Gambling Prevalence in the LatinX Community | Cicero Family Service

Dr. Mauricio Cifuentes, Clinical Director at Cicero Family Service, discusses the importance of intentionally based programs that incorporate cultural humility to reach the LatinX community.  Highlights include:

How religion and beliefs plays a critical role
Intentionally designed outreach programs are key to effectively communicating the potential harm of gambling; and
How Cicero Family Service leads by creating holistic programs that create awareness, educate and serve their community.

Family Service Mental Health Center of Cicero (aka, Cicero Family Service) – https://www.cicerofs.org/

Gateway Foundation Gambling Treatment

Call Gateway Foundation: 855-723-0963

Gambling Problem? Call 1-800-GAMBLER

wagerdanger@gatewayfoundation.org

Transcript:

Host: Shane Cook

Welcome to Wager Danger. Today we’re discussing the unique effects that gambling can have within our Latinx communities. I’m your host, Shane Cook, gambling disorder program director at Gateway Foundation. Gateway is a national nonprofit that provides substance use and gambling disorder treatment through its 16 centers located throughout the state of Illinois. My guest today is Dr. Mauricio Cifuentes, clinical director at Cicero Family Services. Cicero is a predominantly Latinx community located in the southwest suburbs of Chicago. During our conversation, we covered a broad range of topics, including the critical role culture and religion plays in the Latinx community, the importance of creating intentionally designed programs to reach this audience, and how Cicero Family Services takes a holistic approach to serving their community. Welcome to the show, mauricio. 

Guest: Dr. Mauricio Cifuentes

Thank you so much, Shane, for inviting me. It is a pleasure to be here with you and your audience. 

Host: Shane Cook

Yeah, we’re happy to have you here. This is a topic that you and I have discussed previously, and it’s an important topic, one where we focus on the Latinx community in general, and there’s some specific things that we should be keeping in mind as practitioners, as service providers, when we think about this important community. So I just want to start off a little bit and have you tell us about Cicero Family Services. 

Guest: Dr. Mauricio Cifuentes

Absolutely. And I want to self disclose something important for your audience because I don’t have the voice. You have to be on the radio. And I also have an accent, so for everyone to know, I’m Colombian, and that’s where my charming accent is coming from. So that’s the disclosure I want to make now. Yes. Caesar Family Service is a very old agency, actually. We have been around for more than 100 years, and we provide basically mental health services understood in a broad way for different communities, mostly people in Cicero and surrounding areas and a large number of Latinx individuals. But we serve everyone, and we really have as our main purpose to reach out to those who feel more disenfranchised or more on the margins for whatever reason. And that is our purpose. 

Host: Shane Cook

Okay. And as far as the services that you provide at Cicero Family Services, what all does that include? 

Guest: Dr. Mauricio Cifuentes

Let’s say that we have like three main pillars. On one hand, we offer prevention through education. So we have a lot of presentations. Not only have we already prepared presentations on different topics related to mental health, but we also tailor when, for example, a church or a school has specific needs, they reach out to us and they say, you know what? We would like someone to come to present to our staff or to our patients, either in English, or Spanish on this. And we have the ability to tailor the presentation to them because we believe that prevention through education is key for so many people just to feel better. 

The second pillar we have is what we call case management, and we provide case management understood not only as connecting people with services but we understand that if we have our basic needs, for example, being unsatisfied that creates stress. If I don’t know where I’m going to sleep tonight that by itself is or can be a traumatic event for me. So for us connecting people with services and helping them to reach those services to be understood by those other providers and so on is a critical component of mental health. So people can come to us for that kind of service. That is the second pillar. And the third pillar is the direct provision of services. And we do that or we use that term for two things. 

On one hand are community projects and we will talk more about gambling for example, which are direct services but the patient is the community at large. We did a lot of that when we had COVID doing campaigns of education and psychological interventions and so on. That is the community side and we also have the more traditional side of individual couples and group therapy and family therapy. So those are the kind of services we provide at sister or family services. 

Host: Shane Cook

Right. So in terms of and we’re going to get there to the gambling component of this. But in terms of the way you’re structured as an organization you focus it sounds like to me a tremendous amount on pure outreach and engagement within the community as well as okay. And that’s really out of the three pillars. I heard that in two of those pillars. One where it’s a more direct approach working with other organizations but also a holistic approach across the community to raise the awareness about mental health issues. And then the third pillar being where you’re providing the direct services to address specific mental health issues, whether that be substance abuse, whether it be general mental health issues in general. And now transitioning into providing services for gambling as we transition into 2023, if I understand. Okay, very good. 

So tell me a little bit more about the desire to pursue problem gambling as one of the areas for not only creating awareness and doing community outreach but eventually getting to a point where you’re providing services for gambling. 

Guest: Dr. Mauricio Cifuentes

This is one of those areas in which we arrived there as a result of our understanding of ourselves as being a social service community based agency. Because when you consider yourself a community based agency you need to be curious about the realities of the community you want to serve. So having an open mind and learning all the time about what’s going on is a key element in order to be responsive to the people you want to serve. So we started noticing in Cicero a huge number of machines offering online gambling opportunities and were kind of shocked seeing that explosion of something new in our town. So I saw a training on gambling and I thought it was interesting. So I put together what my observation based on the community was and this opportunity. 

So I went out of curiosity, wanting to learn more about something I have noticed in the community. The training was absolutely fantastic. It was a training provided by the Illinois Council on Problem Gambling. And the woman who was doing the training was one of the most engaging speakers I have had. And she was presenting a lot of material totally new for me. And then I realized that I had lived within this huge bubble in which gambling didn’t exist. I was so ignorant. There was this gap about a critical issue affecting lives, millions of lives. And I was naive and ignorant. And that training made me think or wonder how many people that we serve would be affected, impacted by this. And then I reached out to the man who’s the executive director of the Illinois Council on Problem Gambling. 

And he was so responsive and immediately connected me with more services, more people, et cetera. And that coincided with the time when the state released the first study ever on the impact of gambling in the state of Illinois. And the findings in that were even more shocking to me. So that’s what got me and the agency into this path of providing services related to gambling. 

Host: Shane Cook

Mauricio, thanks for sharing. That makes a lot of sense. I think a lot of providers have gotten into problem gambling as a service, a very similar path that Cicero Family Services is going through. Regarding Bill Johnson, I agree 100%. We’ve worked very closely with Bill. We’ve had him on the podcast in the past, a fantastic resource for education, for connecting dots and putting people together. He introduced the two of us, which I’m grateful for. But the other thing that you mentioned is the prevalent study that was recently funded and conducted by the Illinois Department of Human Services. And what it uncovered specifically about the Latinx community I think was very shocking to a lot of us and really opened our eyes to a segment of our community that is potentially being underserved at the moment. 

So if you could lead our listeners through a little bit of the background there, a little bit of the results that came out of that study and in particular for the Latinx. 

Guest: Dr. Mauricio Cifuentes

Community, I would say that reading that document was for me the equivalent of shock therapy. I was totally ignorant about the impact gambling has on the Latinx communities here in Illinois. One of the main things for me that the study highlights is that even though and it is paradoxical, even though Latinx individuals tend not to gamble much once they become frequent gamblers, meaning once they start playing once a month or more, their risk for becoming or having problem gambling issues becomes more than double what happens to other communities like the African American community and the Caucasian community. That was for me, absolutely shocking. 

And then as I was reading the document, the report, I realized that even though the state was able to make that statement and gather that conclusion about the high impact, they were unable to find enough Latinx people with problem gambling issues for conducting a focus group with them. And that was like, what’s going on here? It’s like if you have a field with 1000 apples and you are unable to find one apple as the sample, it’s like there is something wrong here. And then I thought about my own professional experience. I have been in the field for more than 20 years providing mental health services mostly to the Latinx communities. Not even once in my entire life have I had a patient who came to me reporting their presenting problem gambling issues. 

Not even once I have heard from a colleague of mine telling me that a patient, a Latinx patient, has presented problem gambling as an issue. Furthermore, not even once in my life have I had a patient who after some time in therapy, when we have already developed a strong relationship, the person has disclosed gambling issues. And that is so extremely shocking because what happens, for example, with other taboo topics, like women struggling with alcoholism, what happens is that sometimes a woman, after being in therapy for a while for other reasons, then discloses that she’s struggling with alcohol and then we learn. But that has never been the case with gambling. 

And even more shocking to confirm how ignorant in the field we are, I don’t know of any agency serving the Latinx community, the mental health needs of the Latinx communities who have incorporated in their assessment intake process questions about gambling. We ask about substances, we ask about sex, we ask about money, and we do not ask ever about gambling risks. So this was extremely shocking to me. 

Host: Shane Cook

Yeah, and it is a shock, and I can understand how you’re shocked, especially being a part of that community and so embedded in that community that not once have you come across anybody that’s presented with problem gambling as an issue. 

Guest: Dr. Mauricio Cifuentes

Do you know that opened up for me, like, let’s say a Pandora’s box to some extent, because then I was wondering what’s going on, why we as a Latinx community never talk about this, never mention this. And that is reflected in the mental health providers of services to the Latinx communities. It’s like a huge elephant and everybody’s immersed. Or it is like the fish in the fish bowl. And you ask the fish, oh, tell me about water. And the fish says, I don’t know, water. It’s like you need some distance from something to be able to see it. So it seems clear to me that we are so immersed somehow in this. There is something in the culture that does not allow us to see it as an issue, even though it’s harming us as a community. 

Host: Shane Cook

Okay, so can you break that down a little bit more. I think I understand what you’re trying to say, but you covered a lot of ground there. I love the analogy, but I’m looking for a little bit more to help me understand what it is you’re saying. 

Guest: Dr. Mauricio Cifuentes

I wonder why we don’t see as a community gambling as an issue and why so many people may have problem gambling issues and we do not address that at all. And I started reflecting on our cultural values. I started thinking how this can be a reflection of who we are as a community. And several thoughts have been in my mind. One thing is that we are an immigrant community, even if we are not so recent, because you have had especially Mexican immigrants in the country for so many years and some people were here before the border crossed them in the southern part of the US. But the reality is that we are different from other immigrant communities in the sense that, for example, we are the only immigrant community which didn’t bring with them their own clergy. 

Guest: Dr. Mauricio Cifuentes

When you look at all the European immigrant communities, they brought their own clergy. That was an indication from the sociology perspective of their decision to remain and to establish in a permanent way in the new place. That hasn’t been the case with the Latinx communities, or at least in the past. That has changed recently. So the Latinx communities have remained traditionally attached in many ways to their countries of origin, but at the same time they want to reach the American dream. It is: let’s reach the American dream and then someday we’ll be able to come back. So in that sense, they have tried really hard to keep the culture of origin more intact, which is impossible, but they have tried to do that. So they remain very attached to this idea that whatever happens is because God wants that. So on one hand, you want to reach and fulfill the American dream, and on the other hand you have this belief that for that to happen, God needs to reward you, that this is a reward that you can access if God wants. So you are here, you face those realities. You want to reach the American dream. So gambling is a very great opportunity to do that. 

If you bet, you think, okay, then I will be able to provide better things for myself and my family. 

I will be better able to send money back to those I left behind who sacrifice everything for me to be able to come to pay for my trip. So you have this element here and then you believe, oh, because I’m a good person, I’m going to win. Because this is the mentality. God rewards good people. So I’m doing the right thing. I’m being honest. I want to reach the American dream. So gambling is fine. God is going to reward me in order to get that. 

Host: Shane Cook

That’s very interesting. When we had our pre-show discussion the other day when you mentioned this, it was also in the context of how we address gambling in the media through messages that are sent, through outreach that other agencies are doing around the state with the intent or with a purpose of trying to be all inclusive across all communities. And you mentioned that as an example, if God wants, and it stuck with me that our messaging is not hitting the mark when it comes to the Latinx community. And you said it very well, and if you wouldn’t mind, I would love to hear it again. I think it would be important for our listeners to hear our messaging comes from a place of prosperity to begin with, not necessarily seeking prosperity. 

Guest: Dr. Mauricio Cifuentes

Yes. 

Host: Shane Cook

And we’ve missed the cultural aspect of if God wants it for me, it will happen. And that drives a significant amount of behavior in the Latinx community. 

Guest: Dr. Mauricio Cifuentes

Yes. I think there is a very fundamental difference between the US dominant culture and the Latinx culture. In the US. Culture, it is your own effort, which may grant you X, Y or Z benefits. So it’s like the strap on mentality. If you work hard, you’ll get it. So here, that’s why opportunities, equal opportunities, is such a big deal, because people believe that if everyone has the same opportunities, then it depends on how much effort you put into in order to achieve your goals. For us in the Latinx cultures, that is not the case. We do our best, but we kind of surrender our power in God’s hands for the final outcome. So in order to really be effective in addressing this issue of gambling, we need first to deal with that obstacle, that huge obstacle. 

And we need to say, people, you know what? Wake up. Chance is not God and chance is not going to reward you. It’s like rain. And we can even use the gospel if you want. The gospel says God sends rain to everyone, the good people, bad people, the killer, the saint, whomever is receiving the reign. Chance operates exactly the same. Chance is blind, deaf, mute, whatever. Chance is not God and chance is not a way to measure how good you are. Because the other issue here that I believe is embedded in this collective denial is guilt. Because I feel that if you have gambling issues and it’s because you are not winning. And if you are not winning, you are not a good person. 

Guest: Dr. Mauricio Cifuentes

So that adds to the shame you may experience because you are not providing for your family. Because on top of that, God is confirming that you are not a good person. 

Host: Shane Cook

Wow, that’s heavy. 

Guest: Dr. Mauricio Cifuentes

It is. And if we continue reaching out to the Latinx community with the standard kind of advertisement, we are wasting our money. 

Host: Shane Cook

Wow, okay, that’s quite a bit to unpack right there. 

Guest: Dr. Mauricio Cifuentes

And I would like to share Shane one, because when something is so abstract and big it seems impossible to land it in a practical way. But there are ways to do that. And I’m going to share some work that we did precisely with Bill Johnson and the Illinois Coalition. We worked together to develop some radio ads for the Latinx communities. And what we did, for example, was we used characters who are in the unconscious mind of the community associated with danger, like El Coco. So El Coco is a mythical figure that we use to scare children if they disobey. Oh, if you do this, El Coco is going to come and we’ll take it with you, or things like that. So we use those mythical figures as part of the ads to deconstruct them. 

Host: Shane Cook

Idea that winning or losing when you are gambling is associated with being good or bad. 

Guest: Dr. Mauricio Cifuentes

So those mythical figures were associating them with chance, it is something dangerous, but they are not God and they are not rewarding or not you, they are blind, mute, deaf as shakira. So that’s what it is. So there are ways in which we can use the abstract, broad concepts of the cultural values into specific ways to target and to do awareness, raising awareness and so on for the Latinx communities and other communities. Every community will use different kinds of means to achieve that goal. 

Host: Shane Cook

Okay? And I appreciate that. I love the fact that you all have worked together on that radio advertising and you’ve done that in conjunction in general, would you say? And I think I know the answer to this just based on what you previously said, but our messaging currently is totally ineffective in the Latinx community, or at least 90% of it is ineffective. 

Guest: Dr. Mauricio Cifuentes

Is what I’m hearing. I’m very new in the field, so I don’t have in-depth knowledge to answer your question. So I do not work for an agency who’s providing treatment, for example. But based on the state document, what I can say is, okay, the researchers didn’t have the opportunity or were unable to find enough people, latinx people, to be in a focus group. Sure. So that is very telling. 

Host: Shane Cook

Yeah. Back to your previous statement as a result of the prevalence study unable to find the people to conduct a focus. 

Guest: Dr. Mauricio Cifuentes

Group that is already and the other thing is we don’t really know much, I think because even those providers whose job is to offer treatment, even though some of them sometimes may have a bilingual provider. The whole program is not culturally responsive or designed to be. It’s more like universal design, trying to reach out to everyone in a neutral way. But as we are discussing, that might not be the best approach. 

Host: Shane Cook

Right, and I can appreciate that as we’re all struggling with getting our messages out about problem gambling. And I think if I step back and look at it holistically, how we’ve all approached it at the very beginning. It is a very blanket approach to raising awareness. But I think as time goes on we’re getting better at honing in on our specific messages that address various communities. And to that point I think it’s important that we talk about some of the good things that are going on in the Latinx community to try and bridge that communication and awareness gap, or I should say the cultural gap that exists in how we communicate. And it’s through the radio advertisements that you’ve done with the ICpG in conjunction. 

Host: Shane Cook

But also I believe there’s an upcoming event here at the beginning of the new year that various agencies are helping to work with your agency to put on a one day conference. 

Guest: Dr. Mauricio Cifuentes

Yes. And I really want to reinforce what you just said because I don’t want to sound like a whining Latinx person here just complaining. Because I really want to say that I’m having a space for these kinds of conversations. Because the state of Illinois at the highest level and the different providers who are already offering services to the different communities are opening up that space. So I have found so much openness from people, they really want to listen, they want to learn more and the state is putting money where their mouth is. So this event you are mentioning is partially the result of grants being received by the Illinois Council on Problem Gambling and CSET of Family Service to raise awareness. 

There are other organizations also doing statewide work on raising awareness and they have been super inclusive of any thoughts the Latinx communities may present. Everything is being translated into Spanish and they are trying to translate not only literally but in a holistic way so that it makes sense. So there are a lot of good things happening, but it is very new as we are talking. As a Latinx person myself, I’m new, but then what is going to happen in January is that we are going to have the first Latin X conference on problem gambling. And we are so excited because this is going to be like a first major opportunity for targeting very specifically the Latinx communities. 

So the idea is to share from the most general way to educate ourselves on how gambling, even though it may have moral implications, is not a moral issue. From our perspective, gambling is a behavioral issue, something which involves the brain. And so we are going to have someone, a scientist who’s going, the keynote speaker, who’s going to teach us about all her research with rats, showing us how this gambling issue works at the brain level. We are going to have Elizabeth, she’s the same person I told you was the one who opened up my mind in that initial training. 

She’s coming to this conference and she’s going to let us know why gambling, which can be a wonderful activity, also can become an issue and she’s going to provide a lot of information, which I’m sure is going to be so new for most people attending this conference. And we are going to have someone from the state who’s going to share with us the content of the prevalence study and then one of my colleagues and myself will be presenting on the specific project. We have to raise awareness among the Latinx communities in Cicero, which is going to be like a pilot program funded by the state. The state is giving us the money to do this and see how much we can learn and how we can refine our interventions. 

And then we’ll have the opportunity for the attendees to react to what they have been learning and listening and to give us feedback so we can better the plan we have for working initially with the Latinx communities. And we will invite the community at large as well, everyone from the community at the end of the day to come and join us for this to become a really community event. 

Host: Shane Cook

Right? It sounds like a fantastic event and I did get a preview of it and where the agenda is headed. So I’m very excited. I’m planning to be there as well. And if I understand correctly, one of the principal thought processes that went through when organizing this event was to maintain location within the community as opposed to many conferences going off. You’re in close proximity to Chicago. Instead of going to downtown Chicago and having it in a hotel or a university that exists downtown, it’s really focused on providing this within the community itself. 

Guest: Dr. Mauricio Cifuentes

Bill has been adamant from day one or day zero, I would say about this. It’s like if this is an event focused on the Latinx communities, we need to be congruent. So we don’t want to go to a place which is so removed culturally from the community. And we have found an amazing partner in Morton College and I want to say they are a quintessential example of how community colleges are linked to the well being of the communities they serve. This college is the second oldest community college in Illinois and they are so committed, you cannot imagine how they open their arms to facilitate this process. But the thing is, they are also consistent with their values. More than 80% of their students come from zip codes located in Cicero, so they are responding to that. 

And I also want to share some gossip for you to entice your audience. All the food and we are going to have music. Everything is going to be Latinx. So that is a very significant point and it is not window dressing. It is an expression of the core values behind this conference. 

Host: Shane Cook

Well, it sounds extremely well thought out. Also, if I understand correctly, there will be translation services provided during that conference as well. 

Guest: Dr. Mauricio Cifuentes

Very unfortunately, what happened was that due to some logistics involved with this we won’t be able to do that. However, what we are going to do is in the first part of the meeting, which is going to be by invitation only, we are going to have 100 people in attendance. That part is going to be in English. And then we are going to have a TV personality from Munivision, which is the largest TV media present in the Latinx community, which has partnered with the Illinois Council on Problem Gambling and Sister Family Service for this event and more other events. 

And this woman, who’s very well known in the Latinx communities, will come to be part of the second part when we are opening the doors for the community at large to come to receive information from our vendors, people who are going to be there to interact with presenters and so on, to enjoy Colombian Mexican food. And probably what we are going to have for music is a mariachi band. So even some dancing will happen that day. 

Host: Shane Cook

All right, well, I look forward to that. So if I can sum this up a little bit, we’ve talked about some of the challenges, some of the approaches historically that have been challenges. It sounds like we’re making progress collectively and we should continue to work collectively across the state, various providers working together across multiple communities and multiple demographics to really hone our messages so they are resonating with the intended audiences. But moving forward, and as we go forward, are there other things that we could do by way of partnerships or collective effort across our organizations, at least from your perspective? Some additional things that we could be doing, whether those be referrals or it could be any number of things, I’d be curious to hear your thoughts. 

Guest: Dr. Mauricio Cifuentes

Absolutely. And I’m with you. I’m going to use this as an example to respond to your question. Caesar Family Service is an agency with zero experience in the world of gambling. We are starting to do this. But there are some other agencies which are doing, like the Gateway Foundation. There are so many others who have tons of experience with gambling, with how to do treatment, how to reach out, how to do this. We bring just a perspective. We believe it is a critical perspective, but we don’t have the richness of knowledge and experience that others have. So what we believe is necessary now moving forward is that we exchange our areas of expertise with an open mind, so we can create new ways to reach out new sensitivities that can impact everyone, because we all want the best for the people we serve. 

So that is the goal. And I think that spaces like the Illinois Council on Problem Gambling are very critical for that because those are spaces in which different voices can be heard and ideas can be exchanged. And for that reason, for example, for this conference, we are inviting people within the broad spectrum of provision of services, within. Gambling world. So that is absolutely true. What you are saying is no one can do this alone. We need to work as a team. 

And to share what we believe is our expertise and be humbled to receive and accept the expertise of others in different areas. 

Host: Shane Cook

Yes, acting with humility, that’s a key theme here that I’ve heard throughout our conversation. So I certainly appreciate the fact that you and I have had the opportunity to get to know each other and share some perspectives and some ideas, exchange ideas, whether it be in this format or in a different format when we’ve met off camera or off audio to do that. 

Guest: Dr. Mauricio Cifuentes

And I also want to say, Shane, you already invited me, we already have this, so I don’t need to groom you anymore. Right? But I really want to say that what you are doing is an example. Sometimes when we face major problems affecting society at large, we feel that there is little or nothing we can do. And in reality, if each one of us does the best he or she can, that’s how we can transform the world. And you’re giving me this opportunity, it’s not only an opportunity for others to listen to me, but you are forcing me to reflect on my own ideas. When I say things, I take some distance and I see those things and that changes my perspectives and I evolve. So what you are doing here is co creating change. And we may think it is little, but I think it is huge. So thank you so much for that. 

Host: Shane Cook

Well, absolutely, and I certainly appreciate your time and your insights in this area. As I said before, I look forward to many more years ahead as we work together and work collectively. 

Guest: Dr. Mauricio Cifuentes

Thank you so much. Thank you very much. 

Host: Shane Cook

We love hearing from you. So please take a moment to like, share and comment on our podcast. You can find us on Facebook and Twitter at recovergateway on LinkedIn at gateway foundation or through our website@gatewayfoundation.org. Wager Danger is supported through funding in whole or in part through a grant from the Illinois Department of Human Services and the Division of Substance Use, Prevention and Recovery. And remember, recovery is a lifelong process. If you or a family member is struggling with a gambling problem, call Gateway at 844-975-3663 and speak with one of our counselors for a confidential assessment.