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Kraus L, Bickl A, Sedlacek L, Schwarzkopf L, Örnberg JC, Loy JK. 'We are not the ones to blame'. Gamblers' and providers' appraisal of self-exclusion in Germany. BMC Public Health 2023; 23:322. [PMID: 36788494 PMCID: PMC9926676 DOI: 10.1186/s12889-023-15117-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 01/17/2023] [Accepted: 01/23/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Given low utilization by individuals experiencing gambling problems the potential of self-exclusion (SE) might be not fully exploited in Germany. This paper aims to gain insight into different actors' perceptions and reflections on the problems and difficulties in the process of self-exclusion to delineate which specific attitudes hamper a successful implementation of SE. METHODS 13 individual and four group interviews with individuals experiencing gambling problems and governmental or commercial gambling providers were examined. A Grounded Theory Approach was used to portray the opinions of these different actors on existing regulations of SE and to delineate potentially diverging interests between the distinct groups. RESULTS The interviewees agreed on the usefulness of SE and consented that it is important to early recognize individuals experiencing gambling problems. They also considered the present practice insufficient but for different reasons. Individuals experiencing gambling problems and providers particularly disagreed on addressing individuals experiencing gambling problems. While individuals experiencing gambling problems stated that they had hardly ever been approached, providers argued that help offers were mostly rejected. Especially commercial providers also regarded insufficient German language skills and rapid fluctuation of guests as strong barriers to approaching individuals experiencing gambling problems. Interviewees from governmental venues furthermore suspected that commercial providers took addressing individuals experiencing gambling problems less seriously. CONCLUSION Our results emphasize the dilemma of conflicting interests in both individuals experiencing gambling problems and providers. Rather than acting against the economic interests of employers, venue staff blame individuals experiencing gambling problems for lack of problem recognition. Conversely, individuals experiencing gambling problems blame the providers for not offering help. To address individuals experiencing gambling problems appropriate staff training is required, and SE regulations need to be controlled by an independent body rather than by the providers themselves.
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Affiliation(s)
- Ludwig Kraus
- IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Leopoldstraße 175, 80804, Munich, Germany. .,Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden. .,Institute of Psychology, ELTE, Eötvös Loránd University, Budapest, Hungary.
| | - Andreas Bickl
- grid.417840.e0000 0001 1017 4547IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Leopoldstraße 175, 80804 Munich, Germany
| | - Lucia Sedlacek
- grid.417840.e0000 0001 1017 4547IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Leopoldstraße 175, 80804 Munich, Germany
| | - Larissa Schwarzkopf
- grid.417840.e0000 0001 1017 4547IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Leopoldstraße 175, 80804 Munich, Germany
| | - Jenny Cisneros Örnberg
- grid.10548.380000 0004 1936 9377Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
| | - Johanna K. Loy
- grid.417840.e0000 0001 1017 4547IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Leopoldstraße 175, 80804 Munich, Germany
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Kraus L, Loy JK, Bickl AM, Schwarzkopf L, Volberg RA, Rolando S, Kankainen VE, Hellman M, Rossow I, Room R, Norman T, Cisneros Örnberg J. Self-exclusion from gambling: A toothless tiger? Front Psychiatry 2022; 13:992309. [PMID: 36213894 PMCID: PMC9537465 DOI: 10.3389/fpsyt.2022.992309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
Abstract
While there is evidence for self-exclusion (SE) as an individual-level harm reduction intervention, its effects on reducing harm from gambling at the population level remain unclear. Based on a review of national legal frameworks and SE programs, including their utilization and enforcement in selected high-income societies, the present analysis aims to explore the reach and strengths of SE in the protection of gamblers in these jurisdictions. It places particular emphasis on SE programs' potential to prevent and minimize gambling harm at the population level. The overview examined SE in Finland, Germany, Italy, Massachusetts (USA), Norway, Sweden, and Victoria (Australia). These jurisdictions differ considerably in how gambling is regulated as well as in how SE is implemented and enforced. The reach and extent of enforcement of SE apparently vary with the polity's general policy balance between reducing gambling problems and increasing gambling revenue. But in any case, though SE may benefit individual gamblers and those around them, it does not appear to be capable of significantly reducing gambling harm at the population level. To render SE programs an effective measure that prevents gamblers and those linked to them from financial, social, and psychological harm, utilization needs to be substantially increased by reforming legal regulations and exclusion conditions.
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Affiliation(s)
- Ludwig Kraus
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden.,IFT Institut für Therapieforschung, München, Germany.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Johanna K Loy
- IFT Institut für Therapieforschung, München, Germany
| | | | | | - Rachel A Volberg
- School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, United States
| | - Sara Rolando
- Eclectica, Institute for Research and Training, Torino, Italy
| | - Veera E Kankainen
- University of Helsinki Centre for Research on Addiction, Control and Governance (CEACG), University of Helsinki, Helsinki, Finland
| | - Matilda Hellman
- University of Helsinki Centre for Research on Addiction, Control and Governance (CEACG), University of Helsinki, Helsinki, Finland
| | | | - Robin Room
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC, Australia
| | - Thomas Norman
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC, Australia.,Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Jenny Cisneros Örnberg
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
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Abstract
Zusammenfassung. Hintergrund: Qualitative Methoden ermöglichen bei unterschiedlichen Fragestellungen vertieften Erkenntnisgewinn im Feld der Suchtforschung. Allerdings ist der Zugang zu den entsprechenden Methoden nicht einfach, da ihre Komplexität und Vielfalt nicht leicht zu überblicken ist und die Umsetzung umfangreiches theoretisches und methodologisches Wissen erfordert. Bisher scheint der Einsatz qualitativer Methoden in der deutschen Suchtforschung nicht ausreichend methodisch untermauert zu sein. Wir fordern daher eine fundierte, reflektierte und methodisch korrekte Nutzung qualitativer Methoden im Feld der Suchtforschung. Ziel: Ziel dieses Artikels ist, anhand von Methodenliteratur und Originalarbeiten, in denen qualitative Methoden angewandt wurden, aufzuzeigen, wie qualitative Forschungsdesigns verstanden werden können, um Forschende zu ermutigen und zu befähigen, qualitative Methoden in angemessener Weise zu nutzen. In diesem Artikel werden mögliche Einsatzgebiete und grundlegende methodologische Überlegungen für die Entwicklung eines qualitativen Forschungsdesigns dargestellt. Dabei wird zusätzlich auf diverse Erhebungsmethoden sowie ethische Aspekte im Rahmen der Datengenerierung eingegangen.
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Affiliation(s)
- Annette Binder
- Sektion Suchtmedizin und Suchtforschung, Universitätsklinik für Psychiatrie und Psychotherapie Universitätsklinikum Tübingen
| | - Christine Preiser
- Institut für Arbeitsmedizin, Sozialmedizin und Versorgungsforschung, Universitätsklinikum Tübingen
- Zentrum für Öffentliches Gesundheitswesen und Versorgungsforschung, Universitätsklinikum Tübingen
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