Louise Holdsworth

Stigma and problem gambling: current knowledge and future research directions

Stigma has been identified as a major barrier to help-seeking, treatment and recovery from gambling problems. However, little research has attempted to examine in any depth the causes, characteristics and consequences of stigma in relation to people experiencing gambling problems. The effects of stigma on people experiencing gambling problems, although not directly examined, are apparent through low rates of problem disclosure and treatment-seeking. In this paper, we aim to inform research into stigma associated with problem gambling by highlighting gaps in existing research and by providing direction for future research. The contribution of this paper is that for the first time stigma and problem gambling are drawn together and reviewed using broad constructs and literature from a range of seminal and new sources to present a synthesis of new and important information on stigma. In regard to problem gambling, the dimensions of stigma, except for origin, have yet to be investigated, as well as the processes of stigma creation, the characteristics of public and felt stigma, and coping strategies used to manage stigma. The practical implications of this review are summarized in a framework provided to inform future research into stigma related to problem gambling.

Exploring women's problem gambling: a review of the literature

Problem gambling is a social issue that increasingly involves women; however, research into gambling and gambling problems amongst women has not kept pace with the feminization of gambling. The aims of this paper are to review relevant literature, discuss research findings on distinctive features of womens gambling, and consider various explanations for gender differences in gambling. While minimal gendered gambling research has been conducted over the past decade, gender differences are apparent in relation to progression to problem gambling, gambling preferences and motivations. Drawing on literature including social capital theory, gender role theory, socialization and cultural geography helps to illuminate why, for instance, for some older women, their gambling increases as their gendered caring role decreases. A better understanding of womens experiences of gambling will allow practical prevention, harm-minimization and treatment strategies to be implemented, and for womens concerns and needs to be accommodated in gambling policy.

All in the family: help-seeking by significant others of problem gamblers

Problem gambling can significantly affect the lives of concerned significant others (CSOs) of problem gamblers, especially family members, but little is known about their help-seeking activities and experiences. This paper explores help-seeking by CSOs of problem gamblers and their related motivators and barriers. A telephone interview was administered to 48 CSOs who called an Australian gambling helpline seeking assistance for themselves and/or a person with gambling problems. Key motivators for seeking help (through helplines, non-professional sources, and self-help measures) were concerns the gambling might become a major problem, negative emotions, problems maintaining normal daily activities, concerns for dependents’ welfare, and health concerns. Barriers included wanting to solve the problem on their own, and shame. Findings highlight the need to better equip CSOs to assist both the person with gambling problems towards treatment and recovery and to protect their own physical, emotional, social and financial wellbeing.

Impacts of gambling problems on partners: partners’ interpretations

Partners can be especially vulnerable to the negative effects of gambling problems, but little research has sought to understand partners’ experiences from their own unique perspectives. This qualitative interpretive study explored the impacts of gambling problems on partners. In-depth interviews were conducted with 18 partners and ex-partners of people with gambling problems to understand their experiences of gambling problems from their perspectives. The findings showed that partners experienced a wide range of negative effects, especially on their financial security, their emotional, mental and physical health, and on their relationships. The financial impacts of gambling problems on partners were substantial and far-reaching. Some partners were forced to take up extra employment to cover household expenses and pay off gambling-related debts. Others lost their savings, homes, belongings and established ways of life. While these impacts were extensive, partners also experienced a range of emotional impacts that were equally devastating. Their gambling partner’s lies, dishonesty and concealment of problems and gambling behaviour created considerable distress, loss of trust and a sense of betrayal. These experiences undermined these partners’ sense of self-identity, and created additional conflicts within their relationships. Along with accumulating mental and physical health impacts, these challenges lead to separation and/or divorce for many participants. These findings point to the need for greater understanding of partners’ experiences and public health initiatives that protect partners and their families from the harmful effects of gambling problems.

The Temporal Sequencing of Problem Gambling and Comorbid Disorders

Two qualitative studies were undertaken to identify the prevalent comorbid mental disorders in treatment seeking problem gamblers and to also identify the temporal sequencing of the disorders. A forum with problem gambling counsellors and interviews with 24 mental health experts were undertaken. There was general agreement that the most commonly occurring disorders were depression, anxiety disorders, substance disorders (nicotine dependence, alcohol and other drug abuse/dependence) and personality disorders. While some participants gave definite opinions as to the temporal sequencing of disorders, the overall consensus was that it was largely dependent upon the individual. These results concur with other findings in the literature and also the Blaszczynski and Nower (2002) pathways model of problem gambling.

All mixed up together: women’s experiences of problem gambling, comorbidity and co-occurring complex needs

While there has been minimal recent gendered gambling research conducted in Australia and elsewhere, there is some evidence to suggest that gender differences do exist in various ways including gambling motivations such as gambling used as a coping strategy to alleviate or ‘escape’ from stress and anxiety, help-seeking and prevalence of comorbidity. In this Australian qualitative study we explored the experiences and concerns of 20 women electronic gaming machine players through in-depth interviews. Ten women self-identified as recreational gamblers and 10 had received help for their gambling. We present findings as they relate to specific issues of comorbidity and complex needs. For the 10 women who had received gambling help the range of comorbid issues was extensive. Greater understandings of the range of complex issues often involved for women who gamble problematically will assist in the identification of moving from recreational to problem gambling and in the implementation of effective treatment strategies.

A Process Evaluation of a Self-Exclusion Program: A Qualitative Investigation from the Perspective of Excluders and Non-Excluders

This paper draws on a process evaluation of Queensland’ self-exclusion program to examine how people use the program, motivations for self-excluding, barriers to use, experiences and perceptions of program elements, and potential improvements. Detailed, reflective, first-person accounts were gathered through interviews with 103 problem gamblers, including excluders and non-excluders. Identified strengths include the program’s widespread availability. Many self-excluders reported positive experiences with responsive, knowledgeable, respectful venue staff. Major weaknesses include low publicity, limited privacy and confidentiality, the need to exclude individually from venues, and deficiencies in venue monitoring for breaches, which hinder the program’s capacity to meet harm minimisation objectives. While the program reaches some problem gamblers, others are delayed or deterred from self-excluding by low awareness, shame and embarrassment, difficulties of excluding from multiple venues, and low confidence in venue staff to maintain confidentiality and provide effective monitoring. Potential improvements include wider publicity, off-site multi-venue exclusion, and technology-assisted monitoring.

Exploring the Hidden Nature of Gambling Problems among People Who Are Homeless

Abstract Although people with gambling problems are now recognised to be among those groups of people at increased risk of homelessness, little research has explored their experiences. This qualitative interpretive study explored the experiences of people who were homeless and had gambling problems, and the housing and gambling service providers assisting them. In-depth interviews were conducted with 17 service users and 18 service providers. A key finding was that gambling problems among those experiencing homelessness are often hidden; few people presented to housing services admitting to gambling problems. Shame, stigma, and identity issues were described as the main reasons service users did not disclose their gambling activities. The research highlighted that the relationship between service providers and service users was infused with power imbalances and shaped by social discourses and policies that demand self-responsibility and hinder information sharing between service providers and service users.

A Grounded Theory of the Influence of Significant Life Events, Psychological co-Morbidities and Related Social Factors on Gambling Involvement

This study aimed to explore how gambling involvement and gambling-related problems may be affected by significant life events, psychological co-morbidities and related social factors. Twenty recreational gamblers and 20 people experiencing gambling problems were interviewed, with reflective first-person accounts being analysed to develop a grounded theory. While both groups had experienced various significant life events and psychological co-morbidity, they coped with such events in different ways. The problem gambling group was found to increase their gambling involvement, unlike the recreational gambling group. In contrast to the problem gambling group, most recreational gamblers had strong social support networks and a resilience that helped them cope with significant life events and co-morbidities. A major finding of this study is the importance of resilience and social support when coping with adversity as protective factors against gambling problems. A grounded theory framework is presented as a basis for further research in this area.

Untangling the Complex Needs of People Experiencing Gambling Problems and Homelessness

People with gambling problems are now recognised among those at increased risk of homelessness, and the link between housing and gambling problems has been identified as an area requiring further research. This paper discusses the findings of a qualitative study that explored the relationship between gambling problems and homelessness. Interviews and a focus group were conducted with 17 people experiencing gambling problems and homelessness, and 18 housing and gambling service providers. The study found that the multiple needs people with gambling and housing problems experience intensifies the complexity of issues they face. These multiple needs have an amplifying and accumulating outcome that compounds the negative effects of each other over time creating additional problems and barriers to resolution. While there can be significant challenges involved, this study suggests it is important to recognise, understand and untangle these complex issues and needs in order to implement effective strategies and assist beneficial change.