What makes people with gambling disorder undergo treatment? Patient and professional perspectives

Anticipated Motives for Gambling Treatment in Adults from the U.S

Prior works note that identifying problematic play is a leading barrier to treatment seeking, contributing to low treatment rates in those with gambling problems (e.g., Bijker et al., 2022; Suurvali et al., 2012a). While research has looked at treatment seekers' motives for treatment (Gainsbury et al., 2014; Suurvali et al., 2012b), the situations or signs (anticipated motives) individuals look for that suggest they would need treatment in the future remains unknown. Participants were gamblers (N = 1,791) from a census-matched U.S. sample of adults who reported no concerns about their gambling. Participants completed questions assessing how much money they would have to lose while gambling to think they might have a problem and what factors might motivate them to pursue treatment for gambling problems in the future. Participants reported a wide range of financial loss that would suggest they had a problem, and higher income men who gambled more frequently reported higher necessary losses. There was little variation in endorsement (40-60%) of 14 situations that may lead them to seek treatment in the future (e.g., felt guilty). However, income, gender identity, and problem gambling behavior were linked to the endorsement of some of these anticipated motives, with some differences in endorsement between those engaging in high- and low-level problem gambling. Collectively, results are consistent with the inference that many individuals may not be aware of what problematic gambling would look like for them, though income, gender identity, and problem gambling behavior may impact their consideration of anticipated motives.

The role of contextual factors in avenues to recover from gambling disorder: a scoping review

Introduction

Recovery from complex conditions such as gambling disorders (GD) often entail considerable change and require a range of adaptable interventions in the health care system. Outcomes from such avenues to change are influenced by multifarious contextual factors, which are less frequently considered in treatment outcome studies. Accordingly, this scoping review aims to map the level of evidence and explore how contextual factors influence the provision and outcomes of GD interventions.

Methods

A systematic search in selected health and social science research databases yielded a total of 2.464 unique references. The results were screened in three selection steps-titles (n = 2.464), abstracts (n = 284) and full-text (n = 104). The scoping approach was applied to provide a narrative account of the final included references (n = 34).

Results and discussion

Findings suggest that the research on GD treatment is in the early stages of development. Additionally, studies on GD interventions are characterized by cultural biases (Region and ethnicity and Gender perspectives), while three key elements are described as successful avenues to recover from GD (Competence, Perception and Utilization). In line with these findings, proposals for future research and treatment designs are made.

"To me, it was Just a Vice". Stigma and Other Barriers to Gambling Treatment in Piedmont, Italy

In Piedmont (northwestern Italy), as in the rest of the Western world, only a small percentage of the estimated problem gamblers (10-20%) turn to a treatment service to overcome their addiction issues. The study sought to gain a better understanding of the cultural factors that stand in the way of seeking help, thorough qualitative in-depth individual interviews with gamblers both in and out of treatment. A total of 30 interviews were conducted in three different health districts, most via video-call. Data were then analyzed using an abductive approach. The findings appear to indicate that the processes of stigma affecting problem gamblers and public gambling treatment services are the main barriers to seeking help. According to the interviewees, awareness of the problem is a necessary but not sufficient motivator for embarking on treatment, since social stigmatization leads them to hide the problem. Moreover, self-stigmatization processes seem to undermine the sense of self-efficacy that plays a key role in recovery. To encourage help-seeking, the study thus suggests that priority should be given to efforts to reduce stigma, i.e., through informational and educational measures together with advocacy interventions, which aim primarily to reframe the gambling problem, shifting responsibility from the individual to the collective level.

Gambling and Gambling Problem Perception Questionnaire as a tool to evaluate professionals’ attitudes towards problem gamblers and training programmes in Japan

Aim: To develop and measure the psychometric properties of the Gambling and Gambling Problem Perception Questionnaire (GGPPQ); a scale to evaluate professionals’ attitudes towards people with problem gambling in the Japanese context. Data collection: We held 12 workshops in Japan targeted at mental health professionals who consult people with gambling problems. Participants completed the survey before the workshop. Some were also asked to complete the survey after the workshop to measure workshop influence. Setting: Public and private healthcare facilities in all 47 prefectures of Japan. Participants: Medical doctors, nurses, social workers, clinical psychologists, and other professionals working in the aforementioned facilities ( n = 653, response rate = 98.5%). Measurements: licence; knowledge about gambling and gambling problems (questionnaire); self-rating of knowledge and general confidence for helping problem gamblers; years of practice; frequency of working with clients; experience in attending workshops; overall satisfaction with the workshop. Results: A five-factor structure extracted by exploratory factor analysis showed a good fit by confirmatory factor analysis (CFI = .973, TLI = .967, RMSEA = .060, AIC = 28913.6, BIC = 29110.8). The GGPPQ showed good internal consistency and good concurrent validity with participants’ self-rating of their knowledge, general confidence, frequency of working with clients who have gambling problems, and experience in attending workshops. The workshop had a positive influence on participants’ attitudes. Japan's unique gambling industry and lack of training opportunities on problem gambling were assumed to have influenced the psychometric properties of the measurement tool. Conclusion: The GGPPQ is a valid tool to measure the attitudes of healthcare professionals towards people with gambling problems, as well as workshop effectiveness in Japan.

Feasibility of Brief Screening for At-Risk Gambling in Consumer Credit Counseling

Gambling disorder and problem gambling often lead to major suffering in the form of mental health problems, interpersonal conflict, and financial crises. One potential setting for detecting at-risk gambling is credit counseling as gambling problems may manifest themselves in the form of financial distress and bankruptcy. Research studies have not considered those seeking credit counseling as individuals at risk for gambling problems even though gambling may contribute to financial distress. Therefore, the current study sought to quantify the prevalence of at-risk gambling in credit counseling compared with national estimates, to compare at-risk gamblers in this population to lower risk individuals, and to assess the feasibility of gambling screening in these settings. Using a mixed methods approach, the current study found that almost 20% of callers to a national agency reported gambling behavior, and among those who gambled, they reported higher rates of problems related to gambling than the broader U.S. population, thus supporting the idea that screening in credit counseling may help identify those at risk. Low risk gamblers were slightly younger than non-gamblers, but no other differences in sociodemographic and financial status variables were found based on gambling risk status. Results from focus groups and individual interviews suggest that credit counselors and program administrators see the benefit to brief screening within their intake and counseling processes. Our findings suggest that gambling screening is feasible in consumer credit counseling and may be acceptable to staff and administrators at these agencies.