A Sequential Mixed-Method Exploration of Problem Gamblers' Trajectories During and After Self-Exclusion

Abstract

Self-exclusion programs assist individuals in regaining control of their problematic gambling by preventing access to gaming venues for a specified length of time. Despite the widespread availability of these programs, little is known about the ban-length that is most likely to reduce problem gambling and promote abstinence. Currently, self-exclusion programs offer ban-lengths with no empirical evidence indicating their effectiveness. Additionally, little is known about the trajectories during and after program enrollment. To address this gap in knowledge, the purpose of this sequential mixed-method dissertation was to investigate the association between self-exclusion ban-length and program compliance. This research applied a life course perspective to extend the Pathways Model to explore problem gambling trajectories during and after enrollment in a self-exclusion program. First, to systematically identify and synthesize the existing research on ban-lengths and program outcomes, a scoping review was conducted. Results from the 16 included sources revealed that researchers, clinicians, industry, and problem gamblers recommended ban-lengths ranging from six-months to five years, and indefinite bans. However, these recommendations were anecdotal as they lacked empirical support. Second, a quantitative evaluation of a Canadian provincial self-exclusion program (n = 10,976) employed Event History Analysis to conduct time-to-violation (i.e., days remained compliant) analyses, and determine the influence of gender, age, and self-exclusion ban-length on violations. Although older age was associated with higher compliance rates, gender was a non-significant predictor. Self-excluders enrolled in the indefinite ban were the least likely to violate, and if they did, it occurred after a longer period of compliance compared to shorter bans. Third, a cross-sectional qualitative study was conducted with 20 people enrolled in an Australian self-exclusion program. Ban-length selection was based on wanting a temporary break from gambling, or a permanent solution for tackling their problem gambling. Compliance typically occurred out of fear of being caught in a banned venue, and the desire to have a life that did not revolve around gambling. Participants experienced three different trajectories during self-exclusion: full compliance, compliance with the agreement but gambled elsewhere, or non-compliance. After the conclusion of the self-exclusion ban participants either re-entered self-exclusion immediately, returned to gambling briefly and then renewed, or returned to gambling without foreseeably planning to re-enter self-exclusion. The findings of this research increase our understanding problem gambling trajectories during and after self-exclusion program participation and can be used to improve existing policies and practice for reducing problem gambling. Limitations, future research, and implications for policy and practice are discussed.