Total 1176 1103 2279 100.0 Gambling behaviours Clients presenting to BreakEven/Gambler’s Help are asked to provide information about hours and dollars spent gambling at their most recent gambling session by gambling type and days spent gambling during a typical month by gambling type. While Table 10 shows that problem gamblers report involvement in a wide range of types of gambling, by far the most common is EGMs, which are used by more than two thirds (71.1%) of all problem gambling clients (86.4% of female clients and 58.3% of male clients). EGM use was the most common form of gambling reported by BreakEven/Gambler’s Help clients during the entire five-year period. The next most commonly reported type of gambling was offcourse betting at the TAB (11.9%). No other gambling type exceeded 4%. Only a very small number of people reported involvement in forms of Internet gambling, but because it is quite new, there may be a lag period between the introduction of this type of gambling and clients presenting themselves for problem gambling counselling. Table 10 Type of gambling during a typical gambling episode by sex for 1999–2000 clients   N % Type of gambling Male Female Persons   EGMs 841 1076 1917 71.1 Bet on races at TAB (offcourse betting) 275 14 289 10.7 Not known 84 63 147 5.4 Bet on card games 83 13 96 3.6 Lotto/lottery/pools/keno 41 35 76 2.8 Bet at races (oncourse betting) 53 10 63 2.3 Bingo 14 36 50 1.9 Numbers 32 1 33 1.2 Other kinds of gambling 18 7 25 0.9 Internet/on-line 2 0 2 0.1 Total 1443 1255 2698 100.0 These findings concur with previous research findings that problem gambling is typically associated with particular types of gambling, such as EGMs, racing, video-based games, and casino gaming (Blaszczynski, Walker, Sagris, & Dickerson, 1997). The availability of EGMs, in particular, has been shown to have a strong association with problem gambling (Dickerson et al., 1997), and gamblers who regularly prefer racing and gaming machines have been found to be more likely to score in the at-risk categories in the South Oaks Gambling Screen (SOGS) (Lesieur & Blume, 1987). Although surveys indicate that between 30% and 40% of adult Australians play the lottery as a weekly habit, few, if any, manifest signs of associated problems (Blaszczynski et al., 1997). These findings also lend support to research indicating that females are more likely to gamble on activities based on “chance,” such as EGMs and bingo, and males are more likely to gamble on forms of gambling based on “skill,” such as TAB and racing (Walker, 1992). Despite the majority of problem gamblers reporting using EGMs on their most recent day of gambling, a number of issues should be taken into consideration in interpreting the data. Staff in EGM gaming venues are now more aware of BreakEven/ Gambler’s Help services as a result of the gaming industry’s access to training programs for venue staff, the community awareness and edu-cation campaigns conducted throughout the state by BreakEven/ Gambler’s Help community education workers, and the introduction of Responsible Gaming policies in many venues. Thus venue staff are more likely to be in a position both to recognise problem gamblers and to refer them to a BreakEven/Gambler’s Help counselling service. Evaluation of a statewide mass media education campaign supplemented with locally distributed pamphlets also showed that venue patrons were aware of a wide range of messages encouraging responsible play and help-seeking. Of 71 venue patrons interviewed, unprompted recall of problem gambling educational material was 67%, while 79% recalled the slogan “If you have a gambling problem in your life call Gambler’s Helpline toll free” (Jackson, Thomas, Thomason, & Ho, 2000b). This study also showed a direct correlation between placement of educational materials and increased calls to Gambler’s Helpline with a flow-on effect of referrals to BreakEven/ Gambler’s Help (Jackson et al., 2000b, pp. 37–40). Although the amount of money and time spent gambling varies between different types of gambling, as Table 11 indicates, problem gamblers report spending considerable amounts of time and money on most forms of gambling. Table 11 Gambling behaviour during a typical gambling episode for 1999–2000 clients   Median number of Type of gambling hours per episode dollars spent per episode episodes per month Lotto/lottery/ pools/keno 1 20 4 Bet on races at TAB (offcourse betting) 2 100 8 Bet at races (oncourse betting) 3 100 5 EGMs 3 120 8 Bingo 2.5 30 4 Bet on card games 4 375 5 Numbers 4 350 4 Other kinds of gambling 3 300 4 Internet 2.5 200 10 A problem gambler’s involvement in gambling can vary over time, and as Table 12 suggests, BreakEven/Gambler’s Help attracts problem gamblers with wide-ranging patterns of gambling. While one quarter (26.5%) presented to Gambler’s Help when their gambling was increasing, 28.7% of problem gamblers had already decreased their gambling. In some cases there was a total reduction to the point where the clients were not gambling at all when they sought assistance. Table 12 Patterns of gambling behaviour by sex for 1999–2000 clients   N % Pattern of Gambling Male Female Persons   Ascending 266 356 622 26.5 Descending 132 122 254 10.8 Stable 223 226 449 19.1 Chaotic 186 165 351 14.9 Binge 133 120 253 10.8 Not currently gambling 255 167 422 17.9 Total 1195 1156 2351 100.0 The patterns of gambling behaviour in Chart 1 show a slight trend for people’s behaviour to be less stable at the point of referral, and more people tend to describe their pattern as binge gambling or one of increasing gambling activity. As Table 13 shows, for the 1999–2000 cohort, this increase in gambling or binge gambling is likely to be more characteristic of EGM players than those engaged in offcourse betting. Table 13 Problem gamblers: Pattern of gambling behaviour for selected types of gambling   EGMs Bet at TAB (offcourse betting) Pattern of gambling N % N % Ascending 548 28.4 57 19.6 Descending 215 11.1 35 12.0 Stable 370 19.2 72 24.7 Chaotic 292 15.1 55 18.9 Binge 215 11.1 24 8.2 Not currently Gambling 289 15.0 48 16.5 Total 1929 100.0 291 100.0 Debt The extent of clients’ gambling-related debts is reported in Table 14 and shows that males report being more in debt as a result of their gambling than females. This is consistent with the data presented in Table 15 that males are more likely to borrow money to fund their gambling. The mean debt decreased from AUS $14,140 in 1997–1998 to AUS $8,295 in 1998–1999 but rebounded to AUS $11,763 in 1999–2000. Table 14 Total amount of gambling-related debt by sex for 1999–2000 cohort   Male Female Persons Maximum debt $2,000,000 $500,000 $2,000,000 75% quartile $10,000 $6,000 $8,000 Median debt $2,000 $1,900 $2,000 25% quartile $0 $0 $0 Minimum debt $0 $0 $0 Mean debt $14,771.46 $8,555.61 $11,763.03 Although, as Blaszczynski et al. (1997) have pointed out, it is difficult to treat self-reported expenditure (loss) information with certainty, we suggest that information on debt, while probably underreported, is worth examining in more detail to determine finer patterns. While over a third of BreakEven/ Gambler’s Help clients in 1998–1999, for example, had zero debt, there was a small group of people who had considerable debt. Simple addition of the reported debt for 1998–1999 clients resulted in a total debt of AUS $15,342,362 among the client cohort. However, looking at those with large debt, we find that only 1.3% of problem gamblers accounted for 29% of the total debt (26 people owed AUS $4,486,000). Further disaggregation of this small, high-debt group, compared to all 1998–1999 clients, showed that they were more likely to be male (62%), older (mean age of 41 years), born overseas, employed full time as a manager or clerical worker, with either a very high or a very low individual income. They had higher proportions of most presenting problems, particularly financial and employment problems, and were four times more likely to have the maximum 10 maladaptive behaviours or DSM-IV items. Thus, while it is probably a good sign that some people are attending counselling with zero or low debt, we cannot lose sight of the fact that the problem gambling population includes people who have what can only be described as massive financial problems. Presenting problems In a specialised problem gambling counselling service it is not surprising that clients presenting on their own behalf are overwhelmingly concerned about their gambling behaviour, as Chart 2 shows. Other presenting problems as reported by about half or more of these clients were financial, intrapersonal, and relationship or interpersonal issues. While some problems were reported by both sexes, substantial differences were revealed in respect to some problem areas. Employment and other work-related issues and legal issues were more frequently indicated among the presenting problems reported by men, whereas women were more likely to report relationship and family problems and physical symptoms associated with their gambling. Comparing the presenting problems reported by problem gamblers over the period from 1995 to 2000 reveals some fairly major changes. We can see quite distinct differences between the periods 1995–1997 and 1997–2000. In the 1997–2000 period all presenting problems declined, with the exception of gambling behaviour. There was a marked decline in leisure use issues and physical symptoms, for example. Generally, the first two years of the BreakEven/Gambler’s Help counselling service may be characterised by a high level of help-seeking for “symptomatic” effects of gambling. This declines steadily from 1997 as clients put a somewhat greater emphasis on gambling behaviour as the reason to seek help rather than for problems which are consequences of the gambling behaviour. This is not to suggest a simplistic notion of causality, however, with all problems deemed to be the result of gambling. It is clear that for many people in counselling, the gambling itself is symptomatic of other problems, such as loneliness, poor familial and interpersonal relations, and perceived lack of alternative leisure pursuits. The number of presenting problems has also decreased over the years. This suggests both that individuals are seeking help from the program earlier in their “career” as problem gamblers and that the “backlog” of people with longer-standing problems, who had not previously sought help, was dealt with primarily in the first two years of the service’s operation. Almost one quarter (24.2%) of problem gamblers in 1999–2000 presented with only one, or none, of the problems listed in this chart compared to 2.4% in 1995–1996. Conversely, the proportion of those presenting with six or more problems was down to 18.5% in 1999–2000 from a high of 49.4% in 1995–1996. DSM-IV ''maladaptive behaviour'' patterns The client assessment form completed by the counsellors at BreakEven/Gambler’s Help measures the extent to which gambling has become problematic and uses the DSM-IV criteria as part of the measurement of the type, frequency, and intensity of gambling behaviours and their adverse effects. The proportion of gamblers reporting five or more maladaptive behaviours is reasonably stable at about three quarters for the period from 1996–1997 to 1999–2000 (see Table 15). This contrasts with the 1995–1996 figure of 81.7%, although the latter figure may be elevated due to the same backlog effect noted earlier. As with the number of presenting problems, there has been a decrease in the number of maladaptive behaviours that people present with. In 1995–1996, 18.2% of people presented with fewer than five of these behaviours compared with 25.7% in both 1998–1999 and 1999–2000.3 Table 15 Maladaptive behaviours by sex for 1999–2000 clients   Male Female Persons Maladaptive behaviour N % N % N % Gambles as a way of escaping 986 83.8 1,085 94.1 2,071 88.9 After losing money, chases losses 992 84.4 890 77.2 1,882 80.8 Repeated unsuccessful efforts to control gambling 892 75.9 924 80.1 1,816 78.0 Lies to family members, therapist, or others 846 71.9 844 73.2 1,690 72.6 Preoccupied with gambling 742 63.1 717 62.2 1,459 62.6 Needs to gamble increasing amounts of money 676 57.5 677 58.7 1,353 58.1 Is restless or irritable when attempting to cut down 646 54.9 696 60.4 1,342 57.6 Relies on others to provide money 621 52.8 601 52.1 1,222 52.5 Has jeopardised relationships, job, education, etc. 714 60.7 506 43.9 1,220 52.4 Has committed illegal acts 261 22.2 165 14.3 426 18.3 If we take the numbers of maladaptive behaviours to be a crude measure of acuity, then it would seem that clients’ gambling problems are decreasing in acuity. However, we caution that this may not be a sound index of acuity. The quality and scope of a behaviour rather than whether it is shared with other behaviours might be a better case acuity index. These measures are not available within the current data collection and would need to be the subject of a separate investigation. As Table 16 demonstrates, the extent to which maladaptive behaviours manifest themselves also varies according to the type of gambling. Comparing people who gamble using EGMs with those who gamble at the TAB, the TAB clients were more likely than the EGM players to report being preoccupied with gambling; chasing losses; relying on others for money; and having jeopardised relationships, jobs, and education. EGM users were more likely to report gambling as a form of escape. TAB clients were almost twice as likely to report committing illegal acts to finance their gambling. Further disaggregation of the two variables in the MDS relating to illegal actions in relation to gambling shows that males are twice as likely as females to commit such illegal acts. (The variables are illegal action reported as a current source of gambling funds and the DSM-IV criterion of having committed illegal acts.) Problem gamblers who are younger, unemployed, never married, living in a shared household, reporting debt in excess of AUS $10,000, presenting with legal problems, and reporting 10 maladaptive behaviours are over-represented in this area of illegal acts related to gambling. Table 16 Maladaptive behaviours by selected types of gambling for 1999–2000 clients   EGMs Bet at TAB (offcourse betting) Maladaptive behaviour N % N % After losing money, chases losses 1,583 81.7 251 87.2 Gambles as a way of escaping 1,762 91.0 245 85.1 Lies to family members, therapist, or others 1,431 73.9 240 83.3 Repeated unsuccessful efforts to control gambling 1,524 78.7 228 79.2 Preoccupied with gambling 1,236 63.8 217 75.3 Relies on others to provide money 1,024 52.9 194 67.4 Has jeopardised relationships, job, education, etc. 996 51.4 191 66.3 Needs to gamble increasing amounts of money 1,159 59.8 181 62.8 Is restless or irritable when attempting to cut down 1,145 59.1 178 61.8 Has committed illegal acts 326 16.8 91 31.6 Conclusion This paper sought to describe some trends among people seeking help with gambling-related problems and, specifically, trends among clients of BreakEven/Gambler’s Help, the specialised statewide counselling service established as part of the PGSS in Victoria, Australia. A number of areas covered by this overview have been analysed in some detail to date. These include gender differences in help-seeking and problem presentation (Crisp et al., 2000) debt (McCormack & Jackson, 2000) the particular issues faced by partners of problem gamblers (Crisp et al., 2001b) the relationship between number of sessions of counselling and problem resolution (Crisp et al., 2001a) the characteristics of older people’s gambling and help-seeking (McCormack, Jackson, & Thomas, 2003) There are still numerous questions posed by this review, however. Just some of these are as follows: Why is the gender profile for presentations to BreakEven/ Gambler’s Help different from that recorded by other problem gambling counselling services? Although we know that women are more likely to seek help with problems, this does not, in itself, seem to be a good enough explanation. We believe that the reason may lie in the location of these services as a specialist counselling program in generalist community health agencies rather than being stand-alone problem gambling services. This location philosophy addresses both access and stigma issues. Why are the numbers seeking assistance now over two and a half times the per annum referral rate of the first year of operation of the service? There is obviously a growing familiarity with the existence of both the face-to-face counselling service and the Gambler’s Helpline telephone counselling service, which we might expect would lead to more referral, particularly because advertising of the service is increasingly a feature of public education campaigns and venue-based social responsibility initiatives. We have explored in a fairly minimal fashion the relationship between education and help-seeking, but we need stronger evidence of this relationship through detailed evaluations of campaign outcomes. A high level of awareness of actual or potential gambling-related harms may also contribute to a readiness to seek help, to the extent that people may feel that they are less personally responsible (morally and behaviourally) for experiencing problems with their gambling, particularly on EGMs. The Seventh Survey of Community Gambling Patterns and Perceptions (Roy Morgan Research, 2000), for example, found that 84% of Victorians thought that gambling-related problems had worsened, while 83% thought that gambling was now a serious problem. Increased numbers of referrals do not appear to be linked to higher levels of participation in gambling in the general community or to higher levels of participation in forms of gambling associated with greater risk of problem play, such as EGMs. Is the fact that people are referring with fewer problems an indication that community education and the operationalising of beliefs about harmfulness, as noted above, are a sustainable trend towards early intervention? If this is the case, it would be helpful to know what the policy and program mix was that has achieved this result, what the interplay between government regulation based on harm minimisation and industry social responsibility measures is, and whether the effect could be enhanced with higher levels of either or both. We do not know whether fewer problems actually translates into less severity, although, naturally, we would hope for that effect. This still needs to be determined, as does the question of how long people have experienced their gambling problem before seeking help. We are still working on these two important questions: How do programs such as Gambler’s Help attract more problem gamblers under 25 into counselling? How do programs such as Gambler’s Help attract non-English-speaking community members into counselling or into more relevant forms of intervention, given that we know that the client participation rate in counselling is almost identical to that of the general adult community profile, whereas we know that problem gambling rates in some of these communities are at least five to seven times those of the English-speaking population? As suggested, these are just some of the questions that this overview has thrown up, and they are beyond the scope of this paper to answer. There are yet other areas that intersect with research being carried out in other jurisdictions which also need further exploration in the population reported here. Such areas include the DSM-IV profiles of male and female gamblers and also EGM gamblers compared with track (oncourse and offcourse) bettors. What is obvious, however, is the usefulness of “available data,” in the form of an MDS, in gaining a broad picture of help-seeking patterns and in helping to shape a more detailed research agenda in this area of gambling studies. References Abbott, M. W., & Volberg, R. A. (1996). The New Zealand national survey of problem and pathological gambling. Journal of Gambling Studies, 12 (2), 143–160. Auditor General of Victoria. (1996). The Community Support Fund: A significant community asset (Special Report No. 40). Melbourne: Victorian Government Printer. Australian Institute of Health and Welfare. (1996). Australia’s health 1996. Canberra: Australian Government Publishing Service Blaszczynski, A., Walker, M., Sagris, A., & Dickerson, M. (1997, October). Psychological aspects of gambling behaviour. Paper presented at the Annual Conference of the Australian Psychological Society, Cairns, Australia. Ciarrochi, J., & Richardson, R. (1989). Profile of compulsive gamblers in treatment: Update and comparisons. Journal of Gambling Studies, 5, 53–65. Cockerham, W. C. (1997). Lifestyles, social class, demographic characteristics and health behaviour. In D. S. Gochman (Ed.), Handbook of health behaviour research (pp. 253–265). New York: Plenum. Crisp, B. R., Jackson, A. C., Thomas, S. A., Thomason, N., Smith, S., Borrell, J., et al. (2001a). Is more better? The relationship between outcomes achieved by problem gamblers and the number of counselling sessions attended. Australian Social Work , 54 (3), 83–92. Crisp, B. R., Thomas, S. A., Jackson, A. C., & Thomason, N. (2001b). Partners of problem gamblers who present for counselling: Demographic profile and presenting problems. Journal of Family Studies, 7 (2), 208–216. Crisp, B. R., Thomas, S. A., Jackson, A. C., Thomason, N., Smith, S., Borrell, J., et al. (2000). Sex differences in the treatment needs and outcomes of problem gamblers. Research on Social Work Practice, 10 (2), 229–242. Dickerson, M., McMillen, J., Hallebone, E., Volberg, R., & Woolley, R. (1997). Definition and incidence of problem gambling, including the socio-economic distribution of gamblers. Melbourne: Victorian Casino and Gaming Authority. Hayward , D., & Kliger, B. (2002). Breaking a nasty habit: Gaming policy and politics in the state of Victoria. Unpublished manuscript, Institute for Social Research, Swinburne University of Technology. Jackson , A. C., Thomas, S. A., Ross, L., & Kearney, E. (2001). Analysis of clients presenting to problem gambling counselling services, July 1, 1999 to June 30, 2000, Client and Services Analysis Report No. 6. Melbourne: Victorian Department of Human Services. Retrieved 28 January 2005 from http://hnb.dhs.vic.gov.au (pdf file) Jackson , A. C., Thomas, S. A., Thomason, N., Borrell, J., Crisp, B. R., Enderby, K., et al. (2000a). Longitudinal evaluation of the effectiveness of problem gambling counselling services, community education strategies and information products – Volume 1: Service design and access. Melbourne: Victorian Department of Human Services. Available: www.problemgambling.vic.gov.au Jackson , A. C., Thomas, S. A., Thomason, N., Borrell, J., Crisp, B. R., Ho, W., et al. (1999a). Demographic profile, gambling activity and service use of clients presenting to BreakEven problem gambling counselling services, Client and Services Analysis Report No. 3. Melbourne: Victorian Department of Human Services. Retrieved 27 January 2005 from http://hnb.dhs.vic.gov.au (pdf file) Jackson, A. C., Thomas, S. A., Thomason, N., Borrell, J., Crisp, B. R., Ho, W., et al. (1999b). Analysis of clients presenting to problem gambling counselling services, July 1997 to June 1998, Client and Services Analysis Report No. 4. Melbourne: Victorian Department of Human Services. Retrieved 27 January 2005 from http://hnb.dhs.vic.gov.au (pdf file) Jackson, A. C., Thomas, S. A., Thomason, N., Crisp, B. R., Smith, S., Ho, W., et al. (1997). Analysis of clients presenting to problem gambling counselling services from July 1 1996 to June 30 1997, Client and Services Analysis Report No. 2. Melbourne: Victorian Department of Human Services. Retrieved 27 January 2005 from http://www.socialwork.unimelb.edu.au Jackson, A. C., Thomas, S. A., Thomason, N., & Ho, W. (2000b). Longitudinal evaluation of the effectiveness of problem gambling counselling services, community education strategies and information products — Volume 3: Community education strategies and information products. Melbourne: Victorian Department of Human Services. Available: www.problemgambling.vic.gov.au Jackson, A. C., Thomas, S. A., Thomason, N., Holt, T. A., & McCormack, J. (2000c). Analysis of clients presenting to problem gambling counselling services, July 1, 1998 to June 30, 1999, Client and Services Analysis Report No. 5. Melbourne: Victorian Department of Human Services. Retrieved 27 January 2005 from http://hnb.dhs.vic.gov.au (pdf file) Jackson, A. C., Thomason, N., Ryan, V., & Smith, S. (1996). Analysis of clients presenting to problem gambling counselling services from July 1 1995 to June 30 1996, Client and Services Analysis Report No. 1. Melbourne: Victorian Department of Human Services. Retrieved 27 January 2005 from http://www.socialwork.unimelb.edu.au Lesieur, H. R., & Blume, S. B. (1987). The South Oaks Gambling Screen (SOGS): A new instrument for the identification of pathological gamblers. American Journal of Psychiatry, 144 (9), 1184–1188. Market Solutions. (1997). Fifth community gambling patterns survey combined with second positive and negative perceptions of gambling survey. Melbourne: Victorian Casino and Gaming Authority. McCormack, J., & Jackson, A. C. (2000). Gambling with debt? Consumer Rights Journal , 4 (5), 15–16. McCormack, J., Jackson, A. C., & Thomas, S. A. (2003). The characteristics of older people’s gambling and help-seeking. In G. Coman, M. Walker, & A. Jackson (Eds.), Proceedings of the 12 th National Association of Gambling Studies Conference (pp. 329–341). Melbourne: NAGS Inc. McMillen, J., Jackson, A. C., Johnson, D., O’Hara, J., & Woolley, R. (1999). Australian gambling comparative history and analysis. Melbourne: Victorian Casino and Gaming Authority. Potenza , M., Steinberg, M., McLaughlin, S., Rounsaville, B., & O’Malley, S. (2001). Gender-related differences in the characteristics of problem gamblers using a gambling helpline. The American Journal of Psychiatry, 158, 1500–1505. Productivity Commission. (1999). Australia’s gambling industries report No. 10. Canberra: AusInfo. Roy Morgan Research. (1999). Sixth survey of community gambling patterns and perceptions. Melbourne: Victorian Casino and Gaming Authority. Roy Morgan Research. (2000). Seventh survey of community gambling patterns and perceptions. Melbourne: Victorian Casino and Gaming Authority. Rush, B., & Moxam, R. (2001). Treatment of problem gambling in Ontario: Service utilization and client characteristics: January 1, 1998 to April 30, 2000. Toronto: Centre for Addiction and Mental Health. Retrieved 28 January 2005 from http://www.datis.ca (Word file) Smith, J. (1998). Gambling taxation in Australia: Research Study No. 32. Sydney: Australian Tax Research Foundation Taber, J. I., McCormick, R. A., Russo, A. M., Adkins, B. J., & Ramirez, L.F. (1987). Follow-up of pathological gamblers after treatment. American Journal of Psychiatry, 144, 757–761. Tasmanian Gaming Commission. (2001). The 1999/2000 Australian gambling statistics. Hobart: Tasmanian Gaming Commission. Thomas, S. A., & Yamine, R. (2000). The impact of gaming on specific cultural groups. Melbourne: Victorian Casino and Gaming Authority. Victorian Casino and Gaming Authority. (2002). Available: http://www.ogr.gov.au Volberg, R. A. (1994). The prevalence and demographics of pathological gamblers: implications for public health. American Journal of Public Health, 84 (2), 237–241. Volberg, R. A., & Steadman, H. J. (1989). Prevalence estimates of pathological gambling in New Jersey and Maryland. American Journal of Psychiatry, 146 (12), 1618–1619. Walker, M. B. (1992). The psychology of gambling (1st ed.). Oxford: Pergamon Press. * Funding for this project was provided by the Community Support Fund, a hotel electronic gaming machine tax, administered by an independent board through a grant to the Victorian Department of Human Services which commissioned this research through a public tender process. Professor Mark Dickerson provided independent research advice to DHS. This article was peer-reviewed. Submitted: November 23, 2003, all URLs were available at time of submission or updated in copyediting. Accepted: January 28, 2005. For correspondence: Professor Alun C. Jackson, PhD, School of Social Work, The University of Melbourne, Victoria, 3010, Australia. Phone: 61 3 8344 9402; fax 61 3 9347 2496; e-mail: aluncj@unimelb.edu.au Contributors: AJ, ST and NT were principal investigators on the research program from which this paper was derived. They conceived the study, carried out searches and extracted data. TH was a senior research assistant on the study and carried out searches and extracted the data. AJ wrote the first draft and all authors contributed to the final draft. Competing interests: None declared. Ethics approval: Data collection and analysis was carried out as part of a publicly tendered research project awarded by the Victorian Department of Human Services and ethics approval was deemed to be not needed. Analysis beyond the scope of the initial project was approved by the University of Melbourne Human Research Ethics Committee for an annually renewable five-year period from September 15 th 1998 (Approval number 980115). Alun C. Jackson, PhD, is professor of social work at the University of Melbourne; Co-Director of the University of Melbourne /La Trobe University Gambling Research Program; adjunct professor in Public Health, La Trobe University; a fellow of the Murdoch Children’s Research Institute, and a fellow of the Centre on Behavioural Health, University of Hong Kong. He has been involved in the design and direction of many large-scale research programs including: an evaluation of the Victorian Gambler’s Help service, an assessment of the health and mental health effects of gambling on women, an analysis of best practice in treatments, a study of the impact of gambling on children and adolescents, a review of prevalence measures, and the design of practice standards. He has also worked with the Australian Institute for Gambling Research on a range of studies with state governments relating to prevalence, service design and the design of industry-specific and whole of industry responsible gambling policies. E-mail: aluncj@unimelb.edu.au Shane A. Thomas, PhD, is professor in the School of Public Health at La Trobe University, co-director of the University of Melbourne /La Trobe University Gambling Research Program and is a director of Thomas and Associates. He has been involved in the design and direction of many large-scale research programs including an evaluation of the Victorian Gambler’s Help service, an assessment of the impacts of gambling on specific cultural groups; an analysis of best practice in treatments; a study of the impact of gambling on children and adolescents; a review of prevalence measures; and the design of practice standards. The author of Introduction to research in the health sciences, and Clinical decision making for nurses and health care professionals, Professor Thomas is an international authority in research and evaluation methodology and in particular the development and validation of measurement tools . E-mail: ShaneThomas@bigpond.com Tangerine Holt, PhD, is a senior lecturer in the Centre for Medical and Health Sciences Education at Monash University. She is a co-developer, with Professors Jackson and Thomas of the Counsellor Task Analysis (Problem Gambling) tool, and the internationally acclaimed research and clinical tool, the Victorian Problem Gambling Family Impact Scale. Formerly an assistant professor at the Kent School of Social Work at Louisville University, she was principal investigator and project director of the Kentucky Interdisciplinary Community Screenings (KICS) Project and a member of the Kentucky Council on Problem Gambling. E-mail: tangerine.holt@med.monash.edu.au Neil Thomason, PhD, is a senior lecturer in the Department of History and Philosophy of Science at the University of Melbourne. He has published widely on scientific methodology and has conducted research on the psychology of gambling, with particular emphasis on widespread misunderstandings of probability. He was a chief investigator on an Australian Research Council-funded study on the “Cognition of Statistical Misconceptions and Learning,” which was designed to cure some misunderstandings of probability that appear to play a major role in much problem gambling. He is co-developer of statistics software (“StatPlay”), designed to free people from psychologically attractive cognitive illusions about probability and statistics, particularly the so-called “gambler’s fallacy.”E-mail: neilt@unimelb.edu.au Endnotes 1  The research program is now known as the University of Melbourne/La Trobe University Gambling Research Program. 2  The annual loss on all EGMs now exceeds AUS $2.3 billion (Victorian Casino and Gaming Authority, 2002). 3  These data are derived from Jackson et al. (1996; 1997; 1999a; 1999b; 2000a; 2001).
		issue 13 — march 2005