# Case Examples
TIP
# Case One: Negative Brief Screen
Mrs. A is 67-year-old retiree, who is living with her husband and daughter.
Doctor: Hi Mrs. A, I see that you’re here for a routine check-up. We are now asking everyone about their gambling patterns to make sure we are providing the best possible care. Would you mind answering a few questions? It should only take one minute.
Mrs. A: Sure, that sounds fine to me.
Doctor: Okay. First, have you engaged in any gambling over the past year?
Mrs. A: I do go to the bingo hall once a year with my mother-in-law for Mother’s Day and maybe to the casino one to two times with friends. If there is a larger jackpot, I sometimes buy a lottery ticket but that’s only once a year.
Doctor: How many times in a year would you say you gamble?
Mrs. A: I would say five times on average, and I always plan how much I will spend before going to the casino or bingo hall and only ever buy one lottery ticket.
Doctor: [Administers Brief Gambling Screen]
Mrs. A: [Answers “no” to all screening questions]
Doctor: Thank you for taking the time to answer these questions. It seems that you have a low risk for developing problems with gambling. From our discussion, I see that you endorse many features of responsible gambling, such as setting limits on how much money you will spend prior to going to the casino or bingo hall.
TIP
# Case Two: Positive Brief Screen
Mr. B is 46 years old. He works in IT and lives with his long-term girlfriend. Mr. B enjoys watching sports and regularly bets on sporting events. He has recently started to dabble in live action betting. He visits the casino approximately four to five times per year with friends.
He enjoys gambling as a social activity, but he has gotten into debt every once in a while as he tends to spend more than he can afford. He frequently drinks alcohol while at the casino or watching sporting events.
Mr. B got a positive score on the brief screen and therefore completed the full screen.
After completing the full screen, it was determined that Mr. B was on the lower end of the moderate risk range for problem gambling.
The doctor provided this feedback and engaged in a brief discussion with Mr. B about the pros and cons of gambling.
Mr. B identified numerous benefits associated with gambling, but recognized a recent trend of increasing frequency and spending which was often linked to drinking. He endorsed a plan to monitor his spending and to put a monthly limit on gambling. He also committed to limiting his alcohol use while gambling, while offering to be the designated driver.
As Mr. B was not at a higher risk of developing problem gambling, the doctor decided that a referral to treatment was not needed and was comfortable with Mr. B’s plan to limit his risk.
TIP
# Case Three: High Risk Problem Gambler
Mr. C is 25 years old. He is currently not working, is going to school part-time and living with roommates.
He spends the majority of the day playing video games or online poker while smoking marijuana at home alone. He has been feeling very low these days, and has been withdrawing from his friends because he feels that he has not accomplished as much as they have.
While waiting for a counsellor at the community clinic, he completed a brief screen for gambling at the request of the nurse.
It was found that he scored positive on the brief screen and the nurse therefore proceeded with administering a full screen. He scored on the higher end of the moderate risk range for problem gambling.
The counsellor proposed that a brief conversation might be useful.
Mr. C was initially not interested in discussing gambling with the counsellor, but after noting the potential link between his low mood and gambling, he said would like to discuss and learn more.
After reviewing the costs and benefits of his gambling and of making a change, Mr. C concluded that there were few benefits associated with his gambling, although an overall decrease in his leisure activities appeared most related to his low mood and his marijuana use.
When assessing his readiness for change, Mr. C placed a high importance on making a change but his confidence in being able to make this change was quite low.
After going through his options with the counsellor, he endorsed a plan to limit his daily gambling by spending more time at the library studying for his courses without his laptop. He also asked for referrals to treatment to help with his concurrent difficulties.