Understanding how effective interventions are for gambling harm

About the study 

Gambling harms are the adverse impacts of gambling on the health and wellbeing of individuals, families, communities, and society which impact people’s resources, relationships, and health.

GambleAware provided The National Centre for Social Research with funding to conduct a Rapid Evidence Assessment to build understanding around psychological and psychosocial interventions for the treatment of gambling that is associated with harm.

The review aimed to understand the evidence around:

• The effectiveness of a range of interventions including formal, structured psychological interventions and less formal forms of support;
• How the effectiveness of interventions is maintained long-term and for what period;
• Factors which are barriers or enablers to the effectiveness of interventions; and
• The effectiveness of interventions for specific populations.

Findings 

The review found evidence related to a range of treatment and support interventions including formal and structured psychological approaches such as Cognitive Behavioural Therapy (CBT) and less formal interventions, such as peer-led support programs. 

There was evidence that a variety of different interventions were effective. The volume of evidence and the robustness of methods however, varied significantly for each and the largest volume of evidence available was in relation to CBT. Although there was evidence that interventions were effective, most of the evidence identified focused on outcomes related to gambling and gambling-related behaviours rather than broader measures of gambling-related harm such as mental health and wellbeing harm, financial harm, and relationship harm. There was limited evidence regarding how effective interventions are for specific populations or regarding factors relating to individuals. 

Barriers and enablers of interventions, such as different delivery methods and impacts of stigma, varied based on circumstances and for specific groups. Evidence showed therefore, that interventions for gambling associated with harm should be offered in line with individual needs and preferences and with flexibility. 

Although evidence in relation to the effectiveness of interventions was identified, there was limited evidence from Great Britain and therefore, there is a need for further research in this context.

Implications for service delivery 

The report sets out several recommendations for service and healthcare providers:

• Offer evidence-based gambling specific interventions in line with individual needs and preferences;
• Ensure varied options for and flexibility in the delivery of interventions;
• Offer a range of interventions including combined interventions and other approaches to CBT;
• Consider wider social factors to offer holistic support;
• Extend support following interventions with aftercare options;
• Incorporate the views and experiences of those using services in the design and delivery of interventions;
• Ensure 'affected others’ who experience gambling harm also have access to effective, evidence-based interventions; and
• Ensure that treatment and support is comprehensive and coordinated by linking with other appropriate services.

Methodology 

This research used a rapid evidence assessment (REA) methodology. This allowed a review of the available evidence in an efficient way whilst ensuring effective data collation, review, synthesis, and appraisal of evidence. Academic and grey literature sources were included. The papers identified were screened using the title and abstract and full text.

To synthesise the evidence, a data extraction tool was developed. This was designed to capture key findings which were relevant to the research questions including the effectiveness of the interventions included, any evidence relating to the effectiveness for specific populations or groups, and factors which were barriers or enablers to the effectiveness. This also captured any use of stigmatising language used.

The research included input from lived experience and subject matter experts, who had expertise which included their own experiences of gambling harms, academic expertise, gambling harms expertise, and clinical expertise. Their input included reviewing the list of papers included in the review (including identifying any missing evidence), and reviewing the project outputs.