Gamblers at-risk and their helpseeking

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1 Gamblers at-risk and their helpseeking behaviour Report written by: Professor Nerilee Hing Dr Elaine Nuske Dr Sally Gainsbury Centre for Gambling Education and Research School of Tourism and Hospitality Management Southern Cross University Lismore NSW 2480 Final Report For Gambling Research Australia September 2011

2 ACKNOWLEDGEMENTS We gratefully acknowledge the financial assistance for this research project provided by Gambling Research Australia. We particularly thank all survey respondents and interviewees without whom this study would not have been possible. A special acknowledgement goes to those who have been affected by gambling problems thank you for your willingness to engage in this study. The recruitment of helpline callers and gamblers in treatment would not have occurred without the support of numerous gambling help agencies throughout Australia whom we thank very much for their time, effort and willingness to assist. These include: Turning Point Alcohol and Drug Services, McKesson Asia Pacific, Lifeline Canberra, the South Australian Office of Problem Gambling and the South Australian Gambling Helpline, all of whom helped us to recruit callers to gambling helplines throughout Australia. Relationships Australia South Australia who recruited participants from its Consumer Voice Program. Relationships Australia Queensland and Gambler s Help Victoria and their associated agencies, along with gambling counselling services throughout New South Wales, who helped us recruit gamblers in treatment. Lifeline Cairns, Amity House Darwin and several Indigenous health and community organisations who helped us to engage Indigenous Australians for interviews. Clubs NSW and the four participating clubs in that state that allowed us to survey gamblers on- site. The NSW Responsible Gambling Fund for assistance in liaising with NSW counselling agencies. The culturally specific agencies in Sydney and Melbourne who participated in interviews and recruitment of clients. The authors would also like to thank other members and associates of the Centre for Gambling Education and Research who assisted with various aspects of this study. These include one of the Co- Investigators Dr John Haw, as well as Dr Helen Breen, Dr Louise Holdsworth, Mr Ashley Gordon, Dr Lee Shepherd, Ms Shaaron Kapcelovich, Mr Paul Weeks, Dr Matt Lamont and Ms Char- lee McLennan. We also gratefully acknowledge the following experts who provided peer review of the draft literature review, study instrumentation and research report for this study. Their comments helped us to significantly improve on our earlier drafts of these: Professor Max Abbott, Director, Gambling and Addiction Research Centre, Auckland University of Technology. Dr Maria Bellringer, Senior Research Fellow, Gambling and Addiction Research Centre, Auckland University of Technology. We also thank the two anonymous reviewers of the full draft report who provided numerous helpful suggestions for improvement which were subsequently incorporated into this final report. i

3 Table of Contents ACKNOWLEDGEMENTS... i EXECUTIVE SUMMARY... xvi SECTION 1: INTRODUCTION, LITERATURE REVIEW AND METHODOLOGY... 1 CHAPTER 1: INTRODUCTION Aims and Scope Statement of Requirements Structure of the Report... 3 CHAPTER 2: LITERATURE REVIEW Introduction Definitions, Measurement and Prevalence of Problem Gambling Amelioration Transtheoretical Model of Change? Behaviour Change in Problem Gamblers Pathways to Change Barriers to Help- Seeking Motivators for Help- Seeking Demographic Correlates and Barriers/Motivators to Help- Seeking Chapter Conclusion CHAPTER 3: RESEARCH METHODS Introduction Overview of Data Collection Stages and Samples Instrumentation Stage 1: National Telephone Survey of Regular Gamblers Stage 2: Telephone Survey of Callers to Gambling Helplines Stage 3: Survey of Clients in Counselling for Gambling Problems Stage 4: Telephone Interviews with Recovered Problem Gamblers and Family Members Stage 5: Interviews with Indigenous Regular Gamblers, Family Members, Problem Gamblers and Counsellors Stage 6: Interviews with CALD Gamblers in Treatment, Family Members and Counsellors Stage 6: Venue Survey of Gamblers in Culturally Diverse Clubs Summary of Samples Data Analysis Chapter Conclusion ii

4 SECTION 2: QUANTITATIVE FINDINGS CHAPTER 4: RESULTS FROM A NATIONAL TELEPHONE SURVEY OF REGULAR GAMBLERS Introduction Participant Characteristics Gambling Behaviour Problem Gambling Severity Professional Sources of Gambling Help Knowledge of Professional Sources of Gambling Help Use of Professional Sources of Gambling Help Helpfulness of Professional Sources of Gambling Help Preferences for Professional Sources of Gambling Help Motivators for Using Professional Sources of Gambling Help Barriers to Using Professional Sources of Gambling Help What Could Encourage Earlier Professional Help- Seeking Non- Professional Sources of Gambling Help Use of Non- Professional Sources of Gambling Help Helpfulness of Non- Professional Sources of Gambling Help Preferences for Non- Professional Sources of Gambling Help Motivators for Using Non- Professional Sources of Gambling Help Barriers to Using Non- Professional Sources of Gambling Help What Could Encourage Earlier Non- Professional Help- Seeking Self- Help Strategies for Gambling Use of Self- Help Strategies for Gambling Helpfulness of Self- Help Strategies for Gambling Motivators for Using Self- Help Strategies for Gambling Barriers to Using Self- Help Strategies for Gambling What Could Encourage Earlier Use of Self- Help Gambling Strategies Pathways to Help- Seeking Stages of Change Chapter Conclusion CHAPTER 5: RESULTS FROM A TELEPHONE SURVEY OF GAMBLERS WHO HAVE RECENTLY CALLED A GAMBLING HELPLINE Introduction Participant Characteristics Gambling Behaviour iii

5 5.4 Problem Gambling Severity Gambling Helplines as a Source of Professional Help Knowledge, Use and Helpfulness of Gambling Helplines Motivators for Calling a Gambling Helpline Barriers to Calling a Gambling Helpline What Could Encourage People to Call a Gambling Helpline Sooner Other Professional Sources of Gambling Help Knowledge of Other Professional Sources of Gambling Help Before Calling a Helpline Current Use of Other Professional Sources of Gambling Help Past Use of Other Professional Sources of Gambling Help Non- Professional Sources of Gambling Help Use of Non- Professional Sources of Gambling Help Preferences for Non- Professional Sources of Gambling Help Motivators for Using Non- Professional Sources of Gambling Help Barriers to Using Non- Professional Sources of Gambling Help What Could Encourage Earlier Non- Professional Help- Seeking Self- Help Strategies for Gambling Use of Self- Help Strategies for Gambling Helpfulness of Self- Help Strategies for Gambling Motivators for Using Self- Help Strategies for Gambling Barriers to Using Self- Help Strategies for Gambling What Could Encourage Earlier Use of Self- Help Gambling Strategies Pathways to Help- Seeking Stages of Change Chapter Conclusion CHAPTER 6: RESULTS FROM A TELEPHONE SURVEY OF FAMILY MEMBERS WHO HAVE RECENTLY CALLED A GAMBLING HELPLINE Introduction Participant Characteristics Gambling Helplines as a Source of Professional Help Knowledge and Use of Gambling Helplines Motivators for Calling a Gambling Helpline Barriers to Calling a Gambling Helpline What Could Encourage People to Call a Gambling Helpline Sooner iv

6 6.4 Other Professional Sources of Gambling Help Knowledge of Other Professional Sources of Gambling Help Before Calling a Helpline Current Use of Other Professional Sources of Gambling Help Past Use of Other Professional Sources of Gambling Help Non- Professional Sources of Gambling Help Use of Non- Professional Sources of Gambling Help Preferences for Non- Professional Sources of Gambling Help Motivators for Using Non- Professional Sources of Gambling Help Barriers to Using Non- Professional Sources of Gambling Help What Could Encourage Earlier Non- Professional Help- Seeking Self- Help Strategies for Gambling Use of Self- Help Strategies for Gambling Helpfulness of Self- Help Strategies for Gambling Motivators for Using Self- Help Strategies for Gambling What Could Encourage Earlier Use of Self- Help Gambling Strategies Pathways to Help- Seeking Chapter Conclusion CHAPTER 7: RESULTS FROM A SURVEY OF GAMBLERS IN TREATMENT FOR GAMBLING PROBLEMS Introduction Participant Characteristics Gambling Behaviour Problem Gambling Severity Professional Sources of Gambling Help Prior Knowledge of Professional Sources of Gambling Help Current Use of Professional Gambling Help Prior Use of Professional Gambling Help Motivators for Seeking Professional Gambling Help Barriers to Seeking Professional Help What Could Have Encouraged People to Seek Professional Help Sooner Non- Professional Sources of Gambling Help Past Use of Non- Professional Sources of Gambling Help Current Use of Non- Professional Sources of Gambling Help Motivators for Seeking Non- Professional Sources of Gambling Help v

7 7.6.4 Barriers to Seeking Non- Professional Sources of Gambling Help What Could Have Encouraged Earlier Non- Professional Help- Seeking Self- Help Strategies for Gambling Use of Self- Help Strategies for Gambling Motivators for Using Self- Help Strategies for Gambling Barriers to Using Self- Help Strategies for Gambling What Could Have Encouraged Earlier Use of Self- Help Gambling Strategies Pathways to Help- Seeking Stages of Change Chapter Conclusion CHAPTER 8: RESULTS FROM A SURVEY OF REGULAR GAMBLERS FROM CULTURALLY DIVERSE CLUBS Introduction Participant Characteristics Gambling Behaviour Problem Gambling Severity Professional Sources of Gambling Help Knowledge and Use of Professional Sources of Gambling Help Motivators for Seeking Professional Gambling Help Barriers to Seeking Professional Help What Could Encourage People to Seek Professional Help Sooner Non- Professional Sources of Gambling Help Use of Non- Professional Sources of Gambling Help Preferences for Non- Professional Sources of Gambling Help Motivators for Seeking Non- Professional Sources of Gambling Help Barriers to Seeking Non- Professional Sources of Gambling Help What Could Encourage Earlier Non- Professional Help- Seeking Self- Help Strategies for Gambling Use of Self- Help Strategies for Gambling Motivators for Using Self- Help Strategies for Gambling Barriers to Using Self- Help Strategies for Gambling What Could Encourage Earlier Use of Self- Help Gambling Strategies Pathways to Help- Seeking Stages of Change Chapter Conclusion vi

8 CHAPTER 9: COMPARATIVE ANALYSES OF SURVEY RESULTS Introduction Professional Sources of Gambling Help Knowledge of Professional Sources of Gambling Help: Gambling- Specific Services Knowledge of Professional Sources of Gambling Help: Generalist Services Use of Professional Sources of Help Motivations for Seeking Professional Gambling Help Barriers to Seeking Professional Gambling Help Non- Professional Sources of Gambling Help Use of Non- Professional Sources of Gambling Help Motivations for Seeking Non- Professional Sources of Gambling Help Barriers to Seeking Non- Professional Sources of Gambling Help Self- Help Gambling Strategies Use of Self- Help Gambling Strategies Motivations for Using Self- Help Gambling Strategies Barriers to Using Self- Help Gambling Strategies Chapter Conclusion SECTION 3: QUALITATIVE FINDINGS CHAPTER 10: RESULTS FROM INTERVIEWS WITH RECOVERED GAMBLERS AND FAMILY MEMBERS Introduction Findings from the Interviews with Recovered Problem Gamblers First Type of Help Used Second First Type of Help Used Third Type of Help Used Suggested Improvements Summary of Findings from Interviews with Recovered Problem Gamblers Findings from the Interviews with Family Members of Recovered Problem Gamblers How the Problem Gambling Emerged and Previous Help Accessed by the Problem Gambler The Family Member s Role in Helping the Problem Gambler Suggested Improvements Summary of Findings from Interviews with Family Members of Recovered Problem Gamblers Chapter Conclusion vii

9 CHAPTER 11: RESULTS FROM INTERVIEWS WITH INDIGENOUS COUNSELLORS, PROBLEM GAMBLERS IN TREATMENT, REGULAR GAMBLERS AND FAMILY MEMBERS Introduction Findings from Interviews with Counsellors of Indigenous Gamblers Client Characteristics Stage in Development of Gambling Problems When Professional Help is Sought Motivators for Professional Help- Seeking Barriers to Professional Help- Seeking Pathways to Professional Help Treatment Methods Use of Other Professional Sources of Gambling Help Use of General Help Services Help Seeking From Non- Professional Sources Cultural Differences in Non- Professional Help- Seeking Pathways to Non- Professional Help Motivators for Seeking Non- Professional Help Barriers to Seeking Non- Professional Help Suggested Improvements Summary of Findings from Interviews with Counsellors Help Seeking Amongst Indigenous Gamblers in Treatment Client Characteristics Current Use of Professional Help Treatment Methods Cultural Appropriateness of Professional Help Services Reason for Choice of Professional Service Awareness and Use of Other Professional Help Services Motivators and Barriers to Professional Help- Seeking Non- Professional Sources of Help Motivators for Non- Professional Help- Seeking Barriers to Non- Professional Help- Seeking Use of Self- Help Strategies Pathways to Help- Seeking Suggested Improvements Summary of Findings From Interviews with Indigenous Problem Gamblers Findings from Interviews with Indigenous Regular Gamblers viii

10 Characteristics of the Interviewees Awareness of Professional Sources of Help Motivators for Professional Help- Seeking Barriers to Professional Help- Seeking Non- Professional Sources of Help Self- Help Strategies Suggested Improvements Summary of Findings from Interviews with Indigenous Regular Gamblers Findings from Interviews with Family Members of Indigenous Regular Gamblers Characteristics of Interviewees Encouragement to Use Professional Sources of Help Encouragement to Use Non- Professional Sources of Help Encouragement to Use Self- Help Strategies Motivators for Help Seeking Barriers to Help Seeking Suggested Improvements Summary of Findings from Interviews with Family Members of Indigenous Regular Gamblers Chapter Conclusion CHAPTER 12: RESULTS FROM INTERVIEWS WITH CALD COUNSELLORS AND CLIENTS Introduction Findings from Interviews with CALD Counsellors Counsellor Characteristics Counsellors Client Characteristics Stage in the Development of Gambling Problems When Professional Help is Sought Motivators for Professional Help Seeking Barriers to Professional Help Seeking Referral Pathways to Professional Sources of Help Treatment Methods Other Professional Sources of Help Help Seeking Behaviour from Non- Professional Sources of Help Suggested Improvements Summary of Findings from Interviews with CALD Counsellors Findings from Interviews with CALD Clients ix

11 Client Characteristics Professional Sources of Help and Referral Pathways Motivations and Triggers for Help Seeking Barriers to Help Seeking Informal Sources of Help Self- Help Measures Suggested Improvements Summary of Findings from Interviews with CALD Clients Chapter Conclusion SECTION 4: DISCUSSION AND CONCLUSIONS CHAPTER 13: DISCUSSION AND CONCLUSIONS Introduction Help- Seeking Behaviour Professional Help- Seeking Behaviour Non- Professional Help- Seeking Behaviour Self- Help Gambling Strategies Motivators and Barriers for Help- Seeking Motivators for Help- Seeking Barriers to Help- Seeking Role of External and Internal Factors in Help- Seeking Behaviour Guidelines to Enhance Help- Seeking Behaviour by At- Risk/Problem Gamblers and Related Policy Development Chapter Conclusion REFERENCES APPENDICES Appendix A: Survey instrument for the national telephone survey of regular gamblers Appendix C: Online survey of clients in counselling for gambling problems Appendix D: Interview schedule for recovered problem gamblers Appendix E: Interview schedule for family members of recovered problem gamblers Appendix F: Interview schedule for Indigenous regular gamblers Appendix G: Interview schedule for family members of Indigenous regular gamblers Appendix H: Interview schedule for Indigenous problem gamblers Appendix I: Interview schedule for counsellors of Indigenous gamblers Appendix J: Interview schedule for CALD gamblers in treatment Appendix K: Interview schedule for family members of CALD gamblers in treatment Appendix L: Interview schedule for CALD counsellors Appendix M: Survey instrument for CALD gamblers in clubs (English version) Appendix N: Detailed statistical tables for Chapters x

12 LIST OF TABLES Table 3.1: Table 4.1: Table 4.2: Table 5.1: Table 5.2: Table 6.1: Table 7.1: Table 7.2: Table 7.3: Table 7.4: Table 7.5: Table 8.1: Table 8.2: Table 8.3: Survey and Interview Respondents by Geographic Area and Expected Stage of Change NTS Sample: Preferred Pathways to Help- Seeking NTS Sample: Stage of Change in Help- Seeking Behaviour GHS Sample: Preferred Pathways to Help- Seeking GHS Sample: Stage of Change in Help- Seeking Behaviour FHS Sample: Preferred Pathways to Help- Seeking PGT Sample: Themes and Comments About What Could Have Encouraged Respondents to Seek Professional Help Sooner PGT Sample: What Could Have Encouraged Earlier Non- Professional Help- Seeking PGT Sample: What Could Have Encouraged Earlier Use of Self- Help Gambling Strategies PGT Sample: Preferred Pathways to Help- Seeking PGT Sample: Stage of Change in Help- Seeking Behaviour CALD sample: PGSI Categories of Respondents by Country/Region CALD Sample: Preferred Pathways to Help- Seeking CALD Sample: Stage of Change in Help- Seeking Behaviour xi

13 TABLE OF FIGURES Figure 4.1: Figure 4.2: Figure 4.3: Figure 4.4: Figure 4.5: Figure 4.6: Figure 4.7: Figure 4.8: Figure 4.9: Figure 4.10: Figure 4.11: Figure 5.1: Figure 5.2: Figure 5.3: Figure 5.4: Figure 5.5: Figure 5.6: Figure 5.7: Figure 5.8: Figure 5.9: Figure 5.10: Figure 5.11: Figure 5.12: Figure 5.13: Figure 5.14: Figure 6.1: Figure 6.2: NTS Sample: PGSI Categories of Respondents (%) NTS Sample: Knowledge of Professional Sources of Gambling Help (%) NTS Sample: Preferred Sources of Professional Help for Gambling (%) NTS Sample: Motivators for Using Professional Sources of Gambling Help by Respondents Who Have Received and Have Not Received Professional Help NTS Sample: Barriers for Using Professional Sources of Gambling Help by Respondents Who Have Received and Not Received Professional Help NTS Sample: Preferred Sources of Non- Professional Gambling Help (%) NTS Sample: Motivators for Using Non- Professional Sources of Gambling Help by Respondents Who Have and Have Not Received Non- Professional Help NTS Sample: Barriers to Using Non- Professional Sources of Gambling Help by Respondents Who Have and Have Not Received Non- Professional Help NTS Sample: Current Use of Self- Help Gambling Strategies by Respondents Who Have and Have Not Used Other Types of Help (%) NTS Sample: Motivators for Using Self- Help by Respondents Who Have Received and Not Received Other Types of Help NTS Sample: Barriers to Using Self- Help by Respondents Who Had and Had Not Received Other Types of Help GHS Sample: PGSI Categories of Respondents (%) GHS Sample: How Respondents First Found Out About the Gambling Helpline They Called (%) GHS Sample: Motivators for Gamblers for Calling a Gambling Helpline GHS Sample: Barriers to Calling a Gambling Helpline GHS Sample: Knowledge of Other Professional Sources of Gambling Help (%) GHS Sample: Current Use of Other Professional Sources of Gambling Help (%) GHS Sample: How Respondents First Found Out About Other Professional Sources of Help (%) GHS Sample: Current Use of Non- Professional Gambling Help (%) GHS Sample: Preferred Sources of Non- Professional Gambling Help (%) GHS Sample: Motivators for Using Non- Professional Sources of Gambling Help GHS Sample: Barriers to Using Non- Professional Sources of Gambling Help GHS Sample: Use of Self- Help Gambling Strategies Before Seeking Other Types of Help (%) GHS Sample: Motivators for Using Self- Help Gambling Strategies GHS Sample: Barriers to Using Self- Help Gambling Strategies FHS Sample: Relationship of Gambler to Family Member FHS Sample: How Respondents First Found Out About the Gambling Helpline They Called (%) xii

14 Figure 6.3: Figure 6.4: Figure 6.5: Figure 6.6: Figure 6.7: Figure 6.8: Figure 6.9: Figure 6.10: Figure 6.11: Figure 7.1: Figure 7.2: Figure 7.3: Figure 7.4: Figure 7.5: Figure 7.6: Figure 7.7: Figure 7.8: Figure 7.9: Figure 7.10: Figure 7.11: Figure 7.12: Figure 7.13: Figure 7.14: Figure 7.15: Figure 8.1: Figure 8.2: Figure 8.3: Figure 8.4: Figure 8.5: Figure 8.6: Figure 8.7: Figure 8.8: Figure 8.9: Figure 8.10: Figure 8.11: FHS Sample: Motivators for Gamblers for Calling a Gambling Helpline FHS Sample: Barriers to Calling a Gambling Helpline FHS Sample: Knowledge of Other Professional Sources of Gambling Help (%) FHS Sample: Current Use of Non- Professional Gambling Help (%) FHS Sample: Preferred Sources of Non- Professional Gambling Help (%) FHS Sample: Motivators for Using Non- Professional Sources of Gambling Help FHS Sample: Barriers to Using Non- Professional Sources of Gambling Help FHS Sample: Use of Self- Help Gambling Strategies Before Seeking Other Types of Help (%) FHS Sample: Motivators for Using Self- Help Gambling Strategies PGT Sample: PGSI Categories of Respondents (%) PGT: Awareness of Professional Sources of Gambling Help (%) PGT: Current Use of Professional Sources of Gambling Help (%) PGT: How Respondents Found Out About Prior Professional Sources of Gambling Help (%) PGT: Prior Use of Professional Sources of Gambling Help (%) PGT: How Respondents Found Out About Prior Professional Sources of Gambling Help (%) PGT Sample: Motivators for Seeking Professional Help PGT Sample: Barriers to Seeking Professional Help PGT Sample: Past Sources of Non- Professional Gambling Help (%) PGT Sample: Current Sources of Non- Professional Gambling Help (%) PGT Sample: Motivators for Using Non- Professional Sources of Gambling Help PGT Sample: Barriers to Using Non- Professional Sources of Gambling Help PGT Sample: Past Use of Self- Help Gambling Strategies (%) PGT Sample: Motivators for Using Self- Help Gambling Strategies PGT Sample: Barriers to Using Self- Help Gambling Strategies CALD Sample: PGSI Categories of Respondents (%) CALD Sample: Knowledge of Professional Sources of Gambling Help (%) CALD Sample: Preferred Sources of Professional Gambling Help (%) CALD Sample: Motivators for Seeking Professional Help CALD Sample: Barriers to Seeking Professional Help CALD Sample: Preferred Sources of Non- Professional Gambling Help (%) CALD Sample: Motivators for Using Non- Professional Sources of Gambling Help CALD Sample: Barriers to Using Non- Professional Sources of Gambling Help CALD Sample: Use of Self- Help Gambling Strategies: Unprompted Responses (%) 148 CALD Sample: Current Use of Self- Help Gambling Strategies (%) CALD Sample: Motivators for Using Self- Help Gambling Strategies xiii

15 Figure 8.12: Figure 9.1: Figure 9.2: Figure 9.3: Figure 9.4: Figure 9.5: Figure 9.6: Figure 9.7: Figure 9.8: Figure 9.9: Figure 9.10: Figure 9.11: Figure 9.12: Figure 9.13: Figure 9.14: Figure 9.15: Figure 9.16: Figure 9.17: Figure 9.18: Figure 9.19: Figure 9.20: Figure 9.21: Figure 9.22: Figure 9.23: Figure 9.24: Figure 9.25: Figure 9.26: Figure 9.27: CALD Sample: Barriers to Using Self- Help Gambling Strategies CS: Knowledge of Gambling Specific Help Services: Combined Sample CS: Awareness of Gambling Specific Help Services: Comparison By Sample CS: Awareness of Gambling Specific Help Services: Comparison by PGSI Group CS: Knowledge of Generalist Help Services: Combined Sample CS: Awareness of Gambling Help from Generalist Help Services: Comparison by Sample CS: Awareness of Gambling Help from Generalist Help Services: Comparison By PGSI Group CS: Motivators for Seeking Professional Gambling Help: Combined Sample CS: Motivators for Seeking Professional Gambling Help: Comparison by Sample CS: Motivators for Seeking Professional Gambling Help: Comparison By PGSI Group CS: Motivators for Professional Help- Seeking by Problem Gamblers CS: Motivations for Professional Help- Seeking: Comparison by Having Received Professional Help or Not CS: Barriers to Seeking Professional Gambling Help CS: Barriers to Seeking Professional Gambling Help: Comparison by Sample CS: Barriers to Seeking Professional Gambling Help: Comparison by PGSI Group CS: Barriers to Seeking Professional Gambling Help: Problem Gamblers CS: Barriers to Professional Help- Seeking: Comparison by Having Received Professional Help or Not CS: Willingness to Use of Non- Professional Gambling Help: Comparison by Sample CS: Willingness to Use of Non- Professional Gambling Help: Comparison by PGSI Group CS: Motivators for Seeking Non- Professional Gambling Help: Comparison by Sample CS: Motivators for Seeking Non- Professional Gambling Help: Comparison by Sample CS: Motivators for Seeking Non- Professional Gambling Help: Comparison by PGSI Group CS: Motivators for Seeking Non- Professional Gambling Help: Among Problem Gamblers CS: Barriers to Seeking Non- Professional Gambling Help: Combined Sample CS: Barriers to Seeking Non- Professional Gambling Help: Comparison by Sample. 187 CS: Barriers to Seeking Non- Professional Gambling Help: Comparison by PGSI Group CS: Barriers to Seeking Non- Professional Gambling Help: Amongst the Problem Gamblers CS: Use of Self- Help Gambling Strategies: Combined Sample xiv

16 Figure 9.28: Figure 9.29: Figure 9.30: Figure 9.31: Figure 9.32: Figure 9.33: Figure 9.34: Figure 9.35: Figure 9.36: Figure 9.37: CS: Use of Self- Help Gambling Strategies: Comparison by Sample CS: Use of Self- Help Gambling Strategies: Comparison by PGSI Group CS: Motivations to Use Self- Help Gambling Strategies: Combined Sample CS: Motivators for Using Self- Help Gambling Strategies: Comparison by Sample CS: Motivators for Using Self- Help Gambling Strategies: Comparison by PGSI Group CS: Motivators for Using Self- Help Gambling Strategies: Amongst Problem Gamblers CS: Barriers to Using Self- Help Gambling Strategies: Combined Sample CS: Barriers to Using Self- Help Gambling Strategies: Comparison by Sample CS: Barriers to Using Self- Help Gambling Strategies: Comparison by PGSI Group CS: Barriers to Using Self- Help Gambling Strategies: Amongst Problem Gamblers 204 xv

17 ABSTRACT This study investigated the help- seeking behaviour of gamblers in relation to their awareness and use of professional, non- professional and self- help for gambling- related problems, and associated motivators and barriers. Surveys and interviews were conducted with several samples of gamblers at different stages of change in their decision- making about seeking help for gambling problems. Indigenous and culturally and linguistically diverse (CALD) respondents were also included to examine cultural dimensions of help- seeking behaviour. The study found that there is a remarkably low awareness of professional sources of gambling help; and a low willingness to use these sources before experiencing a severe financial crisis. Players prefer self- help strategies initially to avoid the shame and embarrassment of other treatments, and these self- help strategies are sometimes enough for success. Many of these strategies are financial, such as setting a budget and leaving credit and debit cards at home. Thus, this research suggests that much more work (and research) should be directed at the fat- end of the tail of gambling problems, rather than focusing only on players with severe gambling problems. For people who are already experiencing problems, General Practitioners (GPs) are often a popular first point of contact for professional help, although clients often only admit to a co- morbid condition such as depression. In short, therefore, the research suggests that a different policy focus should be directed to at risk gamblers and problem gamblers, with the former focusing on financial self- help resources and the latter focusing on facilitating access at preferred contact points such as GPs. xvi

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