Journal of Gambling Studies

, Volume 28, Issue 2, pp 273–296 | Cite as

Motivators for Seeking Gambling-Related Treatment Among Ontario Problem Gamblers

  • Helen Suurvali
  • David C. Hodgins
  • Tony Toneatto
  • John A. Cunningham
Original Paper


A random digit dialing telephone survey was used to interview 8,467 adults in Ontario, Canada. The NODS-CLiP was used to identify a representative sample of 730 gamblers (54.3% male, mean age 45.3 years) with possible past year gambling problems in order to explore factors that might affect disordered gamblers’ motivators for seeking gambling-related help. A final sample of 526 gamblers provided useable data on possible reasons for and barriers to seeking help, awareness of services, self-perception of gambling problems and experience with help-seeking. Financial and relationship issues were the most frequently volunteered motivators. However, over two-thirds of the respondents could not think of a reason for seeking help. Gamblers who had self-admitted or more severe problems, who knew how to get help, who were employed and had more education, and who identified possible barriers to seeking help were more likely to suggest motivators, especially financial ones. More research is recommended on gamblers’ trajectory towards recognition of a gambling problem, the process of overcoming specific barriers to treatment, and the role of social advantage (e.g., education and employment), in order to devise educational campaigns that will encourage earlier help-seeking among disordered gamblers.


Problem or pathological gambling Motivators for help-seeking Awareness of services Population survey Canada 



This research was supported by the Ontario Problem Gambling Research Centre, Guelph, Ontario. In addition, support to CAMH for salary of scientists and infrastructure has been provided by the Ontario Ministry of Health and Long Term Care. The telephone interviews in this study were conducted by staff of the Institute of Social Research, York University, Toronto, Ontario.


  1. ACNielsen. (2007). Prevalence of Gambling and Problem Gambling in NSWA Community Survey 2006. Final Report. Retrieved March 8, 2008, from
  2. Alberta Gaming Research Institute. (2011, 03/01/11). PrevalenceCanada and Provinces. Retrieved 4 March, 2011, from
  3. Alter, D. A., Stukel, T., Chong, A., & Henry, D. (2011). Lesson from Canada’s universal care: Socially disadvantaged patients use more health services, still have poorer health. Health Affairs, 30, 274–283.PubMedCrossRefGoogle Scholar
  4. American Association for Public Opinion Research. (2011). Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys, 7th edn. AAPOR.Google Scholar
  5. Beacom, A. M., & Newman, S. J. (2010). Communicating health information to disadvantaged populations. Family & Community Health: The Journal of Health Promotion & Maintenance, 33, 152–162.CrossRefGoogle Scholar
  6. Braveman, P. A., Cubbin, C., Egerter, S., Williams, D. R., & Pamuk, E. (2010). Socioeconomic disparities in health in the United States: What the patterns tell us. American Journal of Public Health, 100(S1), S186–S196.Google Scholar
  7. Braveman, P., & Gruskin, S. (2003). Defining equity in health. Journal of Epidemiology and Community Health, 57, 254–258.PubMedCrossRefGoogle Scholar
  8. Campbell, S. M., & Roland, M. O. (1996). Why do people consult the doctor? Family Practice, 13, 75–83.PubMedCrossRefGoogle Scholar
  9. Cooper, G. A. (2001). Online assistance for problem gamblers: An examination of participant characteristics and the role of stigma. Dissertation for Ontario Institute for Studies in Education of the University of Toronto, Toronto.Google Scholar
  10. Cooper, G. (2004). Exploring and understanding online assistance for problem gamblers: The Pathways Disclosure Model. eCommunity: International Journal of Mental Health & Addiction, 1, 32–38.Google Scholar
  11. Cox, B. J., Kwong, J., Michaud, V., & Enns, M. W. (2000). Problem and probable pathological gambling: Considerations from a community survey. Canadian Journal of Psychiatry, 45, 548–553.Google Scholar
  12. Cunningham, J. A. (2005). Little use of treatment among problem gamblers. Psychiatric Services, 56, 1024–1025.PubMedCrossRefGoogle Scholar
  13. Cunningham, J. A., Hodgins, D. C., Toneatto, T., & Cordingley, J. (2008). Final report. Barriers to treatment for problem gamblers in Ontario. (Final report for Ontario Problem Gambling Research Centre). Toronto: Centre for Addiction and Mental Health.Google Scholar
  14. Curtin, R., Presser, S., & Singer, E. (2005). Changes in telephone survey nonresponse over the past quarter century. Public Opinion Quarterly, 69(1), 87–98.CrossRefGoogle Scholar
  15. Delfabbro, P. H., & LeCouteur, A. (2003). A decade of gambling research in Australia and New Zealand (19922002): Implications for policy, regulation and harm minimisation. A report prepared for the Independent Gambling Authority of South Australia. Retrieved 14 February, 2008, from
  16. Doherty, D. T., & Kartalova-O’Doherty, Y. (2010). Gender and self-reported mental health problems: Predictors of help seeking from a general practitioner. British Journal of Health Psychology, 15, 213–228.CrossRefGoogle Scholar
  17. Doiron, J. (2006). Gambling and problem gambling in Prince Edward Island. Retrieved 24 January, 2008, from
  18. Evans, L., & Delfabbro, P. H. (2005). Motivators for change and barriers to help-seeking in Australian problem gamblers. Journal of Gambling Studies, 21, 133–155.PubMedCrossRefGoogle Scholar
  19. Ferris, J., & Wynne, H. (2001). The Canadian problem gambling index: Final report. Ottawa: Canadian Centre on Substance Abuse.Google Scholar
  20. Focal Research Consultants. (2008). 2007 Adult gambling prevalence study. Retrieved 25 February, 2011, from
  21. Gerstein, D. R., Hoffmann, J., Larison, C., Engelman, L., Murphy, S., Palmer, A. et al. (1999). Gambling impact and behavior study. Report to the National Gambling Impact Study Commission, April 1, 1999. Retrieved 15 May, 2008, from
  22. Hodgins, D. C. (2004). Using the NORC DSM Screen for Gambling Problems as an outcome measure for pathological gambling: psychometric evaluation. Addictive Behaviors, 29, 1685–1690.PubMedCrossRefGoogle Scholar
  23. Hodgins, D. C., & Stinchfield, R. (2008). Gambling disorders. In J. Hunsley & E. J. Mash (Eds.), A guide to assessments that work (pp. 370–390). New York: Oxford University Press.Google Scholar
  24. Ialomiteanu, A. R., Adlaf, E. M., Mann, R. E., & Rehm, J. (2011). CAMH Monitor eReport: Addiction and Mental Health Indicators Among Ontario Adults, 1977–2009. (CAMH Research Document Series No. 31). Toronto: Centre for Addiction and Mental Health.Google Scholar
  25. Ipsos Reid Public Affairs & Gemini Research. (2008). Final report: British Columbia problem gambling prevalence study. Retrieved 25 February, 2011, from
  26. Jagdeo, A., Cox, B. J., Stein, M. B., & Sareen, J. (2009). Negative attitudes toward help seeking for mental illness in 2 population-based surveys from the United States and Canada. The Canadian Journal of Psychiatry, 54, 757–766.Google Scholar
  27. Keeter, S., Kennedy, C., Dimock, M., Best, J., & Craighill, P. (2006). Gauging the impact of growing nonresponse on estimates from a national RDD telephone survey. Public Opinion Quarterly, 70(5, Special Issue), 759–779.Google Scholar
  28. Lange, M. A. (2001). “If you do not gamble, check this box”: Perceptions of gambling behaviors. Journal of Gambling Studies, 17, 247–254.PubMedCrossRefGoogle Scholar
  29. Langer, G. (2003). From the field—About response rates—Some unresolved questions. Public Perspective, 14(3), 16–18.Google Scholar
  30. Lemaire, J., MacKay, T.-L., & Patton, D. (2008). Manitoba Gambling and Problem Gambling 2006. Retrieved 25 February, 2011, from
  31. Lesieur, H. R., & Blume, S. B. (1987). The South Oaks Gambling Screen (SOGS): A new instrument for the identification of pathological gamblers. American Journal of Psychiatry, 144, 1184–1188.PubMedGoogle Scholar
  32. Marketquest Research. (2009). 2009 Newfoundland and Labrador gambling prevalence study. Retrieved 7 March, 2011, from
  33. Marketquest Research. (2010). 2009 New Brunswick gambling prevalence study. Retrieved 25 February, 2011, from
  34. Marmot, M. G. (2006). Status Syndrome: A challenge to medicine. Journal of the American Medical Association, 295, 1304–1307.PubMedCrossRefGoogle Scholar
  35. Marshall, K., & Wynne, H. (2003). Fighting the odds. Perspectives on Labour and Income, 4, 5–13.Google Scholar
  36. McMillen, J., Marshall, D., Murphy, L., Lorenzen, S., & Waugh, B. (2004). Help-seeking by problem gamblers, friends and families: A focus on gender and cultural groups. Retrieved March 26, 2008, from
  37. Moodie, C. (2008). Student gambling, erroneous cognitions, and awareness of treatment in Scotland. Journal of Gambling Issues, 21, 30–54.CrossRefGoogle Scholar
  38. Najavits, L. M., Grymala, L. D., & George, B. (2003). Can advertising increase awareness of problem gambling? A statewide survey of impact. Psychology of Addictive Behaviors, 17, 324–327.PubMedCrossRefGoogle Scholar
  39. Petry, N. M. (2005). Pathological gambling: Etiology, comorbidity, and treatment (1st ed.). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  40. Productivity Commission. (1999). Australia’s gambling industries inquiry report. Retrieved 15 February, 2008, from
  41. Pulford, J., Bellringer, M., Abbott, M., Clarke, D., Hodgins, D., & Williams, J. (2009a). 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
  42. Pulford, J., Bellringer, M. E., Abbott, M., Clarke, D., Hodgins, D., & Williams, J. D. (2009b). Reasons for seeking help 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, 19–32.PubMedCrossRefGoogle Scholar
  43. Rush, B., Veldhuizen, S., & Adlaf, E. (2007). Mapping the prevalence of problem gambling and its association with treatment accessibility and proximity to gambling venues. Journal of Gambling Issues, 20, 193–213.CrossRefGoogle Scholar
  44. Shaffer, H. J., LaBrie, R. A., LaPlante, D. A., Nelson, S. E., & Stanton, M. V. (2004). The road less travelled: Moving from distribution to determinants in the study of gambling epidemiology. Canadian Journal of Psychiatry, 49, 504–516.Google Scholar
  45. Slutske, W. S. (2006). Natural recovery and treatment-seeking in pathological gambling: Results of two U.S. national surveys. American Journal of Psychiatry, 163, 297–302.PubMedCrossRefGoogle Scholar
  46. Slutske, W. S., Blaszczynski, A., & Martin, N. G. (2009). Sex differences in the rates of recovery, treatment-seeking, and natural recovery in pathological gambling: Results from an Australian community-based twin survey. Twin Research & Human Genetics: The Official Journal of the International Society for Twin Studies, 12, 425–432.CrossRefGoogle Scholar
  47. Smith, G., & Wynne, H. (2002). Measuring gambling and problem gambling in Alberta using the Canadian problem gambling index (C.P.G.I.). Final Report. Retrieved January 24, 2008, from
  48. Suurvali, H., Cordingley, J., Hodgins, D. C., & Cunningham, J. (2009). Barriers to seeking help for gambling problems: A review of the empirical literature. Journal of Gambling Studies, 25, 407–424.PubMedCrossRefGoogle Scholar
  49. Suurvali, H., Hodgins, D. C., Toneatto, T., & Cunningham, J. A. Hesitation to seek gambling-related treatment among Ontario problem gamblers. Journal of Addiction Medicine (in press).Google Scholar
  50. Suurvali, H., Hodgins, D. C., & Cunningham, J. A. (2010). Motivators for resolving or seeking help for gambling problems: A review of the empirical literature. Journal of Gambling Studies, 26, 1–33.PubMedCrossRefGoogle Scholar
  51. Suurvali, H., Hodgins, D. C., Toneatto, T., & Cunningham, J. A. (2008). Treatment-seeking among Ontario problem gamblers: Results of a population survey. Psychiatric Services, 59, 1347–1350.CrossRefGoogle Scholar
  52. Toce-Gerstein, M., Gerstein, D. R., & Volberg, R. A. (2009). The NODS-CLiP: A rapid screen for adult pathological and problem gambling. Journal of Gambling Studies, 25, 541–555.PubMedCrossRefGoogle Scholar
  53. Toce-Gerstein, M. T., & Volberg, R. A. (2004). The NODS-CLiP: A new brief screen for problem and pathological gambling. In International symposium on problem gambling and co-occurring disorders, Mystic, CT.Google Scholar
  54. Tremayne, K., Masterman-Smith, H., & McMillen, J. (2001). Survey of the nature and extent of gambling and problem gambling in the ACT. Retrieved 7 May, 2008, from
  55. Turner, N., Wiebe, J., Falkowski-Ham, A., Kelly, J., & Skinner, W. (2005). Public awareness of responsible gambling and gambling behaviours in Ontario. International Gambling Studies, 5, 95–112.CrossRefGoogle Scholar
  56. Volberg, R. A. (1994). The prevalence and demographics of pathological gamblers: Implications for public health. American Journal of Public Health, 84, 237–241.PubMedCrossRefGoogle Scholar
  57. Volberg, R. A., Nysse-Carris, K. L., & Gerstein, D. R. (2006). 2006 California problem gambling prevalence survey. Final Report. Retrieved 23 January, 2008, from
  58. Wang, P. S., Berglund, P., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005). Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey replication. Archives of General Psychiatry, 62, 603–613.PubMedCrossRefGoogle Scholar
  59. Wardle, H., Moody, A., Spence, S., Orford, J., Volberg, R., Jotangia, D. et al. (2011). British gambling prevalence survey 2010. Retrieved 18 February, 2011, from
  60. Wardle, H., Sproston, K., Orford, J., Erens, B., Griffiths, M., Constantine, R. et al. (2007). British gambling prevalence survey 2007. Executive Summary. Retrieved 24 January, 2008, from
  61. Wickwire, E. M. J., Burke, R. S., Brown, S. A., Parker, J. D., & May, R. K. (2008). Psychometric evaluation of the National Opinion Research Center DSM-IV Screen for Gambling Problems (NODS). The American Journal on Addictions, 17, 392–395.PubMedCrossRefGoogle Scholar
  62. Wiebe, J., Mun, P., & Kauffman, N. (2006). Gambling and problem gambling in Ontario 2005. Retrieved 24 January, 2008, from
  63. Wiebe, J., & Volberg, R. A. (2007). Problem gambling prevalence research: A critical overview. A Report to the Canadian Gaming Association. Retrieved 25 February, 2011, from
  64. Wynne, H. J. (2002). Gambling and problem gambling in Saskatchewan. Retrieved 24 January, 2008, from,94,88,Documents&MediaID=166&Filename=gambling-final-report.pdf.
  65. Wynne, H. J., Smith, G. J., & Volberg, R. A. (1994). Gambling and problem gambling in Alberta. Final report. Retrieved February, 2011, from

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Helen Suurvali
    • 1
  • David C. Hodgins
    • 2
  • Tony Toneatto
    • 3
  • John A. Cunningham
    • 1
    • 3
  1. 1.Centre for Addiction and Mental HealthTorontoCanada
  2. 2.University of CalgaryCalgaryCanada
  3. 3.University of TorontoTorontoCanada

Personalised recommendations