What Influences the Types of Help that Problem Gamblers Choose? A Preliminary Grounded Theory Model

  • Nerilee Hing
  • Elaine Nuske
  • Barry Tolchard
  • Alex Russell


Research has not fully explored factors that influence types of help used from the suite of available options once problem gamblers reach an action stage of change. This study aimed to explore critical factors influencing choice of help (or interventions) once people have decided to address their gambling problem. Particular emphasis was on counselling and self-exclusion, given their demonstrable effectiveness for most users. Interviews were conducted with 103 problem gamblers taking action to address their gambling problem. Inductive analysis revealed nine critical influences on type(s) of help chosen, presented as a grounded theory model. Independent variables were goals of taking up the intervention, problem gambling severity, and level of independence/pride. Six mediating variables helped to explain relationships between the independent variables and choice of intervention. Understanding key influences on choice of gambling help can illuminate how to encourage further uptake and better align interventions with gamblers’ preferences, to reduce barriers to help-seeking.


Problem gambling Help-seeking Interventions Grounded theory Counselling Self-exclusion 


  1. Blaszczynski, A. P., & McConaghy, N. (1994). Criminal offenses in gamblers anonymous and hospital treated pathological gamblers. Journal of Gambling Studies, 10, 99–127.CrossRefPubMedGoogle Scholar
  2. Blaszczynski, A., & Nower, L. (2002). A pathways model of problem and pathological gambling. Addiction, 97, 487–499.CrossRefPubMedGoogle Scholar
  3. Blaszczynski, A., McConaghy, N., & Frankova, A. (1991). Control versus abstinence in the treatment of pathological gambling: A two to 9 year follow‐up. British Journal of Addiction, 86(3), 299–306.CrossRefPubMedGoogle Scholar
  4. Charmaz, K. (2005). Grounded theory in the 21st century: A qualitative method for advancing social justice research. London: Sage.Google Scholar
  5. Charmaz, K. (2006). Constructing grounded theory: A practical guide to qualitative analysis. London: Sage.Google Scholar
  6. Cohen, I. M., McCormick, A. V., & Corrado, R. R. (2011). BCLC’s voluntary self-exclusion program: Perceptions and experiences of a sample of program participants. Vancouver: BC Centre for Social Responsibility.Google Scholar
  7. Cooper, G. A. (2001). Online assistance for problem gamblers: An examination of participant characteristics and the role of stigma. Doctoral dissertation. Toronto: University of Toronto.Google Scholar
  8. Cooper, G. (2004). Exploring and understanding online assistance for problem gamblers: The pathways disclosure model. International Journal of Mental Health and Addiction, 1(2), 32–38.Google Scholar
  9. Cunningham, J. A. (2005). Little use of treatment among problem gamblers. Psychiatric Services, 56, 1024–1025.CrossRefPubMedGoogle Scholar
  10. Delfabbro, P. H. (2012). Australasian gambling review (5th ed.). Adelaide: Independent Gambling Authority.Google Scholar
  11. Evans, L., & Delfabbro, P. H. (2005). Motivators for change and barriers to help-seeking in Australian problem gamblers. Journal of Gambling Studies, 21(2), 133–155.CrossRefPubMedGoogle Scholar
  12. Ferris, J., & Wynne, H. (2001). The Canadian problem gambling index: Final report. Ottawa: Canadian Centre on Substance Abuse.Google Scholar
  13. Gainsbury, S., Hing, N., & Suhonen, N. (2013). Professional help-seeking for gambling problems: Awareness, barriers and motivators for treatment. Journal of Gambling Studies, 30(2), 503–519.CrossRefGoogle Scholar
  14. Glaser, B., & Strauss, A. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine.Google Scholar
  15. Grant, B. F., Stinson, F. S., Dawson, D. A., Chou, S. P., Ruan, W. J., & Pickering, R. P. (2004). Co-occurrence of 12-month alcohol and drug use disorders and personality disorders in the United States: Results from the national epidemiologic survey on alcohol and related conditions. Archives of General Psychiatry, 61(4), 361–368.Google Scholar
  16. Hayer, T., & Meyer, G. (2011). Self-exclusion as a harm minimization strategy: Evidence for the casino sector from selected European countries. Journal of Gambling Studies, 27, 685–700.CrossRefPubMedGoogle Scholar
  17. Hing, N., & Nuske, E. (2012). The self-exclusion experience for problem gamblers in South Australia. Australian Social Work, 64(4), 457–473.CrossRefGoogle Scholar
  18. Hing, N., Nuske, E., & Gainsbury, S. (2012). Gamblers at risk and their help-seeking behaviour. Melbourne: Gambling Research Australia.Google Scholar
  19. Hing, N., Holdsworth, L., Tiyce, M., & Breen, H. (2014). Stigma and problem gambling: Current knowledge and future research directions. International Gambling Studies, 14(1), 64–81.CrossRefGoogle Scholar
  20. Hodgins, D. (2001). Processes of changing gambling behavior. Addictive Behaviors, 26, 121–128.CrossRefPubMedGoogle Scholar
  21. Hodgins, D., & el-Guebaly, N. (2000). Natural and treatment-assisted recovery from gambling problems: A comparison of resolved and active gamblers. Addiction, 95(5), 777–89.CrossRefPubMedGoogle Scholar
  22. Ladouceur, R. (2005). Controlled gambling for pathological gamblers. Journal of Gambling Studies, 21(1), 49–57.CrossRefPubMedGoogle Scholar
  23. Ladouceur, R., Sylvain, C., & Gosselin, P. (2007). Self-exclusion program: A longitudinal evaluation study. Journal of Gambling Studies, 23, 85–94.CrossRefPubMedGoogle Scholar
  24. Ladouceur, R., Lachance, S., & Fournier, P. M. (2009). Is control a viable goal in the treatment of pathological gambling? Behaviour Research and Therapy, 47(3), 189–197.CrossRefPubMedGoogle Scholar
  25. 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. Canberra: ACT Gambling and Racing Commission.Google Scholar
  26. Nelson, S., Kleschinsky, J. H., LaBrie, R. A., Kaplan, S., & Shaffer, H. J. (2010). One decade of self-exclusion: Missouri casino self-excluders four to 10 years after enrolment. Journal of Gambling Studies, 26, 129–144.CrossRefPubMedGoogle Scholar
  27. Nuske, E., & Hing, N. (2013). A narrative analysis of help-seeking behaviour and critical change points for recovering problem gamblers: The power of storytelling. Australian Social Work, 66(1), 39–55.CrossRefGoogle Scholar
  28. Pallesen, S., Mitsem, M., Kvale, G., Johnsen, B. H., & Molde, H. (2005). Outcome of psychological treatments of pathological gambling: A review and meta-analysis. Addiction, 100(10), 1412–22.CrossRefPubMedGoogle Scholar
  29. Patford, J. L. (2007a). Linked lives: Adult children’s experiences of late onset parental gambling problems. International Journal of Mental Health and Addiction, 5(4), 367–380.CrossRefGoogle Scholar
  30. Patford, J. L. (2007b). The yoke of care: How parents and parents-in-law experience, understand and respond to adult children’s gambling problems. Australian Journal of Primary Health, 13(3), 59–68.CrossRefGoogle Scholar
  31. Patford, J. L. (2009). For worse, for poorer and in ill health: How women experience, understand and respond to a partner’s gambling problems. International Journal of Mental Health and Addiction, 7(1), 177–189.CrossRefGoogle Scholar
  32. Petry, N. M. (2003). Patterns and correlates of gamblers anonymous attendance in pathological gamblers seeking professional treatment. Addictive Behaviors, 28(6), 1049–1062.CrossRefPubMedGoogle Scholar
  33. Petry, N. M. (2005). Pathological gambling: Etiology, comorbidity, and treatment. Washington: American Psychological Association.CrossRefGoogle Scholar
  34. Pulford, J., Bellringer, M., Abbott, M., Clarke, D., Hodgins, D. C., & Williams, J. (2009a). 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(1), 19–32.CrossRefPubMedGoogle Scholar
  35. Pulford, J., Bellringer, M., Abbott, M., Clarke, D., Hodgins, D., & Williams, J. (2009b). 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(1), 33–48.CrossRefPubMedGoogle Scholar
  36. Rockloff, M., & Schofield, G. (2004). Factor analysis of barriers to treatment for problem gambling. Journal of Gambling Studies, 20, 121–127.CrossRefPubMedGoogle Scholar
  37. Rodda, S., & Lubman, D. I. (2014). Characteristics of gamblers using a national online counselling service for problem gambling. Journal of Gambling Studies, 30(2), 277–289.CrossRefPubMedGoogle Scholar
  38. Schwandt, T. (2003). Three epistemological stances for qualitative inquiry. In N. K. Denzin & Y. S. Lincoln (Eds.), The landscape of qualitative research theories and issues (2nd ed., pp. 189–214). Thousand Oaks: Sage.Google Scholar
  39. Slutske, W. S. (2006). Natural recovery and treatment-seeking in pathological gambling: Results of two US national surveys. American Journal of Psychiatry, 163(2), 297–302.CrossRefPubMedGoogle Scholar
  40. Stewart, R. M., & Brown, R. I. F. (1988). An outcome study of gamblers anonymous. British Journal of Psychiatry, 152, 284–288.CrossRefPubMedGoogle Scholar
  41. 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(11), 1343–1346.CrossRefPubMedGoogle Scholar
  42. Suurvali, H., Cordingley, J., Hodgins, D. C., & Cunningham, J. A. (2009). Barriers to seeking help for gambling problems: A review of the empirical literature. Journal of Gambling Studies, 25(3), 407–424.CrossRefPubMedGoogle Scholar
  43. 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), 1–33.CrossRefPubMedGoogle Scholar
  44. Weinstock, J., Burton, S., Rash, C. J., Moran, S., Biller, W., Krudelbach, N., & Morasco, B. J. (2011). Predictors of engaging in problem gambling treatment: Data from the west Virginia problem gamblers help network. Psychology of Addictive Behaviors, 25(2), 372.CrossRefPubMedCentralPubMedGoogle Scholar
  45. Williams, R. J., West, B. L., & Simpson, R. I. (2012). Prevention of problem gambling: A comprehensive review of the evidence and identified best practices. Guelph: Ontario Problem Gambling Research Centre.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Nerilee Hing
    • 1
  • Elaine Nuske
    • 1
  • Barry Tolchard
    • 2
  • Alex Russell
    • 1
  1. 1.Centre for Gambling Education and ResearchSouthern Cross UniversityLismoreAustralia
  2. 2.School of HealthUniversity of New EnglandArmidaleAustralia

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