Journal of Gambling Studies

, Volume 28, Issue 3, pp 465–479 | Cite as

A Focus Group Study of Predictors of Relapse in Electronic Gaming Machine Problem Gambling, Part 2: Factors that ‘Pull’ the Gambler Away from Relapse

  • J. Oakes
  • R. Pols
  • M. Battersby
  • S. Lawn
  • M. Pulvirenti
  • D. Smith
Original Paper


This study aimed to develop an empirically based description of relapse in Electronic Gaming Machine (EGM) problem gambling (PG) by describing the processes and factors that ‘pull’ the problem gambler away from relapse contrasted with the ‘push’ towards relapse. These conceptualisations describe two opposing, interacting emotional processes occurring within the problem gambler during any relapse episode. Each relapse episode comprises a complex set of psychological and social behaviours where many factors interact sequentially and simultaneously within the problem gambler to produce a series of mental and behaviour events that end (1) with relapse where ‘push’ overcomes ‘pull’ or (2) continued abstinence where ‘pull’ overcomes ‘push’. Four focus groups comprising thirty participants who were EGM problem gamblers, gamblers’ significant others, therapists and counsellors described their experiences and understanding of relapse. The groups were recorded, recordings were then transcribed and analysed using thematic textual analysis. It was established that vigilance, motivation to commit to change, positive social support, cognitive strategies such as remembering past gambling harms or distraction techniques to avoid thinking about gambling to enable gamblers to manage the urge to gamble and urge extinction were key factors that protected against relapse. Three complementary theories emerged from the analysis. Firstly, a process of reappraisal of personal gambling behaviour pulls the gambler away from relapse. This results in a commitment to change that develops over time and affects but is independent of each episode of relapse. Secondly, relapse may be halted by interacting factors that ‘pull’ the problem gambler away from the sequence of mental and behavioural events, which follow the triggering of the urge and cognitions to gamble. Thirdly, urge extinction and apparent ‘cure’ is possible for EGM gambling. This study provides a qualitative, empirical model for understanding protective factors against gambling relapse.


Pathological and problem gambling Relapse Predictors Focus group Protective factors Qualitative research Recovery Management ‘Pull’ 



The researchers would like to acknowledge Gambling Research Australia (GRA) who has commissioned this study and the support from the Office for Problem Gambling, Department for Families and Communities South Australia during the period of this study. We thank the participants who gave freely of their time and to our colleagues in the Statewide Gambling Therapy Service (SGTS) who provided excellent support in recruitment and follow up. We would also like to acknowledge the assistance and support of Gambling Helpline, Relationships Australia, Pokies Anonymous and OARS in recruitment and ongoing support for the follow up of Participants.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • J. Oakes
    • 1
    • 2
  • R. Pols
    • 1
    • 3
  • M. Battersby
    • 1
  • S. Lawn
    • 1
  • M. Pulvirenti
    • 4
  • D. Smith
    • 1
  1. 1.Flinders Human Behaviour and Health Research Unit, Department of PsychiatryFlinders UniversityAdelaideAustralia
  2. 2.Statewide Gambling Therapy Service, Flinders Medical CentreBedford ParkAustralia
  3. 3.Suite 4A 151, Consultation Liaison Psychiatry ServiceFlinders Medical CentreBedford ParkAustralia
  4. 4.Discipline of Public Health School of MedicineFlinders UniversityAdelaideAustralia

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