Problem Gambling Treatment with Hispanics

 Sergio Gutierrez, CADC I  Raul de la O, CGAC II, NCGC I  Janese Olalde, M.Ed, CADC II, CGAC II

IN OREGON:  Latinos comprise 10.5% of total population  Majority of Latino immigrants in Oregon are from Mexico

Respect “respeto” Family “familia”

Based on age, sex, social position, economic status and authority

Explain without condescending Take seriously responsibility as a helper Don’t misinterpret avoiding eye contact Address elders in traditional ways

Out of respect… Will avoid disagreeing or expressing doubts May be reluctant to ask questions or admit are confused

Cultural taboo about expressing negative feelings directly… May withhold information, May not follow treatment directions, OR may terminate medical care

How is respect effective when working with Latino problem gamblers in treatment?

Includes many people in extended family Support role is significant Family involvement important

Seen as willful, self-destructive conduct Threatens well-being of entire family Shame Banishment from family is enormous threat

More tolerant of mentally ill:  Sick role  Lowered expectations  People to be protected  Remain in home

Explore natural support system Investigate if some family members played role in addiction Look for pockets in family support to help with recovery

What methods do you use to involve family members of Latino problem gamblers?

 Personal relationships or “personalismo”  Spirituality or “espiritualismo”

Importance of personal relationships Expect providers to be warm, friendly, personal Take interest in personal life Rely on community-based organizations

Prefer being closer to each other If too far away, may be seen as uninterested Sit closer, lean forward, give pat on shoulder, other gestures to show interest

How do you employ “personalismo” with Latino problem gamblers and their family members ?

Combine respect for mainstream medicine, traditional healing with religious component If provider respects and understand this perspective, will be effective

“Embrujado” (Hexed) “Curanderos” (Healers) “Susto” (Fright)  Belief mental illness can be caused by witchcraft or evil spirits

How do you use “espiritualismo” when working with Latino problem gamblers and their family members?

Involve family members Show respect Get personal Respect traditional healing approaches Encourage asking of questions

Values: Family life Support for recovery Educate family on nature of addiction Spirituality – faith in God Collective cultural identify