Abstract
Problem gambling (PG) is a condition affecting the economy, mental health, and relationships of both the individuals with gambling problems, and concerned significant others (CSOs). While PG is treatable, few individuals with gambling problems seek treatment, and many drop out of treatment. This qualitative study aims to investigate a) the reasons for individuals with gambling problems to drop-out from Internet-based PG treatment, and b) what individuals with gambling problems and CSOs find helpful and unhelpful processes in PG recovery. A total of 16 participants (8 individuals with gambling problems and 8 CSOs) who had participated in an Internet-based PG treatment were interviewed over the telephone in a semi-structured interview. The interviews were analyzed using thematic analysis. Drop-out from treatment was one aspect of an overarching theme identified as unstable path to recovery, where alternating periods of progress and setbacks delineate several aspects of PG. Relapses, negative emotions, and changing life circumstances were identified to separately, and in combination, contribute to drop-out. Drop-outs were also explained by participants’ experiences of a reduced need for treatment. Openness and a support from CSOs and peers were identified as themes important for recovery. The results suggest that PG treatments should consider the emotional state, and comorbidities of the patients, in order to reduce drop-out and improve chances of recovery.
Highlights
2% of the world population have a gambling problem (Williams et al, 2012), and it is estimated that another six people are concerned significant others (CSO) to every individual with a gambling problem (Goodwin et al, 2017)
Problem Gambling (PG) is characterized by difficulties in limiting money and/or time spent on gambling which leads to adverse consequences for the gambler, others, or for the community (Neal et al, 2005)
The aim of this study was to investigate the perspective of individuals with gambling problems and CSOs who had participated in a study on Internet-based treatment for PG on a) the reasons for individuals with gambling problems to drop-out of PG treatment, and b) what individuals with gambling problems and CSOs find helpful and unhelpful processes in the recovery of PG?
Summary
2% of the world population have a gambling problem (Williams et al, 2012), and it is estimated that another six people are concerned significant others (CSO) to every individual with a gambling problem (Goodwin et al, 2017). 39% have been estimated to drop-out prematurely from PG treatments trials (Pfund et al, 2021), compared to an estimated 23–50% in outpatient treatment for drug abuse (Brorson et al, 2013), and 20% for other psychiatric disorders (Swift & Greenberg, 2012). This poses a substantial threat to the validity of the studies, and what conclusions can be drawn from them, referred to as attrition bias (Westphal, 2007). Attrition usually refers to when participants drop-out of treatment or are lost to follow up by not filling out followup measures in intervention research (Eysenbach, 2005)
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