Inventory of Gambling Situations: User's Guide
Contents
1. Pleasant Emotions Social Pressure Need for Excitement e Worried about Debts e Winning and Chasing e Confidence in Skill The ics report lists a Problem Index Score for each subscale 2009 Centre for Addiction and Mental Health 32 Inventory of Gambling Situations User s Guide PROBLEM INDEX SCORE EXPLANATION 0 25 You rarely or infrequently gamble in this type of situation 25 60 You sometimes gamble in this type of situation 60 75 You frequently gamble in this type of situation 75 100 You very frequently gamble in this type of situation You and your therapist can use your scores to help you develop coping strategies You may choose to work on the situations where you seem to have the most problems with gambling since without coping strategies for these situations you are more like ly to return to gambling Often people recognize on their own that these situations are serious triggers for their gambling behaviours so you may already have ideas on how to handle them Another approach is to start with situations that are moderately problematic Mastering these situations is usually easier Accomplishing your goal can improve your confidence and make it easier to cope with more problematic situations For example suppose you had a score of 55 for Need for Excitement but a score of 70 for Negative Emotion You would first work on dealing with the excitement issue by learning new ways of enjoying yourself and then fo2. 2 3 4 11 When didn t want to have to think 2 3 4 12 When talked myself into gambling 2 3 4 13 When other people didn t seem to like me 2 3 4 2009 Centre for Addiction and Mental Health Inventory of Gambling Situations User s Guide NEVER I GAMBLED HEAVILY RARELY FREQUENTLY ALMOST ALWAYS 14 When I was in a situation in which I was in the habit of gambling 5 When I saw a good opportunity that I hated to pass up 6 When I felt confident and relaxed 7 When everyday life seemed boring 8 When people around me expected me to gamble 9 When I was winning and wanted to keep on winning 20 When I was drinking using drugs 21 When I couldn t stand things any more and needed to get away 22 When I suddenly had an urge to gamble 23 When I had an argument with a friend 24 When I decided to try to limit my gambling 25 When I felt I wasn t getting what I was entitled to 26 When I was afraid of the people to whom I owed money 27 When I felt confident about my gambling skills 28 When everything was going well 29 When I was in trouble with the law because of my gambling 30 When someone challenged me to a bet 31 When I saw something that reminded me of gambling 32 When there were fights at home 33 When I felt that I had gone too far to go back 34 When I felt bad about myself 2009 Centre for Addiction and Mental Health 2 3 4 2 3 4 2 3 4 2 3 4
3. 2 and 10 are also scored 2009 Centre for Addiction and Mental Health 10 Inventory of Gambling Situations User s Guide The rcs also produces a PDF which contains the bar graphs plus a list of the 10 sub scales from highest to lowest risk for heavy gambling for that person The report also lists the specific situations that is the items in which that client frequently or almost always has gambled heavily Printing and saving reports Note The online version of the Ics does not save your client s scores You will need to save the results to your own computer by clicking on Save Report After all 63 questions have been answered click Submit The client s scores will be displayed on the screen In order to save the results click Save report You will then be given the option to Open Save or Cancel Click Save you can name the file any thing you like This will save the results on your computer as a PDF portable docu ment format file An example of a computer generated 1Gs report is included in Section 3 p 25 USING THE PAPER BASED FORMS Please contact Dr Nigel Turner nigel_turner camh net for more information on the paper based 1Gs forms Instructions for completing the 1Gs are provided on the questionnaire allowing most clients to complete it on their own If a client has trouble reading or understanding the questions the therapist should help administer the questionna
4. N E 1998 Group Comparisons of Coping Self Efficacy Between Alcohol and Cocaine Abusers Seeking Treatment Psychology of Addictive Behaviors 13 2 123 133 Sklar S M Annis H M amp Turner N E 1997 Development of the Drug Taking Confidence Questionnaire measure of coping self efficacy Addictive Behaviors 22 655 670 Turner N E Annis H M amp Sklar S M 1997 Measurement of antecedents of drug use and drinking Psychometric Properties of the Inventory of Drug Taking Situations 1pTs Behavior Research and Therapy 35 465 483 2009 Centre for Addiction and Mental Health 31 Appendix 1 Client s guide to interpreting IGS results This section can be shared with clients to help them understand their IGS results What do the scores mean The 1Gs does not diagnose whether a person has a gambling problem The 1Gs does show you the type of situations in which gambling has been a problem for you in the past This information can be very valuable to you and your therapist when you are developing a treatment plan together When you are aware of what particular situa tions trigger your gambling behaviours it will be easier for you to plan strategies that are specifically targeted to the problem as you experience it Your responses to the questions on the 1Gs form are organized into 10 categories or subscales e Negative Emotions Conflict with Others Urges and Temptations Testing Personal Control
5. 2 3 4 2 3 4 Inventory of Gambling Situations User s Guide 21 I GAMBLED HEAVILY NEVER RARELY FREQUENTLY ALMOST ALWAYS 55 When I had free time 1 2 3 4 56 When wanted to prove that could make a few bets without going too far 1 2 3 4 57 When knew it was a sure thing 1 2 3 4 58 When was out with friends and they suggested we gamble 1 2 3 4 59 When felt that needed just one more winning streak to fix everything 2 3 4 60 When people were pressuring me to come up with money 2 3 4 61 When I was angry 2 3 4 62 When gambling was easily available 2 3 4 63 When someone criticized me 2 3 4 Subscales of the ics in four clusters Note Some items are included in more than one subscale NEGATIVE AFFECT SITUATIONS Negative Emotions 07 When I was depressed 11 When I didn t want to have to think 21 When I couldn t stand things any more and needed to get away 34 When I felt bad about myself 37 When I felt under a lot of stress 41 When I felt empty inside 51 When I was lonely 53 When I just couldn t think about anything but gambling 54 When I felt under a lot of pressure from family members 61 When I was angry 2009 Centre for Addiction and Mental Health 22 Inventory of Gambling Situations User s Guide Conflict with Others 13 When other people didn t seem to like me 23 When I had an argument with a friend 32 When there were fi
6. tool Research shows the 1Gs to have good internal consistency reliability and validity Description of the Ics The 1Gs in its initial development followed a classification system based on the work of Alan Marlatt and his associates on relapse prevention and addictive behaviours Marlatt 1978 1979a 1979b Marlatt amp Gordon 1980 1985 Modified by findings from research with people who gamble the high risk classifi cation system was revised for the 1Gs to include situations more specific to gambling The 1Gs has 10 subscales Some are derived from Marlatt and Gordon but see also Turner et al 1997 and some from a number of items specifically related to gambling situations Subscales of the IGS e Negative Emotions 10 items Conflict with Others 7 items Urges and Temptations 9 items Testing Personal Control 7 items Pleasant Emotions 5 items e Social Pressure 7 items e Need for Excitement 6 items e Worried about Debts 5 items Winning and Chasing 6 items e Confidence in Skill 5 items Two 1Gs items are not included in any of the subscales but still may be clinically useful 2 When I was able to gamble without anyone knowing 10 When I wanted to prove to others that I was worthy of respect In completing the ics clients are asked to indicate how frequently during the past 12 months they have gambled heavily in each of 63 situations using a four point scale r
7. wanted to keep on winning 33 When I felt that I had gone too far to go back 45 When I saw signs that my luck was with me 46 When I needed to win back the money I lost gambling 59 When I felt that I needed just one more winning streak to fix everything Confidence in Skill 03 When I decided that this time I would use good gambling strategies 15 When I saw a good opportunity that I hated to pass up 27 When I felt confident about my gambling skills 40 When I felt that I could profit from careful gambling 57 When I knew it was a sure thing Sample Ics report The next four pages show a sample Inventory of Gambling Situations report 2009 Centre for Addiction and Mental Health Inventory of Gambling Situations User s Guide 25 ProblemGambling ca 16S Subscale Scores Sharing solutions Changing lives Client Profile Negative Emotions Temptation Situations Conflict with Others a 53 Testing Personal Control Negative Emotions Urges and Temptations 0 10 20 30 40 50 60 70 80 90100 0 10 20 30 40 50 60 70 80 90100 Positive Affect Situations Gambling Cycle Situations Need for Excitement Confidence in Skill Social Pressure Winning and Chasing Pleasant Emotions worried about Debts 0 10 20 30 40 50 60 70 80 90100 0 10 20 30 40 50 60 70 80 90100 Notes Asterisks and Red Bar Graph indicate a high score on an IGS Subscale Inventory of Gambling Situations I 2009 Ce
8. 13 13 13 14 14 I5 16 16 INTERPRETING THE IGS Problem Index Scores Overall impression of subscale scores Hierarchy of risk situations Identifying triggers Client Profile Four clusters of 1Gs subscale scores Differentiated Client Profiles Undifferentiated Client Profiles Working with the Client Profile Using the 1Gs as a research tool Section 3 IGS questionnaire and tools 18 21 21 22 22 23 25 29 31 37 IGS QUESTIONNAIRE SAMPLE CLIENT FORM SUBSCALES OF THE IGS IN FOUR CLUSTERS Negative affect situations Positive affect situations Temptation situations Gambling cycle situations SAMPLE IGS REPORT References Appendix 1 Client s guide to interpreting Ics results Appendix 2 Working with the ics data 2009 Centre for Addiction and Mental Health Section 1 Introduction Overview of the 1cs Advantages of the 1cs Description of the 1cs Subscales of the 1Gs 2009 Centre for Addiction and Mental Health Overview of the IGS This manual provides problem gambling therapists and researchers with guidelines for using the Inventory of Gambling Situations 1Gs The 1cs is a 63 item self report questionnaire and is easily administered in either online or paper based format The IGS converts its results into an individualized Client Profile that details the situations in which that particular client has gambled excessively during the past 12 months In structure and design the Gs is similar to the Inv
9. 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 20 Inventory of Gambling Situations User s Guide I GAMBLED HEAVILY NEVER RARELY FREQUENTLY ALMOST ALWAYS 35 When I felt like taking a risk 1 2 3 4 36 When felt sure that could spend time in a gambling situation without gambling 37 When felt under a lot of stress 38 When felt content with my life 39 When was worried about my debts 40 When felt that could profit from careful gambling 41 When felt empty inside 42 When had money in my pocket 43 When felt people mistrusted me 44 When was in a social situation and other people were gambling 45 When saw signs that my luck was with me 46 When needed to win back the money lost gambling 47 When convinced myself that was a new person and could make a few bets 48 When wanted to feel in control for a little while 49 When wanted to celebrate 50 When began to think how exciting or relaxing a little gambling would be 51 When was lonely 52 When was looking for excitement 53 When I just couldn t think about anything but gambling 54 When felt under a lot of pressure from family members 2009 Centre for Addiction and Mental Health 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4
10. HE IGS IN FOUR CLUSTERS Negative affect situations Positive affect situations Temptation situations Gambling cycle situations SAMPLE IGS REPORT 2009 Centre for Addiction and Mental Health 18 Inventory of Gambling Situations User s Guide IGS questionnaire Sample client form INVENTORY OF GAMBLING SITUATIONS IGS Listed below are a number of situations or events in which some people gamble heavily Read each item carefully and answer in terms of your own gambling over the past year If you NEVER gambled heavily in that situation circle 1 If you RARELY gambled heavily in that situation circle 2 If you FREQUENTLY gambled heavily in that situation circle 3 If you ALMOST ALWAYS gambled heavily in that situation circle 4 GAMBLED HEAVILY NEVER RARELY FREQUENTLY ALMOST ALWAYS 1 When almost won and felt that would win very soon 1 2 3 4 2 When was able to gamble without anyone knowing 1 2 3 4 3 When decided that this time would use good gambling strategies 2 3 4 4 When was happy 2 3 4 5 When wanted some action 2 3 4 6 When someone encouraged me to bet 2 3 4 7 When was depressed 2 3 4 8 When was about to get caught unless came up with some money fast 1 2 3 4 9 When started to believe that gambling was no longer a problem for me 1 2 3 4 10 When wanted to prove to others that was worthy of respect
11. Inventory of Gambling Situations IGS User s Guide Nina Littman Sharp Nigel E Turner Tony Toneatto Centre for Addiction and Mental Health Inventory of Gambling Situations 1Gs User s Guide Nina Littman Sharp Nigel E Turner Tony Toneatto ISBN 978 1 77052 448 4 PRINT ISBN 978 1 77052 449 1 PDF ISBN 978 1 77052 450 7 HTML ISBN 978 1 77052 451 4 ePUB Copyright 2009 Centre for Addiction and Mental Health Toronto ON No part of this work may be reproduced or transmitted for profit or otherwise in any form or by any means electronic or mechanical including photocopying and recording or by any information storage and retrieval system without written per mission from the publisher except for a brief quotation not to exceed 200 words in a review or professional work 4116 09 2009 Contents Section 1 Introduction Aon NR Overview of the 1Gs Advantages of the 1Gs Description of the 1Gs Subscales of the 1Gs Section 2 Guidelines for using the ics 8 8 8 8 8 9 9 9 9 IO IO IO II ADMINISTERING THE IGS When not to administer the 1Gs Using the online format Terms of use Step 1 Details Clinician details Client details Study consent Step 2 Questionnaire Printing and saving reports Using the paper based forms SCORING THE IGS Hand scoring Calculating the Problem Index Scores 2009 Centre for Addiction and Mental Health I2 I2 I2
12. M amp Graham J M 1988 Situational Confidence Questionnaire sco User s Guide Toronto Addiction Research Foundation of Ontario Annis H M amp Graham J M 1992 Inventory of Drug Taking Situations IDTS User s Guide Adolescent Version Unpublished manuscript Toronto Addiction Research Foundation of Ontario Annis H M amp Graham J M 1995 Profile types on the Inventory of Drinking Situations Implications for relapse prevention counselling Psychology of Addictive Behaviours 9 176 182 Annis H M Graham J M amp Davis C S 1987 Inventory of Drinking Situations IDS User s Guide Toronto Addiction Research Foundation of Ontario Annis H M amp Martin G 1985 Inventory of Drug Taking Situations Toronto Addiction Research Foundation of Ontario Annis H M Schober R amp Kelly E 1996 Matching addiction outpatient counsel ing to client readiness for change The role of structured relapse prevention counsel ing Experimental and Clinical Psychopharmacology 4 37 45 2009 Centre for Addiction and Mental Health 30 Inventory of Gambling Situations User s Guide Annis H M Sklar S M amp Turner N E 1996 Drug Taking Confidence Questionnaire DTCoO User s Guide Toronto Addiction Research Foundation of Ontario Annis H M Turner N E amp Sklar S M 1996 Inventory of Drug Taking Situations User s Guide Toronto Addiction Research Foundation of Ontario M
13. Need for Excitement db Worried about Debts wc Winning and Chasing sc Confidence in Skill ski in spss syntax see below 2009 Centre for Addiction and Mental Health 38 Inventory of Gambling Situations User s Guide SPSS SYNTAX FOR COMPUTING IGS SUBSCALE SCORES compute totigsr rnd mean igst to igs63 1 3 100 compute neigsr rnd mean igs7 igst1 igs21 igs34 igs41 igs51 igss4 igs53 igs37 igs61 1 3 100 execute jgsr7 compute coigsr rnd mean igs13 igs23 igs32 igs43 igs33 igs63 igs61 1 3 100 compute utigsr rnd mean igs2 igs22 igs31 igs42 igs53 igs02 igs14 igs17 igs35 1 3 100 compute tpcigsr rnd mean igs9 igs24 igs36 igs47 igs56 igs48 igs25 1 3 100 compute peigsr rnd mean igs4 igs16 igs28 igs38 igs49 1 3 100 perhaps drop 49 as well execute compute spigsr rnd mean igs6 igs18 igs30 igs44 igs58 igs20 igs49 1 3 100 execute compute exigsr rnd mean igs5 igs44 igs50 igs45 igs52 igs55 1 3 100 compute dbigsr rnd mean igs8 igs26 igs39 igs6o igs29 1 3 100 compute wcigsr rnd mean igst igs19 igs33 igs46 igs59 igs45 1 3 100 compute skigsr rnd mean igs3 igs15 igs27 igs40 igs57 1 3 100 execute 2009 Centre for Addiction and Mental Health
14. and Mental Health Inventory of Gambling Situations User s Guide depends on clients willingness to be honest about themselves and their gambling behaviour Often an addiction problem can seem so overwhelming that clients can t identify a first step toward solving it The 1Gs gives them a clear outline of the areas they need to work on By exploring and ranking a person s most problematic gambling triggers the 1Gs can help both therapists and clients recognize previous situations in which the client has had problems with gambling anticipate future situations in which the client is likely to be at risk of gambling or of gambling excessively develop an individualized plan for treatment and or aftercare work on developing strategies for coping when in high risk situations While the 1Gs was originally developed for use as part of a cognitive behavioural treat ment program the information that the 1cs supplies about a client s risk situations is important for use in a broad range of treatment approaches including approaches based on a 12 step model of recovery psychodynamic therapy structured relapse prevention The information provided by the 1Gs can be used in both individual and group coun selling programs with clients whose gambling problems range from mild to severe Advantages of the ics The rcs is a well validated assessment tool that provides a systematic profile of the antecedents or triggers of a client s prob
15. anging from never to almost always see sample form p 18 Taken together the Problem Index Scores on the 10 subscales constitute a situational risk profile for that individual 2009 Centre for Addiction and Mental Health Section 2 Guidelines for using the IGS ADMINISTERING THE IGS When not to administer the 1Gs Using the online format Terms of use Step 1 Details Clinician details Client details Consent Step 2 Questionnaire Printing and saving reports Using the paper based forms SCORING THE IGS Hand scoring Calculating the Problem Index Scores INTERPRETING THE IGS Problem Index Scores Overall impression of subscale scores Hierarchy of risk situations Identifying triggers Client Profile Four clusters of 1Gs subscale scores Differentiated Client Profiles Undifferentiated Client Profiles Working with the Client Profile Using the 1Gs as a research tool 2009 Centre for Addiction and Mental Health Inventory of Gambling Situations User s Guide Administering the ics The 1Gs should be administered by a therapist using the online format located at www ProblemGambling ca It should take approximately 20 minutes to complete The rcs is also available in a paper based version from Dr Nigel Turner nigel_turner camh net This version is generally used when therapists want to administer the 1Gs in a group setting If the paper based version is used the client s res
16. arlatt G A 1978 Craving for alcohol loss of control and relapse A cognitive behavioral analysis In P E Nathan G A Marlatt amp T Loberg Eds Alcoholism New Directions in Behavioral Research and Treatment pp 2 71 314 New York Plenum Press Marlatt G A 1979a Alcohol use and problem drinking A cognitive behavioral analysis In P C Kendall amp S D Hollon Eds Cognitive Behavioral Interventions Theory Research and Procedures pp 319 355 New York Academic Press Marlatt G A 1979b A cognitive behavioral model of the relapse process In N A Krasnegor Ed Behavioral Analysis and Treatment of Substance Abuse National Institute on Drug Abuse Research Monograph 25 pp 191 200 Rockville MD National Institute on Drug Abuse Marlatt G A 1985 Situation determinants of relapse and skill training interven tions In G A Marlatt amp J R Gordon Eds Relapse Prevention Maintenance Strategies in the Treatment of Addictive Behaviours New York Guilford Marlatt G A amp Gordon J R 1980 Determinants of relapse Implications for the maintenance of behaviour change In P O Davidson amp S M Davidson Eds Behavioral Medicine Changing Health Lifestyles pp 410 452 New York Brunner Mazel Sklar S M amp Turner N E 1999 A brief measure for the assessment of coping self efficacy among alcohol and other drug users Addiction 94 723 729 Sklar S M Annis H M amp Turner
17. ations A hierarchy of risk situations can be constructed by ranking the respondent s Problem Index Scores for each of the 10 1Gs subscales from highest to lowest see the example on p 12 of the steps in calculating a subscale score The situations with the highest rank represent the situations in which that person is likely to be at greatest risk for gambling Sometimes clients enter treatment after they have already addressed their situations of highest risk With such clients it may be helpful to examine the next highest risk situations Such situations may take individuals by surprise and so lead to gam bling behaviours simply because they occur less frequently As long as the client remains unprepared for and unaware of these albeit less risky situations these trig gers remain powerful and are a common cause of relapse over the longer term Identifying triggers The 1Gs can be a good tool for raising awareness in both the client and the therapist Clients can be invited to consider and discuss any connections between their various triggers It is also helpful to look at clients responses to individual items The responses can be useful jumping off places for discussion With 63 items there may be triggers that affect the client but which they have not previously noticed or consciously identified CLIENT PROFILE The Client Profile is displayed as a bar graph on the printed report of the 1Gs results click Submit to ou
18. cus on dealing with negative feelings You also need to consider the urgency of the circumstances and the avail ability of support as well as a variety of other factors You and your therapist should work together to develop a plan of action Explanation of ics categories subscales NEGATIVE EMOTIONS A high score indicates that you may gamble excessively to escape from or cope with feelings such as depression loneliness or frustration You may need to learn to deal with these negative emotions without gambling If gambling is causing problems in your life and so increasing the negative feelings you may need to work in a positive way to resolve the problems CONFLICT WITH OTHERS A high score indicates that you may gamble excessively when you are in conflict with the people in your life You may need to work on managing problems in your relationships This can involve a number of approaches such as learning skills in communication conflict man agement or anger management or seeking relationship counselling 2009 Centre for Addiction and Mental Health Inventory of Gambling Situations User s Guide 33 If the conflicts are related to your gambling addressing the gambling problem will gradually reduce the level of conflict Some people manufacture arguments so they have an excuse to gamble When this is the case it is helpful to address the real rea sons you want to gamble URGES AND TEMPTATIONS A high score indica
19. e are peaks for these subscales These profiles also often include elevated scores in the Urges and Temptations and Worried about Debts subscales People who gamble as a way of dealing with prob lems and stress in their lives are likely to have this pattern MIXED PROFILES Many Client Profiles show peaks for subscales that reflect both positive and negative situations These mixed profiles usually indicate that although the client is gambling to satisfy a need for excitement he or she also has suffered serious consequences as a result of the gambling behaviour Undifferentiated client profiles If a profile is relatively flat across the 10 risk categories it is considered to be undif ferentiated Such profiles can be of either generally high or generally low elevation For example with an undifferentiated profile of high elevation Problem Index Scores pre dominately greater than 60 the client is reporting frequent heavy gambling across all situations An undifferentiated profile presents a challenge in that it would seem to indicate that no situation is more or less problematic than any other There may be a number of reasons for an undifferentiated profile The client may have been gambling for long enough that the behaviour has become the standard response to virtually every need and thus has become generalized across all cate gories of risk situations Some clients may tend to exaggerate high elevation profile or minimize low el
20. entory of Drinking Situations IDS Annis et al 1987 and the Inventory of Drug Taking Situations 1prs Turner et al 1997 All three tools were developed at the Centre for Addiction and Mental Health camH and are widely used in Canada and the United States as well as in many other countries In contrast to screening and diagnostic tools whose purpose is to detect gambling problems the 1Gs s role is to help the therapist develop an individualized treatment plan for people with gambling problems The rcs like the 1ps is based on the perspective that excessive gambling is a behav ioural and cognitive pattern that has been learned and thus can be changed The overall score on the rcs or the scores on some or all of its subscales known as Problem Index Scores often will be appreciably higher for people who have prob lems with gambling than for people who do not have such problems even if they do occasionally gamble recreationally However in themselves the scores are not an indi cation of a gambling problem Rather the rcs is designed to give the therapist and client insight into the client s spe cific gambling pattern by identifying those types of situations that are most likely to trigger problem gambling behaviour Ideally the 1Gs will help therapists teach clients to identify and address their own areas of vulnerability As with most self report instruments the utility of the 1cs profiles 2009 Centre for Addiction
21. erate score Someone scoring in this range will have answered frequently or almost always to at least one item in the subscale Above 60 is a high score Someone scoring over 60 will have answered frequently to most of the items or almost always to more than one item in the subscale e Above 70 is a very high score Someone scoring over 70 will have answered fre quently or almost always on most of the items in the subscale As a general rule a score above 60 should be treated as clinically significant However people differ considerably in their criteria for selecting rarely frequently 2009 Centre for Addiction and Mental Health Inventory of Gambling Situations User s Guide 13 or almost always so comparing individuals with each other or comparing an individual against an arbitrary standard is questionable Instead a person s scores on one subscale should be compared with his or her own scores on another subscale The higher scores indicate situations where the problems are likely to be more serious relative to the situations for which the scores are lower regardless of what the absolute score numbers might be It is possible to consider the Problem Index Score for each subscale separately However more information can be gained by viewing the client s pattern profile of scores across all 10 categories of situations that involve heavy gambling Hierarchy of risk situ
22. evation profile their gambling in their responses Thus an undif ferentiated profile of low elevation may reflect either a low level of gambling prob lems or a low current motivation for change The therapist should consider whether the profile is an accurate reflection of the client s gambling based on other sources of information and on discussion with the client A flat profile is not very helpful in pinpointing risk situations and developing 2009 Centre for Addiction and Mental Health Inventory of Gambling Situations User s Guide coping strategies In most cases however even clients who have been gambling heavily for years are able to identify with supplementary questioning by the therapist examples of situations where they are at particularly high risk The therapist should explore with the client the situational components in a few recent episodes where the client gambled heavily This kind of discussion will often be sufficient to demonstrate to the client the value of this approach and will help the person learn to differentiate risk situations Having the client monitor his or her urges to gamble in some detail and or keep a log of his or her emotional states can also help the client differentiate between the relative risk for gambling in different situations Working with the client profile Having obtained the Client Profile the therapist should present it to the client and ask whether it seems to be an accurate reflect
23. f winning It r wy that When I almost won and felt that I would 4 Vee become EE t eb aie aa EP h win very soon than you intended to People who score hig _ on this sub scale often believe that if they When I was winning and wanted to keep G an minmin 4 keep gambling they will recoup their losses VES You may need to learn about the true odds of g 9 4 winning and also about how to cope with the Wh ee er fi feelings that are raised by winning and en I saw signs that my Iuck was WI 4 chasing me Inventory of Gambling Situations 2009 Centre for Addiction and Mental Health Page 3 4 2009 Centre for Addiction and Mental Health 28 Inventory of Gambling Situations User s Guide ProblemGambling ca Sharing solutions Changing lives 3 Confidence in Skill i Your 10n ur Answer When I decided that this time I would use 3 good gambling strategies When I saw a good opportunity that I 3 hated to pass up When felt confident about my gambling 4 skills When felt that could profit from careful 3 gambling 4 Urges and Temptations Your Question Answer When I talked myself into gambling 3 When I was in a situation in which I was 3 in the habit of gambling When I suddenly had an urge to gamble 3 When I saw something that reminded me 3 of gambling When I felt like taking a risk 4 When I had money in my pocket When gambling was easily available 3 Score 67 Top Four IGS Subscale Scores A
24. ghts at home 33 When I felt that I had gone too far to go back 43 When I felt people mistrusted me 61 When I was angry 63 When someone criticized me POSITIVE AFFECT SITUATIONS Pleasant Emotions 04 When I was happy 16 When I felt confident and relaxed 28 When everything was going well 38 When I felt content with my life 49 When I wanted to celebrate Social Pressure 06 When someone encouraged me to bet 18 When people around me expected me to gamble 20 When I was drinking using drugs 30 When someone challenged me to a bet 44 When I was in a social situation and other people were gambling 49 When I wanted to celebrate 58 When I was out with friends and they suggested we gamble TEMPTATION SITUATIONS Urges and Temptations 12 When I talked myself into gambling 14 When I was in a situation in which I was in the habit of gambling 17 When everyday life seemed boring 22 When I suddenly had an urge to gamble 2009 Centre for Addiction and Mental Health Inventory of Gambling Situations User s Guide 23 31 When I saw something that reminded me of gambling 35 When I felt like taking a risk 42 When I had money in my pocket 53 When I just couldn t think about anything but gambling 62 When gambling was easily available Testing Personal Control 09 When I started to believe that gambling was no longer a problem for me 24 When I decided to
25. high score indicates that you may gamble excessively when you are confident about your skill or system You may have some mistaken beliefs about how odds work Even though some games seem to benefit from skills or knowledge there is still too much randomness to assure wins over the long term It is helpful to add up your wins and losses over time rather than focusing on individual wins Score 63 A high score indicates that you may gamble excessively when gambling is easily available or when events or circumstances make you think of gambling You may need to pinpoint the events or circumstances that trigger you Then you can develop strategies to cope with cravings and find new ways to reduce or respond to gambling triggers For example since access to money is a common trigger it is usually helpful to limit your access to cash or credit Inventory of Gambling Situations 2009 Centre for Addiction and Mental Health 2009 Centre for Addiction and Mental Health Page 4 29 References Annis H M 1982 Inventory of Drinking Situations Toronto Canada Addiction Research Foundation of Ontario Annis H M 1990 Effective Treatment for Drug and Alcohol Problems What do we know Forum on Corrections Research 2 18 23 Annis H M amp Davis C S 1989 Relapse prevention In R K Hester amp W R Miller Eds Handbook of Alcoholism Treatment Approaches pp 170 182 New York Pergamon Press Annis H
26. ill scale consists of five items 3 15 27 40 57 Suppose a person taking the 1Gs had the following scores on the items in this subscale 3 3 2 4 4 1 The raw score for the subscale is 3 3 2 4 4 16 2 Subtract the number of items in the subscale 16 5 11 3 Divide the result of Step 2 by the number of items in the subscale 11 5 2 2 This is the client s average score for the items in this subscale 4 Convert to a Problem Index Score by dividing result in Step 3 by 3 and then multi plying by 100 Thus 2 2 3 x 100 73 3 This person has a high score on the Confidence in Skill subscale which could mean that for this person gambling may be triggered by erroneous that is overly opti mistic beliefs about his or her ability to beat the odds Interpreting the ics The 1Gs can be interpreted from two related perspectives Problem Index Scores Client Profile PROBLEM INDEX SCORES Problem Index Scores the scores for each subscale which result from the calculations above permit comparison across subscales that contain different numbers of items Overall impression of subscale scores A preliminary interpretation of a respondent s scores on each 1cs subscale may be made on the following basis e Between o and 25 is a fairly low score Someone scoring in this range will have answered never or rarely on all of the items in that particular subscale e Between 25 and 60 is a mod
27. ion of his or her gambling experience and behaviour Clients should be encouraged to discuss how their gambling varies across different types of situations and to elaborate on areas of particularly high risk for gambling This discussion provides clients with feedback on their assessment results It can also help clients to understand their particular high risk situations and to engage them as active collaborators in the treatment process USING THE IGS AS A RESEARCH TOOL The 1Gs was designed for clinical use but as with the Inventory of Drug Taking Situations IpTs and the Drug Taking Confidence Questionnaire pTcQ it can also be used as a research tool For instance it might be used to help understand and pre dict relapse or to evaluate changes in gambling behaviour in response to treatment In the latter case a three to six month time frame would be preferable The 1Gs can also be used to identify different motives for gambling and thus can be used to search for different clusters of gamblers The sub scale scores of the 1cs can be obtained from the ppF output For research purposes the raw rcs scores may be needed The online program is not set up to provide raw scores so the paper and pencil version may be needed Instructions for scoring the raw data are given in Appendix 2 p 37 2009 Centre for Addiction and Mental Health Section 3 IGS questionnaire and tools IGS QUESTIONNAIRE SAMPLE CLIENT FORM SUBSCALES OF T
28. ire After the client completes the questionnaire the results are entered into the online IGS for scoring If the Internet is not available the questionnaire can be scored by hand using the instructions on p II Scoring the ics Responses to the 63 items in the 1Gs are assigned to 10 categories or subscales listed in Section 1 page 11 and a Problem Index Scores is provided for each subscale Scores for the two items not included in the subscales are recorded at the end of the report as mentioned above these items are included for their clinical utility This section also contains scores for two more items 20 When I was drinking using drugs 29 When I was in trouble with the law because of my gambling These two items are included in the subscales but are repeated here because they indicate important facts about the client that may not be directly related to gambling 2009 Centre for Addiction and Mental Health Inventory of Gambling Situations User s Guide but that might complicate the person s recovery if not given attention Although presented together in the results these items do not constitute a subscale and should be interpreted separately for clinical purposes HAND SCORING IGS scores can also be computed manually The client will have entered a value for each of the 63 items 1 for Never 2 for Rarely 3 for Frequently and 4 for Almost always To calculate the rc
29. lematic gambling behaviour While many therapists elicit this kind of information in assessment interviews with their clients the 1cs offers a simple way to develop an individualized profile of each client s risk situations This information can then be applied in a number of ways including e supplementing or focusing the assessment interview planning the client s treatment preparing an aftercare plan The ics offers a number of advantages to therapists researchers and clients includ ing the following The 1Gs can be administered using either a paper based form or an interactive online program at www ProblemGambling ca The online version automatically scores the client s responses and generates a report with a Client Profile in the form of a bar graph showing the client s level of risk in 10 types of situations as well as a list of specific high risk situations for that client e The 1Gs questionnaire is easily administered Once the client has been introduced to 2009 Centre for Addiction and Mental Health Inventory of Gambling Situations User s Guide 5 the 1Gs he or she can complete the questionnaire independently using either the online or paper based version It takes about 20 minutes to complete the questionnaire e Where there are barriers such as low literacy or language problems either version can also be completed with the therapist s help The 1Gs can be used as both a research and a clinical
30. may need to learn about the true odds of winning and also about how to cope with the feelings that are raised by winning and chasing CONFIDENCE IN SKILL A high score indicates that you may gamble excessively when you are confident about your skill or system You may have some mistaken beliefs about how odds work Even though some games seem to benefit from skills or knowledge there is still too much randomness to assure wins over the long term It is helpful to add up your wins and losses over time rather than focusing on indi vidual wins SPECIAL ITEMS These items appear at the end of your IGs report Special item 2 When was able to gamble without anyone knowing A score of 3 or 4 on this item may mean that you are in the habit of concealing your gambling from family and friends You may be so accustomed to gambling in these 2009 Centre for Addiction and Mental Health Inventory of Gambling Situations User s Guide 35 circumstances that you do so whenever you get the chance You may need to look at arranging your life and finances to make it harder to gam ble You may also want to think about the way in which habit is controlling your deci sion making Special item 10 When I wanted to prove to others that I was worthy of respect A score of 3 or 4 on this item may indicate a problem with self esteem or may sug gest that money and winning are important to your self esteem You may want to look at alter
31. native ways to feel good about yourself Special item 20 When I was drinking using drugs A score of 3 or 4 on this item could indicate an alcohol or other drug problem that might need treatment You should also explore with your therapist the relationship between substance use and gambling does drinking or using other drugs trigger your gambling or does gambling trigger your drinking or both Special item 29 When I was in trouble with the law because of my gambling A score of 3 or 4 on this item suggests that you and your therapist should look at the relationship between your legal problems and your gambling Do legal troubles trigger the gambling or have the legal problems resulted from pre vious gambling or both Interpreting responses to individual ics items The ics report also gives you your score for each question A score of 4 almost always 3 frequently 2 rarely and 1 never Items with high scores 3 and 4 are situations in which you are most likely to gamble Items with low scores 1 and 2 are situations in which you are less likely to gamble If you are concerned about any of your scores please talk to your therapist 2009 Centre for Addiction and Mental Health 37 Appendix 2 Working with the 1Gs data Subscale codes ne Negative Emotions co Conflict with Others ut Urges and Temptations tpc Testing Personal Control pe Pleasant Emotions sp Social Pressure ex
32. note that the IGS does not diagnose if a person has a problem It only indicates which situations tend to be problematic Scores for individual items are listed in front of each item A score of 4 always 3 frequently 2 rarely and 1 never Items with high scores 3 and 4 are situations in which you are most likely to gamble Items with low scores 1 and 2 are situations in which you are less likely to gamble If you are concerned about your scores on any of these scales please talk to your therapist Inventory of Gambling Situations 2009 Centre for Addiction and Mental Health Page 2 4 2009 Centre for Addiction and Mental Health Inventory of Gambling Situations User s Guide 27 Q ProblemGambling ca Top Four Sharing solutions Changing lives 1 Pleasant Emotions Score 80 IGS Subscale Scores A high score indicates that you may gamble Question Your Answer excessively when you are feeling good You When I was happy 4 may gamble impulsively without worrying Aen NSIRESRRSK ar ESEKed 3 about consequences You may need to find Sy SE SPM ENN eee new ways to enjoy yourself when you are When everything was going well 4 feeling good as well as ways to avoid getting When I felt content with my life 3 carried away by the fun of gambling When I wanted to celebrate 3 2 Winning and Chasing Score 78 A high score indicates that you may gamble ti Your excessively when you are winning chasing Question Answer losses or Mee o
33. ntre for Addiction and Mental Health Page 1 4 2009 Centre for Addiction and Mental Health 26 Inventory of Gambling Situations User s Guide ProblemGambling ca 16S Subscale Scores Sharing solutions Changing lives Client Profile Index Index RankSubScale ee Extra Items Score 1 Pleasant Emotions 80 When I was drinking using drugs 4 2 Winning and Chasing 78 3 Confidence in Skill 67 When I was able to gamble without 3 Urges and anyone knowing 4 63 Temptations 5 Need for Excitement 61 The items above are not part of any sub scale but are 6 Conflict with Others 52 included individually because they may be useful in 7 Testing Personal 52 treatment and or their content may need special attention Control 8 Social Pressure 43 9 Worried about Debts 40 10 Negative Emotions 33 Guidelines The following is provided as a guide to interpreting your scores 0 to 25 you are rarely triggered by this situation 25 to 50 you sometimes are triggered by this situation 50 to 75 you are frequently triggered by this situation 75 to 100 you are very frequently triggered by this situation A high score on an IGS scale indicates the type of situation in which you have often gambled heavily in the past This information can be very valuable to a therapist and client in treatment planning When you are aware of what particular situations trigger you it will be easier to plan specific strategies that are targeted to the problem Please
34. on deciding for yourself whether you want to gamble If your close friends gamble frequently you may need to find other activities to share with them Talk to your friends about your gambling They may support your efforts to change You might also consider developing new friendships 2009 Centre for Addiction and Mental Health 34 Inventory of Gambling Situations User s Guide NEED FOR EXCITEMENT A high score indicates that you may gamble excessively when you are bored and in need of excitement You may particularly enjoy activities that are exciting or give you an adrenaline rush It may be helpful to look for other exciting leisure activities that are not harmful to you You may also need to make sure you have enough activities to keep you busy WORRIED ABOUT DEBTS A high score indicates that you may gamble excessively when you are in debt and need money You may try to get the money back by gambling again This will likely worsen the financial problem and trigger more gambling You may need to break the cycle by looking at alternative ways of managing your money and dealing with your debts WINNING AND CHASING A high score indicates that you may gamble excessively when you are winning chas ing losses or dreaming of winning It is likely that you become caught up and gam ble longer than you intend to People who score high on this subscale often believe that if they keep gambling they will recoup their losses You
35. ot to be used as a substitute for screening Racial ancestry Age Country and Province state are all optional fields Study Consent Consenting to the collection of the above information is not mandatory in order to access the 1Gs tool Individuals may proceed to the 1Gs without granting consent As part of our ongoing effort to ensure quality Dr Nigel Turner is collecting data that will be used to verify the validity of the 1cs Participation in this quality assurance research is voluntary and the 1Gs is available for use by anyone regardless of whether they consent to have their data used in the research Step 2 Questionnaire Clients are asked to read each item carefully and to select the response that most accurately describes how frequently they gambled heavily when they were in that sit uation during the past year The 1Gs automatically scores the responses and calculates the raw scores and a Problem Index Score for each subscale see Section 1 above The 10 Problem Index Scores are displayed in the form of a table and this constitutes the Client Profile These are grouped into four clusters Negative Emotions Temptation Situations Positive Affect Situations and Gambling Cycle Situations which are displayed in bar graphs Asterisks and red coloured bar graphs indicate a high score on an 1cs sub scale Problem Index Scores predominately greater than 60 The two items not included in any subscales
36. pes two common types are positive and negative POSITIVE PROFILES Generally where the profile is positive the client has reported more frequent gam bling in situations that are positive in nature By positive we do not mean that the gambling is healthy Rather a positive situation is one in which the anticipation of a 2009 Centre for Addiction and Mental Health Inventory of Gambling Situations User s Guide 15 positive mood e g being happy from gambling is a trigger for gambling heavily It is also related to the idea of positive reinforcement of the behaviour People who have been positively reinforced for gambling e g wins being the centre of attention will seek out this positive reinforcement For such a client peaks occur for the Positive Emotions and or Need for Excitement subscales Often the scores for Testing Personal Control and Social Pressure are also higher People who have a positive profile generally gamble for fun and excitement People who gamble without problems occasionally have positive profiles but their overall scores tend to be lower than those of people with gambling problems People who gamble for the action who tend to prefer the more interactive and skills based games are more likely to have positive profiles than negative profiles NEGATIVE PROFILES Negative profiles reflect more frequent gambling in situations involving negative emotions and or conflict with others and so ther
37. ponses can be entered into a computer and scored using the rcs software Responses can also be scored using spss software the spss syntax is provided in Appendix 3 p 37 Typically the therapist administers the 1Gs as a part of an initial assessment to deter mine how frequently and in what situations the client has gambled heavily during the previous 12 months see 1cs sample questionnaire in Section 3 p 18 Clients define heavy gambling in terms of their own patterns and perceptions of what constitutes heavy Clients answer each of 63 items using a four point scale where I never 2 rarely 3 frequently and 4 almost always WHEN NOT TO ADMINISTER THE IGS The rcs should not be given when a person is under the influence of alcohol or other drugs or is experiencing withdrawal Under these conditions the reliability and validity of the 1Gs would be suspect USING THE ONLINE FORMAT Terms of use Before using the 1Gs or any portion of it users must first read and accept the Terms of Use If you have any questions about the Terms of Use please contact webmaster problemgambling ca Step 1 Details The 1Gs is completely anonymous and absolutely no personal information including any client identifiers will be accessible by anyone at camu For research purposes one of the authors of this screening tool Dr Nigel Turner would like to collect a few demographic details from consenting 1Gs users A con
38. s subscale Problem Index Scores follow these steps 1 Add up the scores for the items in each subscale to obtain a raw score see Table 1 below for the items included in each subscale 2 Subtract from each total the number of items in the subscale e g 10 items for Negative Emotions or 5 for Confidence in Skill 3 Calculate the average score per item in the subscale by dividing the result of Step 2 by the number of items in the subscale 4 Convert the average score to a number between o and 100 by taking the result from Step 3 dividing it by 3 and then multiplying this result by 100 This will yield a Problem Index Score between o and 100 for each subscale Table 1 ics subscales including number of items and item numbers Note some items are included in more than one subscale SUBSCALE NUMBER ITEMS INCLUDED OF ITEMS IN SUBSCALE Negative Emotions 10 7 11 21 34 37 41 51 53 54 61 Conflict with Others 7 13 23 32 33 43 61 63 Urges and Temptations 9 12 14 17 22 31 35 42 53 62 Testing Personal Control 7 9 24 25 36 47 48 56 Pleasant Emotions 5 4 16 28 38 49 Social Pressure 6 18 20 30 44 49 58 Need for Excitement 6 5 44 45 50 52 55 Worried about Debts 5 8 26 29 39 60 Winning and Chasing 6 1 19 33 45 46 59 Confidence in Skill 5 3 15 27 40 57 2009 Centre for Addiction and Mental Health Inventory of Gambling Situations User s Guide Example The Confidence in Sk
39. sent form will be shown to the client on the computer screen This data will only be used for research if the individ ual consents to it by checking the statement I consent to the use of my information for statistical purposes The only mandatory field is Completed by As mentioned above if the person does not consent to the use of his or her information the data can be excluded If a person does not consent they can still use all features of the 1Gs website 2009 Centre for Addiction and Mental Health Inventory of Gambling Situations User s Guide 9 Clinician details There are two fields in this section Clinician organization optional Enter the name of the clinic hospital or organi zation referring the client to fill out the 1Gs Completed by mandatory Asks if the 1Gs is being filled out directly by the dient by the therapist or by someone else such as a concerned family member or friend Only data entered by a client will be used to validate the tes Client details Sex optional Problem status optional asks the client to indicate which one of the following categories best describes his or her gambling behaviour social gambler e moderate problem gambler e severe problem gambler e former problem gambler Note This question is intended to give the therapist and researchers an indication of the client s perception of his or her own gambling behaviour It is n
40. tes that you may gamble excessively when gambling is easily avail able or when events or circumstances make you think of gambling You may need to pinpoint the events or circumstances that trigger you Then you can develop strategies to cope with cravings and find new ways to reduce or respond to gambling triggers For example since access to money is a common trigger it is usu ally helpful to limit your access to cash or credit TESTING PERSONAL CONTROL A high score indicates that you may gamble excessively when you are trying to prove to yourself that you don t have a gambling problem are trying to limit your gambling or are spending time at gambling venues while trying not to gamble You may find it shameful or embarrassing to have a gambling problem Or you may believe that you should be strong enough to resist even if gambling is right in front of you You may need to look realistically at how effective your attempts to control your gam bling are PLEASANT EMOTIONS A high score indicates that you may gamble excessively when you are feeling good You may gamble impulsively without worrying about consequences You may need to find new ways to enjoy yourself when you are feeling good as well as ways to avoid getting carried away by the fun of gambling SOCIAL PRESSURE A high score indicates that you may gamble excessively when people around you want to gamble Gambling may be part of your social life You may need to work
41. tput the graph and then Save report to save the results to your computer The Client Profile can be viewed on a number of dimensions which are discussed below 2009 Centre for Addiction and Mental Health 14 Inventory of Gambling Situations User s Guide Four clusters of IGS subscale scores Client Profiles tend to cluster into one of four patterns see Table 2 below negative affect situations positive affect situations e temptation situations e gambling cycle situations Of course individual Client Profiles may also indicate other kinds of patterns Table 2 Four typical clusters of ics subscales CLUSTER SUBSCALES Negative affect situations Negative Emotions Conflict with Others Positive affect situations Pleasant Emotions Social Pressure Temptation situations Urges and Temptations Testing Personal Control Gambling cycle situations Need for Excitement Worried about Debts Winning and Chasing Confidence in Skill Differentiated Client Profiles A differentiated profile with clearly defined peaks and valleys across the 10 sub scales suggests that for the client there are specific high risk situations that are like ly to trigger heavy gambling Differentiated profiles may have either relatively high or relatively low elevation A differentiated profile provides a useful guide for both the therapist and client in developing an individualized treatment plan Although differentiated profiles can be of many ty
42. try to limit my gambling 25 When I felt I wasn t getting what I was entitled to 36 When I felt sure that I could spend time in a gambling situation without gambling 47 When I convinced myself that I was a new person and could make a few bets 48 When I wanted to feel in control for a little while 56 When I wanted to prove that I could make a few bets without going too far GAMBLING CYCLE SITUATIONS These scales are unique to the IGS In contrast to the other three clusters they are conceptual events in the cycle of gambling problems rather than an empirical cluster of situations Need for Excitement 05 When I wanted some action 44 When I was in a social situation and other people were gambling 45 When I saw signs that my luck was with me 50 When I began to think how exciting or relaxing a little gambling would be 52 When I was looking for excitement 55 When I had free time Worried about Debts 08 When I was about to get caught unless I came up with some money fast 26 When I was afraid of the people to whom I owed money 29 When I was in trouble with the law because of my gambling 39 When I was worried about my debts 60 When people were pressuring me to come up with money 2009 Centre for Addiction and Mental Health 24 Inventory of Gambling Situations User s Guide Winning and Chasing 01 When I almost won and felt that I would win very soon 19 When I was winning and
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