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CAMP LESTER, Okinawa — Although people with gambling addictions have long been able to get help from base family counseling centers and chaplains, the only overseas medical program for “pathological” gamblers is at the U.S. Naval Hospital on Okinawa.

“The program has been in place without interruption since its inception in 2003 and is open to anyone eligible for care at a military health care facility,” said hospital spokesman Brian Davis. “Okinawa’s program is the first to be established at an overseas location and continues to be the referral center for gambling addiction treatment in the Western Pacific.”

Davis said 107 patients have completed the program since 2003.

A report on a study of the program’s first year said 35 people entered the program. Twenty-five were active-duty servicemembers; 26 were men. Seven were military spouses and three were Department of Defense civilians.

According to the study report, published in the August 2005 issue of Military Medicine, all 35 met the criteria for having pathological gambling disorders. The American Psychiatric Association defines pathological gambling as an impulse control disorder that is a chronic and progressive mental illness.

Seven patients said they had suicidal thoughts and three reported they had attempted suicide because of gambling problems before they entered the program.

The individual average gambling debt of the 35 patients was $11,407 for money borrowed to cover losses, according to the report. Their average individual gambling losses were $24,154.

Most patients said slot machines in base clubs were their primary form of gambling. Of the active-duty patients, 21 remained in the military. Four, however, were booted out of the military after being disciplined on charges related to gambling, such as writing bad checks.

All 35 sought help on their own, with four taking the step when they faced legal proceedings against them, according to the report.

Begun as part of the overall Substance Abuse Rehabilitation Program, treatment was easily implemented within the hospital’s existing substance abuse program and did not require additional personnel, the report said.

“One of the largest hurdles,” however, was training counselors to treat gambling addiction.

“Existing rehabilitation staff were well versed in the treatment of substance disorders but were not educated regarding gambling, which … presents unique treatment challenges,” the report said.

Trimeridian Inc., an Indianapolis consulting firm, provided training to certify counselors at the hospital and some 40 other substance abuse professionals from service Morale, Welfare and Recreation programs on Okinawa, and in Japan and South Korea.

The hospital’s program is an outpatient service that operates with other agencies providing marital and family therapy and financial and mental health counseling. What it adds, according to the study, are psychological evaluations, group and individual counseling, patient and family education, group meetings, financial planning and access to a 24-hour crisis counselor.

Patients came from bases on Okinawa, mainland Japan and South Korea.

“Like any other patient from outside Okinawa coming to us for outpatient care, we find them billeting,” Davis said.

Navy Cmdr. Gary B. Hoyt, head of the hospital’s mental health department, said the outpatient setting involves treatment during the day with the patients released to their barracks, workplace or home around 3 p.m.

The patients are both self-referred and command sponsored, he said.

“Patients from outside Okinawa would be referred in the same manner as they would with any other medical condition that would require treatment in Okinawa,” he wrote in response to a Stripes query.

Treatment would range from one to three weeks. The normal course of treatment consists of motivational interviewing and cognitive behavioral techniques through the following settings — group therapy, psycho-educational classes, individualized sessions, homework, financial planning and pressure relief groups.”

Hoyt said individual treatment plans are tailored to meet patients’ needs as identified on a “master problem” list.

“Clients are also required to attend AA meetings, as we currently don’t have GA (Gambler’s Anonymous) meetings on island,” Hoyt said. “Exposure to a 12-step program has been effective in the past for gambling patients. We also have access to financial, mental health, and other referral sources if necessary.”

The 2005 study concluded the program was effective in preventing suicides and helped servicemembers with gambling problems remain in the military.

Hoyt said he did not know the motivation for beginning the gambling program.

“We don’t have any documentation that states a specific reason for initiating the program, but my guess is due to counselor initiative and interest,” he said. “I don’t have any knowledge of a gambling crisis that precluded or required it; it was most likely an effort to expand the scope of services that we provide.”

The hospital’s gambling addiction treatment program operates out of the Counseling Center, Building 440, on Camp Foster. To set up an appointment for a screening interview with a counselor, call 645-3009.

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