Preparing Massachusetts treatment providers for gambling expansion: Initial observations from a statewide needs assessment and capacity building program

Kira Landauer, MPH

Cambridge Health Alliance – Community Health Educator
LANDAUER_KIRA poster

Scientific Abstract

Background: Massachusetts (MA) is undergoing a period of gambling expansion which might increase the prevalence of problem gambling (PG) and need for treatment. The behavioral health workforce must be prepared to manage PG. The MA Technical Assistance Center for Problem Gambling Treatment (M-TAC) provides MA Department of Public Health (DPH)-funded clinical and community-based substance use treatment programs with tailored technical assistance (TA) to build program capacity to address PG. M-TAC’s first year of activities included a statewide needs assessment and the development of individualized TA plans.

Methods: 26 programs, some with multiple sites, completed an online self-assessment of their capacity to address PG. Questions covered PG screening, assessment, and treatment; training; recruitment and retention; and marketing and promotion. A subset of programs completed a follow-up interview to further assess capacity in these areas. Overall findings were analyzed to understand breadth and depth of PG capacity across programs. Individual assessments were used to identify program priority needs and develop a tailored TA plan for each program.

Results: Almost half (46%) of programs screen most or all patients for PG and 62% provide PG treatment to most or all patients who need it. Over two-thirds (69%) of programs reported a high need for PG-related training. Forty-two percent indicated that their ability to recruit and retain staff is somewhat or not effective and many reported challenges retaining addiction-trained clinicians. Sixty-five percent of programs indicated a high ability to market their overall services.

TA Coordinators developed customized TA plans for 32 individual program sites. The most common priority needs across sites were: increase PG screening and assessment, increase capacity to treat PG, improve recruitment and retention rates, and increase marketing and promotion of PG services. Recommended TA strategies include training and individual site support.

Conclusions: Substance use treatment programs vary in their capacity to manage PG but share many overlapping priority needs that can be addressed through training and individual TA strategies.

 

SoundCloud Transcript

Preparing Massachusetts treatment providers for gambling expansion: Initial observations from a statewide needs assessment and capacity building program.

Massachusetts is undergoing a period of gambling expansion. Increased availability of gambling opportunities might increase the prevalence of problem gambling and need for problem gambling treatment. The behavioral health workforce must be prepared to manage problem gambling among their clientele.

The Massachusetts Department of Public Health Office of Problem Gambling Services has partnered with Health Resources in Action and the Division on Addiction at Cambridge Health Alliance to develop and implement the Massachusetts Technical Assistance Center for Problem Gambling Treatment, or M-TAC. M-TAC provides Department of Public Health-funded clinical and community-based substance use treatment programs with tailored training, technical assistance, and resources to build program capacity to address problem gambling and reduce persistent health disparities.

Programs are paired with technical assistance, or TA, Coordinators, who identify, plan, and implement appropriate services. M-TAC’s first year of activities included a statewide needs assessment and the development of individualized TA plans.

A two-part statewide needs assessment was conducted to identify treatment providers’ most pressing needs as they relate to integrating problem gambling treatment into their portfolio of services. Twenty-six programs, some with multiple sites, completed an online self-assessment of their capacity to address problem gambling. Questions covered problem gambling screening, assessment, and treatment, training and workforce development, recruitment and retention, and marketing and promotion. A subset of programs completed a follow-up interview to further assess capacity in these areas.

Overall findings were analyzed to understand the breadth and depth of problem gambling capacity needs across programs. Individual assessments were used to identify program priority needs and develop a tailored TA plan for each program.

Results from the needs assessment indicated that half of the programs surveyed screen most or all patients for problem gambling. Sixty-two percent of programs indicated that they provide problem gambling treatment to most or all patients who need it. Treatment challenges included limited provider knowledge of billing practices, patients not disclosing problem gambling due to stigma, problem gambling as a secondary issue after another behavioral health concern, and lack of demand for services due to limited awareness of the problem.

Over two-thirds of programs reported a high need for problem gambling-related training. Training challenges included limited provider and staff time to attend training, few training opportunities, and lack of provider compensation to attend training.

Forty-two percent of programs indicated that their ability to recruit and retain staff is somewhat or not effective and many reported challenges retaining addiction-trained clinicians. Many programs reported a need to hire staff that represent and speak the languages of the populations they serve.

Finally, sixty-five percent of programs indicated a high ability to market their overall services. Most programs used websites, community events, and social media to promote services.

M-TAC TA Coordinators then developed individualized TA plans using information gathered from the needs assessment. TA plans were customized to address specific program challenges while leveraging strengths in order to build capacity to deliver problem gambling treatment services. In total, 32 individual program sites are represented in a total of 25 TA plans.

Increasing problem gambling screening and assessment was one of the most common priority needs identified. TA strategies to address this included training on screening best practices, tools, and implementation strategies and supporting sites in selecting and implementing a screening tool.

Increasing problem gambling treatment capacity was another common priority need. Strategies to address this included training on treatment best practices, treatment and referral resources, and implementation strategies.

Improvement of recruitment and retention of clinicians was another priority need. Recommended TA strategies to address this include training on recruitment and retention best practices and implementation of these best practices.

Finally, increasing marketing and promotion was another common priority need. TA strategies to address this includes training on marketing and promotion best practices and supporting sites in developing marketing materials and a communications plan.

In conclusion, we found that substance use treatment programs vary in their capacity to manage problem gambling but share many overlapping priority needs that can be addressed through training and individual technical assistance strategies.

M-TAC is funded by the Massachusetts Department of Public Health Office of Problem Gambling Services.

Live Zoom Session – March 9th

research Areas

Authors

Kira Landauer, MPH

Principal Investigator

Heather Gray, PhD

Affiliated Website