A Preliminary, Qualitative Exploration of the Influences Associated with Drop-Out from Cognitive-Behavioural Therapy for Problem Gambling: An Australian Perspective
- 540 Downloads
It has been estimated that 80% of Australians engage in some form of gambling, with approximately 115,000 Australians experiencing severe problems (Productivity Commission 2010). Very few people with problem gambling seek help and, of those who do, large numbers drop-out of therapy before completing their program. To gain insights into these problems, participants who had either completed or withdrawn prematurely from an individual CBT-based problem gambling treatment program were interviewed to examine factors predictive of premature withdrawal from therapy as well as people’s ‘readiness’ for change. The results indicated that there might be some early indicators of risk for early withdrawal. These included: gambling for pleasure or social interaction; non-compliance with homework tasks; gambling as a strategy to avoid personal issues or dysphoric mood; high levels of guilt and shame; and a lack of readiness for change. The study further showed that application of the term ‘drop-out’ to some clients may be an unnecessarily negative label in that a number appear to have been able to reduce their gambling urges even after a short exposure to therapy.
KeywordsQualitative Gambling Drop-out CBT
Ms Megan Bartlett (third year psychology student, Flinders University) for her assistance with data coding.
- Abbott, M. W., & Volberg, R. A. (2000). A report on phase one of the 1999 national prevalence survey: Taking the pulse on gambling and problem gambling in New Zealand. Wellington: Department of Internal Affairs.Google Scholar
- Abbott, M. W., Williams, M., & Volberg, R. (1999). Seven years on: A follow-up study of frequent and problem gamblers living in the community. Report no. 2 of the New Zealand gambling survey. Wellington: Department of Internal Affairs.Google Scholar
- American Psychiatric Association. (2000). Diagnostic and statistical manual of the mental disorders (text revision) (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
- Blaszczynski, A. (1998). Overcoming compulsive gambling: A self-help guide using cognitive behavioural techniques. London: Robinson Publishing.Google Scholar
- Bowling, A. (1999). Research methods in health: Investigating health and health services. Philadelphia: Open University Press.Google Scholar
- Cox, B. J., Yu, N., Afifi, T. O., & Ladouceur, R. (2005). A national survey of gambling problems in Canada. Canadian Journal of Psychiatry, 50, 213–217.Google Scholar
- Czerny, E., Koenig, S., & Turner, N. E. (2008). Exploring the mind of the gambler: Psychological aspects of gambling and problem gambling. In M. Zangeneh, A. Blaszczynski, & N. E. Turner (Eds.), In the pursuit of winning: Problem gambling theory, research and treatment (pp. 65–82). New York: Springer Science and Business Media.CrossRefGoogle Scholar
- Delfabbro, P. H. (2008). Australasian gambling review (AGR) fourth edition (1992–2008). Adelaide: University of Adelaide.Google Scholar
- Dowling, N., Jackson, A. C., & Thomas, S. A. (2008). Behavioural interventions in the treatment of pathological gambling: A review of activity scheduling and desensitization. International Journal of Behavioral Consultation and Therapy, 4, 172–187.Google Scholar
- Grall-Bronnec, M., Wainstein, L., Guillou-Landréat, M., & Vénisse, J. (2009). Pathological gambling among seniors. Alcoologie et Addictologie, 31, 51–56.Google Scholar
- Green, J., & Thorogood, N. (2009). Qualitative methods for health research (2nd ed.). London: SAGE Publications Ltd.Google Scholar
- Haworth, B. (2005). Longitudinal gambling study. In G.Coman (Ed.), Proceedings of the 15th annual conference of the national association for gambling studies (pp. 128–154), Alice Springs.Google Scholar
- Jackson, A. C., Thomas, S. A., Thomason, N., Borrell, J., Crisp, B. R., Ho, W., et al. (2000). Longitudinal evaluation of the effectiveness of problem gambling counselling services, community education strategies and information products—Volume 2: Counselling interventions. Melbourne: Victorian Department of Human Services.Google Scholar
- Ladouceur, R., Gosselin, P., Laberge, M., & Blaszczynski, A. (2001). Dropouts in clinical research: Do results reported in the field of addiction reflect clinical reality? The Behavior Therapist, 24, 44–46.Google Scholar
- National Opinion Research Centre. (1999). Gambing impact and behavior study: Report to the national gambling impact study commission. Chicago: University of Chicago.Google Scholar
- Productivity Commission. (2010). Gambling: Inquiry report. Retrieved from http://www.pc.gov.au/projects/inquiry/gambling-2009/report.
- Pulford, J., Bellringer, M., Abbott, M., Clarke, D., Hodgins, D., & Williams, J. (2009). Barriers to help-seeking for a gambling problem: The experiences of gamblers who have sought specialist assistance and the perceptions of those who have not. Journal of Gambling Studies, 25, 33–48.PubMedCrossRefGoogle Scholar
- Sprosten, K., Erens, B., & Orford, J. (2000). Gambling behaviour in Britain: Results from the British gambling prevalence survey. Melbourne: Australasian Gaming Council.Google Scholar