The use of self-management strategies for problem gambling: a scoping review

Abstract

Background Problem gambling (PG) is a serious public health concern that disproportionately affects people experiencing poverty, homelessness, and multimorbidity including mental health and substance use concerns. Little research has focused on self-help and self-management in gambling recovery, despite evidence that a substantial number of people do not seek formal treatment. This study explored the literature on PG self-management strategies. Self-management was defined as the capacity to manage symptoms, the intervention, health consequences and altered lifestyle that accompanies a chronic health concern. Methods We searched 10 databases to identity interdisciplinary articles from the social sciences, allied health professions, nursing and psychology, between 2000 and June 28, 2017. We reviewed records for eligibility and extracted data from relevant articles. Studies were included in the review if they examined PG self-management strategies used by adults (18+) in at least a subset of the sample, and in which PG was confirmed using a validated diagnostic or screening tool. Results We conducted a scoping review of studies from 2000 to 2017, identifying 31 articles that met the criteria for full text review from a search strategy that yielded 2662 potential articles. The majority of studies examined self-exclusion (39%), followed by use of workbooks (35%), and money or time limiting strategies (17%). The remaining 8% focused on cognitive, behavioural and coping strategies, stress management, and mindfulness. Conclusions Given that a minority of people with gambling concerns seek treatment, that stigma is an enormous barrier to care, and that PG services are scarce and most do not address multimorbidity, it is important to examine the personal self-management of gambling as an alternative to formalized treatment. Electronic supplementary material The online version of this article (10.1186/s12889-019-6755-8) contains supplementary material, which is available to authorized users.

<p>Gender Differences in Problem Gamblers in an Online Gambling Setting</p>

“…While male-oriented gambling, such as sports betting has been studied in this context, [43][44][45] more research may need to address how women, including women with poor psychological health, may be influenced by gambling advertising. Strategies for the management of at-risk gambling may include a range of interventions, such as time-or loss-limit regulations in a gambler's involvement with a gambling operator, voluntary self-exclusion, 46 motivational interviewing, 47 cognitive behavioral therapy, 48 or possibly brief interventions 49 or even pharmaceutical treatment. 50 Recent data have focused on the potential for the reduction of gamblingrelated harm if gamblers adopt a range of safe gambling practices, such as a budget and a preset limit of how much one can afford to lose, not borrowing money in order to gamble, not using gambling as a part of emotional control, and alternative activities.…”

Gambling Despite Nationwide Self-Exclusion–A Survey in Online Gamblers in Sweden

“…Although there is growing scientific support in favor of treatment of gambling disorder, such as through cognitivebehavioral therapy (8) or brief (9) or motivational interventions (10), treatment seeking is known to be low and associated with different barriers (11). Besides formal treatment, and in particular for individuals with problem gambling even in the absence of formal treatment seeking, voluntary self-exclusion from gambling is a commonly used harm reduction instrument (12,13). Such self-exclusion tools, however, have been scientifically studied in several land-based gambling settings (14)(15)(16)(17)(18)(19), meaning that an individual self-excludes from entering one or several specific gambling venues, such as land-based casinos.…”

Effective Treatment and Support for Problem Gambling

“…12 While the evidence supporting the use of CBT for treating gambling problems is compelling for those who attend treatment, research shows that one of the biggest barriers to overall treatment effectiveness is that people with gambling problems rarely seek treatment. 60,93 Many problem gamblers experience and/or perceive barriers to treatment, and these barriers can have a significant, negative impact on a person's likelihood of accessing treatment. 60 Helplines, 60 motivational interventions, 45 remote interventions, [46][47][48] and self-help interventions 55 may also play an important role in problem gambling treatment strategies, as they all demonstrate the potential to promote treatment uptake, even among groups who are typically less likely to access treatment.…”