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What is Stigma? Stigma is a social phenomenon where certain characteristics, qualities or features of an identifiable group are regarded in a strongly negative light. As a consequence, stigmatisation can operate in a discriminatory way, create increased isolation, punish individuals further and lead to increased levels of harm. This article discusses some of the consequences of the stigma that people with gambling harm may experience before explaining how language can be used to remove stigmatisation. How does stigma affect people with gambling harm? It is reported that stigma hinders or prevents treatment for individuals suffering from substance abuse and problem gambling (Yang, Wong, Grivel and Hasin, 2017). Stigma can lead to policymakers underfunding necessary treatment programmes. Equally, stigma can dissuade individuals from speaking openly. If people who have a gambling disorder experience less stigma, they may feel more able to ask for help and take steps towards recovery. Studies have shown that people who suffer from gambling harm experience anxiety over how their disorder might be perceived and the potential negative consequences accompanying this. Because of this anxiety, other less healthy coping mechanisms are adopted, such as hiding and cognitive distancing (Dąbrowska and Wieczorek, 2020). The Victorian Responsible Gambling Foundation make a distinction between self-stigma and public stigma. The former refers to stigma from the point of view of people with a gambling disorder and how they perceive themselves. The latter describes the point of view of others, perceiving individuals with a gambling disorder. Stigmatising beliefs can lead to people who gamble compulsively experiencing greater difficulties and further harm, such as increased self-blame and intensified feelings of guilt. Moreover, individuals with problem gambling experience high levels of fear regarding how others perceive them, despite experiences of direct discriminatory behaviours being relatively low (Hing, Nuske, Gainsbury and Russell, 2015). Why is some language stigmatising? It is important to think about why certain language is stigmatising. The choice of certain language and phrases over others can have far-reaching implications for the way in which topics, such as gambling harm, are discussed. Whether or not something is stigmatising often comes down to how the topic is framed. Subtle differences in the words we use, often chosen unconsciously, can create vastly different impressions. The language we use is important because of the non-explicit messages which are conveyed. Depending on how we phrase our words, we have the ability to avoid accidentally implying unnecessarily punitive attitudes and individual blame. For example, when speaking about people who gamble, phrases such as “a compulsive gambler” or “a gambling addict” place gambling as the central aspect of the identity of an individual. Placing gambling as the central aspect of the identity of an individual can be stigmatising because it defines the individual in terms of gambling which could be considered as placing ultimate responsibility, or even blame, on the individual, and add to the pre-existing harm they experience. Alternatively, individuals who gamble compulsively may prefer to be described as exactly that: “a person who gambles compulsively”. This language is non-stigmatising and centres the focus on the person, acknowledging them as an individual first and foremost, while also speaking about gambling in a clear and neutral way. It conveys the meaning that a person “has” a problem rather than that a person “is” a problem (Kelly, Saitz and Wakeman, 2016). When these ideas about stigmatisation are applied to all language used to discuss gambling harm, a far healthier environment is created. What are the stigmatising terms for gambling harm and drug use and what are the terms that they should be using? The table below has been prepared to provide examples of non-stigmatising language alongside equivalent stigmatising language, based on a table provided for similar terms relating to drug addiction. On the right-hand side of the table are two columns. The first is a list of terms that can be used to describe Problem Gambling in a way which frames the conversation by putting individuals first. The second column is a list of terms that are often used yet stigmatise those who gamble compulsively. For reference, the two left-hand columns provide the original table of terms concerning drug usage. References Dąbrowska, K. and Wieczorek, Ł. (2020) ‘Perceived social stigmatisation of gambling disorders and coping with stigma’, Nordic Studies on Alcohol and Drugs, 37(3), pp. 279–297. Hing, N., Nuske, E., Gainsbury, S. and Russell, A., 2015. Perceived stigma and self-stigma of problem gambling: perspectives of people with gambling problems. International Gambling Studies, 16(1), pp.31-48. Kelly, J., Saitz, R. and Wakeman, S., 2016. Language, Substance Use Disorders, and Policy: The Need to Reach Consensus on an “Addiction-ary”. Alcoholism Treatment Quarterly, 34(1), pp.116-123. Yang, L., Wong, L., Grivel, M. and Hasin, D., 2017. Stigma and substance use disorders. Current Opinion in Psychiatry, 30(5), pp.378-388.

Create a blog post subtitle that summarizes your post in a few short, punchy sentences and entices your audience to continue reading. Welcome to your blog post. Use this space to connect with your readers and potential customers in a way that’s current and interesting. Think of it as an ongoing conversation where you can share updates about business, trends, news, and more. Design with Ease “Do you have a design in mind for your blog? Whether you prefer a trendy postcard look or you’re going for a more editorial style blog - there’s a stunning layout for everyone.” Every layout comes with the latest social features built in. Readers will be able to easily share posts on social networks like Facebook and Twitter, view how many people have liked a post, made comments and more. With Wix, building your online community has never been easier. Create Relevant Content You’ll be posting loads of engaging content, so be sure to keep your blog organized with Categories that also allow readers to explore more of what interests them. Each category of your blog has its own page that’s fully customizable. Add a catchy title, a brief description and a beautiful image to the category page header to truly make it your own. You can also add tags (#vacation #dream #summer) throughout your posts to reach more people, and help readers search for relevant content. Using hashtags can expand your post reach and help people find the content that matters to them. Go ahead, #hashtag away. Stun Your Readers “Be original, show off your style, and tell your story.” Blogging gives your site a voice, so let your business’ personality shine through. Are you a creative agency? Go wild with original blog posts about recent projects, cool inspirational ideas, or what your company culture is like. Add images, and videos to really spice it up, and pepper it with slang to keep readers interested. Are you a programmer? Stay on the more technical side by offering weekly tips, tricks, and hacks that show off your knowledge of the industry. No matter what type of business you have, one thing is for sure - blogging gives your business the opportunity to be heard in a way in a different and unconventional way. Get Inspired To keep up with all things Wix, including website building tips and interesting articles, head over to the Wix Blog. You may even find yourself inspired to start crafting your own blog, adding unique content, and stunning images and videos. Start creating your own blog now. Good luck!

Create a blog post subtitle that summarizes your post in a few short, punchy sentences and entices your audience to continue reading. Welcome to your blog post. Use this space to connect with your readers and potential customers in a way that’s current and interesting. Think of it as an ongoing conversation where you can share updates about business, trends, news, and more. Design with Ease “Do you have a design in mind for your blog? Whether you prefer a trendy postcard look or you’re going for a more editorial style blog - there’s a stunning layout for everyone.” Every layout comes with the latest social features built in. Readers will be able to easily share posts on social networks like Facebook and Twitter, view how many people have liked a post, made comments and more. With Wix, building your online community has never been easier. Create Relevant Content You’ll be posting loads of engaging content, so be sure to keep your blog organized with Categories that also allow readers to explore more of what interests them. Each category of your blog has its own page that’s fully customizable. Add a catchy title, a brief description and a beautiful image to the category page header to truly make it your own. You can also add tags (#vacation #dream #summer) throughout your posts to reach more people, and help readers search for relevant content. Using hashtags can expand your post reach and help people find the content that matters to them. Go ahead, #hashtag away. Stun Your Readers “Be original, show off your style, and tell your story.” Blogging gives your site a voice, so let your business’ personality shine through. Are you a creative agency? Go wild with original blog posts about recent projects, cool inspirational ideas, or what your company culture is like. Add images, and videos to really spice it up, and pepper it with slang to keep readers interested. Are you a programmer? Stay on the more technical side by offering weekly tips, tricks, and hacks that show off your knowledge of the industry. No matter what type of business you have, one thing is for sure - blogging gives your business the opportunity to be heard in a way in a different and unconventional way. Get Inspired To keep up with all things Wix, including website building tips and interesting articles, head over to the Wix Blog. You may even find yourself inspired to start crafting your own blog, adding unique content, and stunning images and videos. Start creating your own blog now. Good luck!

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We have been building a fruitful relationship with Healthwatch Essex for a while now, so it was great being asked to take part in an episode of their Hidden Voices podcast which was dedicated to gambling harm. It was wonderful to be joined by my friend and fellow in recovery Lisa for the episode. The episode "New Beginnings" - Living with Gambling Addiction can be listened to here https://open.spotify.com/episode/3Sj5hbu5zsnRGMDpea6696?si=61671945c2584a26

Join us for our event about gambling-harm on 16/9/21 at 6pm on Zoom with Professor Henrietta Bowden-Jones OBE and Kishan Patel.

I was asked to contribute to an article in The Big Issue North written by Mark Lomas about gambling's relationship with football. The article Pitch imperfect - Big Issue North was written following another Big Step. This time we walked 300 miles from Scotland to England asking for broadcasters to remove gambling advertising during Euro 2020 (which took place in 2021). Twitter - @marklomasSport

On Saturday 17th July the gambling harms / recovery community, family and friends, all came together at the home of Billericay Town Football club, to watch a charity football match between the All Bets Are Off podcast and charity YouTube football team, Peoples FC. The teams were comprised of individuals harmed by gambling and players from the Peoples FC to create two evenly-matched and well-balanced squads. The All Bets Are Off team was managed by co-host of the pod Chris' father John Gilham, whilst Peoples FC were led by Steve Watts, the founder of GamFam. Our friends at Gamban sponsored the match in the name of the TalkBanStop campaign which they are a part of, alongside GamCare and GAMSTOP. EPIC Risk Management were our matchball sponsors and kindly provided nine brand new Premier League footballs for the warm-up and match itself. A number of our allies from within the gambling harms education, prevention and treatment world supported us by purchasing advertising space in the matchday programme. They include RecoverMe, Gambling Guardian, Reframe Coaching, Betknowmore, Deal Me Out and EPIC Restart Foundation. This helped to cover the cost of printing and so every programme sold could go towards the three causes that we were raising money for (you can download a PDF version of the matchday programme below). The event was incredibly well received by everyone who participated and the sepctators, many of whom work within gambling harm prevention and/or whom campaign for positive legislative change. We were also joined by representatives from NHS mental wellbeing service VitaMinds, who gave a talk on the subject of mental health. Prior to kick-off the players and spectators held an extremely emotional one minute applause for all those that had lost their lives to gambling-related harms and mental health problems. It was an incredibly hot day but that didn't impact the quality of football on display. The All Bets Are Off team triumped 4-3 in a pulsating, yet very close, game of football. Collectively we were able to raise £2370.06, which was split between the following three chosen causes: NHS Northern Gambling Service, Gamvisory's Hardship Fund and Rosie's Legs. Each receiving £790.02. At the full-time whistle many people commented on how much that they had enjoyed the day and were already asking us whether this would be an annual event. Given its success we can confirm that we will be making this a permanent fixture. We would like to thank everyone that came and supported us and all those that contributed, Billericay Town Football Club for being magnificent hosts as always, and the fantastic volunteers who ran the gate and car park for us. The full 90-minute match can be found on YouTube by clicking here.

The National Education Group are a multi-award winning provider of remote, expert-led CPD, with a mission to empower schools in the UK and overseas to drive up standards. Recently we were approached by The National Education Group to support in providing information and copy for a guide on sports betting and the risks that parents and carers need to know, to protect children (see below). The guide was shared on National Online Safety which has over 300,000 users in over 40 countries and shared on their social media platforms which has over 43,000 followers. We look forward to working with The National Education Group on future initiatives.

What is Stigma? Stigma is a social phenomenon where certain characteristics, qualities or features of an identifiable group are regarded in a strongly negative light. Stigma against marginalised groups can lead to stereotypes, prejudice, and even discrimination. It occurs on a personal and institutional scale – stigma may make it harder for a single person affected by harm to speak out, or it may cause policymakers to underfund necessary prevention and treatment programmes. Types of stigma: Self-stigma: an individual’s self-discrimination from self-blame concerning their gambling and an accompanying sense of shame Public stigma: widespread negative perceptions of people affected by gambling harm propagated by society Structural stigma: political and policy approaches which discriminate against those affected by gambling harms How does stigma affect people with gambling harm? It is reported that stigma hinders or prevents treatment for individuals suffering from substance abuse and disordered gambling (Yang, Wong, Grivel and Hasin, 2017). Stigma can lead to policymakers underfunding necessary treatment programmes. Equally, stigma can dissuade individuals from speaking openly. If people who have a gambling disorder experience less stigma, they may feel more able to ask for help and take steps towards recovery. Studies have shown that people who suffer from gambling harm experience anxiety over how their disorder might be perceived and the potential negative consequences accompanying this. Because of this anxiety, other less healthy coping mechanisms are adopted, such as hiding and cognitive distancing (Dąbrowska and Wieczorek, 2020). The Victorian Responsible Gambling Foundation make a distinction between self-stigma and public stigma. The former refers to stigma from the point of view of people with a gambling disorder and how they perceive themselves. The latter describes the point of view of others, perceiving individuals with a gambling disorder. Stigmatising beliefs can lead to people who gamble compulsively experiencing greater difficulties and further harm, such as increased self-blame and intensified feelings of guilt. Moreover, individuals with problem gambling experience high levels of fear regarding how others perceive them, despite experiences of direct discriminatory behaviours being relatively low (Hing, Nuske, Gainsbury and Russell, 2015). Examples of stigmatising misconceptions surrounding those with gambling disorders: Fixed nature of disorders: people affected by disordered gambling are framed as though they have no capacity or desire to change, which misrepresents gambling addiction Personal responsibility: people affected by disordered gambling are framed as though they are making deliberate choices to gamble Othering and dehumanisation: people affected by disordered gambling are described through addiction-first language that dehumanises them. People tend to keep a distance from them – thinking, “This could never happen to someone like me”. Why is some language stigmatising? It is important to think about why certain language is stigmatising. The choice of certain language and phrases over others can have far-reaching implications for the way in which topics, such as gambling harm, are discussed. Whether or not something is stigmatising often comes down to how the topic is framed. Subtle differences in the words we use, often chosen unconsciously, can create vastly different impressions. The language we use is important because of the non-explicit messages which are conveyed. Depending on how we phrase our words, we have the ability to avoid accidentally implying unnecessarily punitive attitudes and individual blame. The most appropriate terminology is person-first and emphasises that this person has a problem – for example, “person with a gambling disorder” or “person who gambles compulsively” instead of “gambling addict” or “problem gambler”. In addition, language should be clinically accurate – “in recovery” rather than “clean”. This language is non-stigmatising and centres the focus on the person, acknowledging them as an individual first and foremost, while also speaking about gambling in a clear and neutral way. It conveys the meaning that a person “has” a problem rather than that a person “is” a problem (Kelly, Saitz and Wakeman, 2016). When these ideas about stigmatisation are applied to all language used to discuss gambling harm, a far healthier environment is created. Unfortunately, language like “problem gambler” is still common in research, policy and media despite these terms being found to negatively impact the sense of hope and self-efficacy of patients. What are the stigmatising terms for gambling harm and drug use and what are the terms that they should be using? The table below has been prepared to provide examples of non-stigmatising language alongside equivalent stigmatising language, based on a table provided for similar terms relating to drug addiction. On the right-hand side of the table are two columns. The first is a list of terms that can be used to describe Problem Gambling in a way which frames the conversation by putting individuals first. The second column is a list of terms that are often used yet stigmatise those who gamble compulsively. For reference, the two left-hand columns provide the original table of terms concerning drug usage. Theories for understanding stigma Just World Theory: Refers to the cognitive fallacy that people tend to believe that the world is orderly and fair, and that people’s actions will bring morally just consequences. Good will be rewarded, and “evil” will be punished. Some people, for example, may wrongly think people who are in debt “deserve” it, for being affected by compulsive gambling, or some other perceived misdeed. Attribution error: the assumption a person’s actions are dependent on what “kind” of person they are – people who do “bad” things must be “bad” people. This attribution can be applied retroactively. Labelling theory: The understanding that when somebody has been given a label that differentiates them as “other”, they will be treated differently and worse than “normal people.” Intersectional stigma: is a way of understanding how multiple stigmatised identities affect a person or group. These may be various addictions, health issues or demographic factors (from an ethnic minority, lower-income community, or marginalised sexuality/gender background). Intersectionality exacerbates the effect of certain types of stigma. What has been done to combat stigma? The traditional approach to combatting addiction stigma has been the disease model of addiction. This approach has been traditionally applied to problematic drug and alcohol usage and more recently to gambling harm, with compulsive gambling introduced as a disorder in the DSM. Although the disease model might reduce some aspects of social stigma, it has issues as it fails to consider some of the social factors contributing to gambling harm. Anonymity is a strategy used in treatment, such as Gamblers Anonymous. Anonymous support allows people to talk openly without fear of the stigma of gambling affecting them so deeply and helps people access support, but it is also limited, and may contribute to self-stigma in some people as they perceive themselves as less honest. Emerging ways of combatting stigma As mentioned, one of the ways in which we as individuals and organisations can combat stigma is through utilising person-first language. This can help reduce marginalisation through depersonalisation. Destigmatisation can also come through storytelling and narrative psychology, involving changing the ways in which people suffering from gambling harm are spoken about, as well as contact theory, which posits that intermingling of people affected by gambling harm and those who are not affected will decrease stigmatisation. Contact theory is sometimes considered at odds with anonymity, although there is ample room for both in a plan to reduce stigma. Similar to the disease model is defining compulsive gambling and addictions in general as health problems. The two are not synonymous, however. In addition to increasing understanding of mechanisms of addiction, gambling addictions should also be understood as public health issues. Therefore, the societal conditions which contribute to gambling harm, such as targeted advertising, the minority stress model, and socioeconomic inequality, must be meaningfully addressed. In addition, harm that comes to “moderate” and “low-risk” gamblers must be taken seriously. Empowerment through co-production and creation of services by those who have lived experience of gambling harms is something that can empower people to channel these lived experiences to positive personal and social change. Social change can also be directly campaigned for through formal objection to negative portrayals of those with gambling harm or structural stigma limiting the support given to those with gambling disorders. A method of gaining support from political and social figures is rational compassion – fighting discrimination by appealing to the rational benefits of the desired approach, such as via health economics, as gambling harms cost the economy more than prevention and improved treatment would. Suggestions for tactics that could help to reduce stigma Research and report production to detail the causes and effect of gambling harms Educational outreach programmes for youth Storytelling through various forms of media to increase empathetic understanding and compassion Increasing opportunities for contact between those with gambling disorders and those without which will combat otherisation Direct campaigning against discriminatory policies or media which frames those with gambling addictions in a stigmatising way Social media campaigns dispelling stigma References Dąbrowska, K. and Wieczorek, Ł. (2020) ‘Perceived social stigmatisation of gambling disorders and coping with stigma’, Nordic Studies on Alcohol and Drugs, 37(3), pp. 279–297. Hing, N., Nuske, E., Gainsbury, S. and Russell, A., 2015. Perceived stigma and self-stigma of problem gambling: perspectives of people with gambling problems. International Gambling Studies, 16(1), pp.31-48. Kelly, J., Saitz, R. and Wakeman, S., 2016. Language, Substance Use Disorders, and Policy: The Need to Reach Consensus on an “Addiction-ary”. Alcoholism Treatment Quarterly, 34(1), pp.116-123. Yang, L., Wong, L., Grivel, M. and Hasin, D., 2017. Stigma and substance use disorders. Current Opinion in Psychiatry, 30(5), pp.378-388.

I was privileged to take part in BBC Radio 4's Money Box. The show included discussion with Matt Gaskell, Clinical Lead at The NHS Northern Gambling Service, Anna Hemmings, CEO of Gamcare, Jack Symons, Gamban and myself and Stacey Goodwin who brought the lived experience perspective to the show. Topics discussed included industry practice, enticements, advertising, support services and recovery. The programme was presented by Charmaine Cozier.