In this article, Becky, a colleague from West Midlands Gambling Harms Clinic, discusses the importance of hearing and understanding service user’s trauma in order to provide them with the most suitable path for their journey.

At the West Midlands Gambling Harms Clinic, one of the ways in which we offer treatment and support is through online Cognitive Behavioural Therapy (CBT) group work. I am the facilitator of these groups and as well as delivering the programme, I pay particular interest to the dynamic of the groups to ensure they are therapeutic and most importantly, safe. This can be a challenge with online groups, and I feel we are all still learning about this.

In one of my groups, there was a person who disclosed to me that she felt re-triggered when male service users in the group did not have their cameras on. This was making it hard for her to attend the group, and understandably, was causing distress. This person disclosed that the reliving of this distress was often a reason she would gamble. She mentioned the use of gambling to help regulate her emotional state, and sometimes to deflect and distract from the felt trauma and distress.

As part of my role, I constantly reflect, use supervision and pay attention to my own felt sense of what the needs of the groups and individuals might be. I had picked up on the discomfort and made space for a conversation. Once we discussed this and I heard more from her, we decided to change the treatment offer and moved to a one-to-one therapy approach to help stabilise, as well as have space to process some of what was happening around her relationship with gambling. This validation and the feeling of being seen is a crucial part of what we all offer, and can be a big factor in the healing process for anyone who has felt missed or rejected in their life.

For anyone reading this, I would offer the advice of the NHS Addiction Provider Alliance #StigmaKills campaign. It encourages us to see the person and hear their story. I think this support was successful because I took time to see the person, listen to how the world made sense to them, and where possible change what we could do to support them.  It is important to look out for reasons for gambling and whether this is to cope with something else, such as trauma, and not to fall into trying to solve a problem.