Gambling Self Assessment

Current Is there a problem?
Consequences
Self-Awareness
Reasons for Gambling
Financial Costs
Results
Complete

Is there a problem?

About 93 percent of people gamble in any given year. Most of these people do not have any problem with their gambling; it is merely a form of entertainment. However about 5 percent of people do develop a problem. These people have a level of gambling that is causing harm to themselves and those around them. These problems can range from mild to severe. Anyone can have a problem with gambling.

The South Oaks Gambling Screen is a 20-item scale, which will help you to decide whether or not you have a problem with your gambling.

Questions	No	Yes
1. When you participate in gambling activities, do you go back another day to win back money you lost? (most of the time or every time)	No	Yes
2. Have you ever claimed to be winning money from your gambling activities when in fact you lost?	No	Yes
3. Do you ever spend more time or money gambling than you intended?	No	Yes
4. Have people ever criticized your gambling?	No	Yes
5. Have you ever felt guilty about the way you gamble or about what happens when you gamble?	No	Yes
6. Have you ever felt that you would like to stop gambling, but didn’t think that you could?	No	Yes
7. Have you ever hidden betting slips, lottery tickets, gambling money or other signs of gambling from your spouse or partner, children or other important people in your life?	No	Yes
8. Have you ever argued with people you live with over how you handle money? (If “no,” go to question 9.) If “yes,” have these arguments ever centered on your gambling?	No	Yes
9. Have you ever missed time from work or school due to gambling?	No	Yes
10. Have you ever borrowed from someone and not paid them back as a result of your gambling?	No	Yes
11. Have you ever borrowed from household money to finance gambling?	No	Yes
12. Have you ever borrowed money from your spouse or partner to finance gambling?	No	Yes
13. Have you ever borrowed from other relatives or in-laws to finance gambling?	No	Yes
14. Have you received loans from banks, loan companies, or credit unions for gambling or to pay gambling debts?	No	Yes
15. Have you ever made cash withdrawals on credit cards such as Visa® or MasterCard® to get money to gamble or to pay gambling debts? (Not including ATM cards.)	No	Yes
16. Have you ever received loans from loan sharks to gamble or to pay gambling debts?	No	Yes
17. Have you ever cashed in stocks, bonds or other securities to finance gambling?	No	Yes
18. Have you sold personal or family property to gamble or pay gambling debts?	No	Yes
19. Have you ever borrowed money from your checking account by writing checks that bounced to get money for gambling or to pay gambling debts?	No	Yes
20. Do you feel that you have ever had a problem betting money or gambling?	No	Yes

To calculate your score: count one point for each “yes” response.

0 = no problem
1-4 = mild to moderate problem
5-20 = significant problem

My score is:

Adapted from South Oaks Gambling Screen, 1992, South Oaks Foundation.

Henry Lesieur and Sheila Blume.

Consequences

Negative consequences of gambling

People make changes in their lives because negative consequences happen or because they fear negative consequences might happen. Consider which consequences apply to you now or could apply to you in the future.

Consequences	This applies to me now	I worry this may apply to me in the future (if I continue gambling)
1. Job-related problems	This applies to me now	I worry this may apply to me in the future<br/>(if I continue gambling)
2. Family or marital conflicts	This applies to me now	I worry this may apply to me in the future<br/>(if I continue gambling)
3. Financial problems	This applies to me now	I worry this may apply to me in the future<br/>(if I continue gambling)
4. Legal problems	This applies to me now	I worry this may apply to me in the future<br/>(if I continue gambling)
5. Physical health	This applies to me now	I worry this may apply to me in the future<br/>(if I continue gambling)
6. Self-disgust	This applies to me now	I worry this may apply to me in the future<br/>(if I continue gambling)
7. Emotional health problem	This applies to me now	I worry this may apply to me in the future<br/>(if I continue gambling)
8. Low self-esteem	This applies to me now	I worry this may apply to me in the future<br/>(if I continue gambling)
9. Does not fit with my self-image	This applies to me now	I worry this may apply to me in the future<br/>(if I continue gambling)
10. Thoughts of suicide	This applies to me now	I worry this may apply to me in the future<br/>(if I continue gambling)
11. No time for other things	This applies to me now	I worry this may apply to me in the future<br/>(if I continue gambling)

Other consequences

Consequence	Applicability
Consequence	Applicability This applies to me now I worry this may apply in the future (if I continue gambling)

Self-Awareness

Understanding more about your gambling:
Increasing your self-awareness

People who gamble regularly often operate on "automatic pilot." They do not pay attention to the factors that are related to their desire to gamble. It is useful to pay attention to these factors to help you regain control over your gambling.

Think back to the last three times you gambled:

Where/Situation	Feelings before	Thoughts before and during	$ Amount
Where/Situation	Feelings before	Thoughts before and during	$ Amount

Reasons for Gambling

Identifying your reasons for gambling

This checklist will help you to identify your reasons for gambling. Check off which ones apply to you.

Reasons for gambling	Never	Sometimes	Every time
1. Feeling bored	Never	Sometimes	Every time
2. Feeling depressed	Never	Sometimes	Every time
3. Feeling lonely	Never	Sometimes	Every time
4. For pleasure or entertainment	Never	Sometimes	Every time
5. To escape from problems or forget troubles	Never	Sometimes	Every time
6. Out of habit	Never	Sometimes	Every time
7. For excitement	Never	Sometimes	Every time
8. Problems at home	Never	Sometimes	Every time
9. Problems at work	Never	Sometimes	Every time
10. Feeling broke (worrying about debt)	Never	Sometimes	Every time
11. To get money	Never	Sometimes	Every time
12. To be social with people	Never	Sometimes	Every time
13. To avoid people	Never	Sometimes	Every time
14. To celebrate	Never	Sometimes	Every time
15. To chase after losses	Never	Sometimes	Every time

Other reasons

Reasons for gambling	Frequency
Reasons for gambling	Frequency Never Sometimes Every time

Financial Costs

Tracking your gambling costs

Problem gamblers often focus on the “wins” which feel good and ignore the “losses” which feel bad. Let’s examine the actual cost of your gambling over the past 30 days:

Fill in the dates for the past month and circle the last 30 days.
Identify any holidays and special events over the past month.
Record what days you gambled and what kind of gambling you participated in.
Record the amount of cash you started out with, how much you finished with, and any details of the session you can recall.
Consider if this is a typical month. Add up what your gambling typically costs per month.

Date	Details
Date	Details

Total losses $

Total wins $

My gambling cost me $

Results

Thank you for completing the Problem Gambling Self-assessment (CHOICES).
Your responses for Question 2 indicate you may have a gambling problem.

If you would like to talk with a problem gambling professional, please choose an option below.

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