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Gambling treatment service providers’ views about contingency management: a thematic analysis

Gambling treatment service providers’ views about contingency management: a thematic analysis
Gambling treatment service providers’ views about contingency management: a thematic analysis
Background: there is a need to improve retention and outcomes for treatment of problem gambling and gambling disorder. Contingency management (CM) is a behavioural intervention involving identification of target behaviours (such as attendance, abstinence, or steps towards recovery) and the provision of incentives (such as vouchers or credits towards the purchase of preferred items) contingent on objective evidence of these behaviours. Contingency management for abstinence and attendance in substance misuse treatment has a substantial evidence base but has not been widely adopted or extended to other addictive behaviours such as gambling. Potential barriers to the widespread adoption of CM may relate to practitioners’ perceptions about this form of incentive-based treatment. The present study sought to explore United Kingdom (UK) gambling treatment providers’ views of CM for treatment of problem gambling and gambling disorder.

Methods: we conducted semi-structured interviews with 30 treatment providers from across the UK working with people with gambling problems. Participants were provided with an explanation of CM, several hypothetical scenarios, and a structured questionnaire to facilitate discussion. Thematic analysis was used to interpret findings.

Results: participants felt there could be a conflict between CM and their treatment philosophies, that CM was similar in some ways to gambling, and that the CM approach could be manipulated and reduce trust between client and therapist. Some participants were more supportive of implementing CM for specific treatment goals than others, such as for incentivising attendance over abstinence due to perceived difficulties in objectively verifying abstinence. Participants favoured providing credits accruing to services relevant to personal recovery rather than voucher-based incentives.

Conclusions: UK gambling treatment providers are somewhat receptive to CM approaches for treatment of problem gambling and gambling disorder. Potential barriers and obstacles are readily addressable, and more research is needed on the efficacy and effectiveness of CM for gambling.
1477-7517
Dorey, Lucy
4503bf78-b9be-47fa-a231-46d35c68a402
Christensen, Darren R.
0dbcf246-8006-47aa-bea3-15709651ed1f
May, Richard
176d13d9-8382-4e27-8cd6-b03d4449e22f
Hoon, Alice E.
60a08b6c-5392-4387-a698-894861ddd961
Dymond, Simon
b4bdf644-edbd-47d1-96a4-bd3fcbe9ef24
Dorey, Lucy
4503bf78-b9be-47fa-a231-46d35c68a402
Christensen, Darren R.
0dbcf246-8006-47aa-bea3-15709651ed1f
May, Richard
176d13d9-8382-4e27-8cd6-b03d4449e22f
Hoon, Alice E.
60a08b6c-5392-4387-a698-894861ddd961
Dymond, Simon
b4bdf644-edbd-47d1-96a4-bd3fcbe9ef24

Dorey, Lucy, Christensen, Darren R., May, Richard, Hoon, Alice E. and Dymond, Simon (2022) Gambling treatment service providers’ views about contingency management: a thematic analysis. Harm Reduction Journal, 19, [19]. (doi:10.1186/s12954-022-00600-0).

Record type: Article

Abstract

Background: there is a need to improve retention and outcomes for treatment of problem gambling and gambling disorder. Contingency management (CM) is a behavioural intervention involving identification of target behaviours (such as attendance, abstinence, or steps towards recovery) and the provision of incentives (such as vouchers or credits towards the purchase of preferred items) contingent on objective evidence of these behaviours. Contingency management for abstinence and attendance in substance misuse treatment has a substantial evidence base but has not been widely adopted or extended to other addictive behaviours such as gambling. Potential barriers to the widespread adoption of CM may relate to practitioners’ perceptions about this form of incentive-based treatment. The present study sought to explore United Kingdom (UK) gambling treatment providers’ views of CM for treatment of problem gambling and gambling disorder.

Methods: we conducted semi-structured interviews with 30 treatment providers from across the UK working with people with gambling problems. Participants were provided with an explanation of CM, several hypothetical scenarios, and a structured questionnaire to facilitate discussion. Thematic analysis was used to interpret findings.

Results: participants felt there could be a conflict between CM and their treatment philosophies, that CM was similar in some ways to gambling, and that the CM approach could be manipulated and reduce trust between client and therapist. Some participants were more supportive of implementing CM for specific treatment goals than others, such as for incentivising attendance over abstinence due to perceived difficulties in objectively verifying abstinence. Participants favoured providing credits accruing to services relevant to personal recovery rather than voucher-based incentives.

Conclusions: UK gambling treatment providers are somewhat receptive to CM approaches for treatment of problem gambling and gambling disorder. Potential barriers and obstacles are readily addressable, and more research is needed on the efficacy and effectiveness of CM for gambling.

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Accepted/In Press date: 14 February 2022
e-pub ahead of print date: 25 February 2022

Identifiers

Local EPrints ID: 486328
URI: http://eprints.soton.ac.uk/id/eprint/486328
ISSN: 1477-7517
PURE UUID: ce926889-30f7-4427-8a11-942968b3def9
ORCID for Lucy Dorey: ORCID iD orcid.org/0000-0002-5580-6592

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Date deposited: 17 Jan 2024 19:46
Last modified: 18 Mar 2024 04:05

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Contributors

Author: Lucy Dorey ORCID iD
Author: Darren R. Christensen
Author: Richard May
Author: Alice E. Hoon
Author: Simon Dymond

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