How Do Service Providers Impact Family Involvement in Problem Gambling Treatment?

Background and Purpose:Research has shown that family involvement in problem gambling (PG) treatment is important because families are significantly impacted and their involvement can improve treatment outcomes for the PG individual and family.  Although the consequences of PG negatively impact the entire family, the treatment of this behavioral addiction continues to have an individual focus (Orford et al., 2013).  Researchers have stated that family focused services are a neglected aspect of addiction treatment (Csiernik, 2002).  There have been limited studies on family involvement in PG treatment and even fewer that examine facilitators and barriers that influence the degree to which families are involved in the treatment of a PG individual.  This qualitative study examined the impact of the services or service providers on family involvement in PG treatment from the perspective of family members and PG individuals.

Methods:In this qualitative study we interviewed 11 dyads consisting of one family member and one PG individual who had received PG treatment services at an addiction treatment center.  The sample had more females (64%) than males (36%).  Most of the sample identified as White (77%), while 23% identified as Middle Eastern, East Asian, South Asian, and Caribbean.  The interviews were semi-structured and focused on the treatment and services received by both members of the dyad and the factors that made the services helpful or unhelpful.  Participants were asked to describe the degree to which family members were involved in services and elements that may have facilitated or acted as a barrier to family involvement.  The qualitative data were analyzed using thematic analysis (Boyatzis, 1998; Braun & Clarke, 2006).  Rigour and trustworthiness were enhanced through prolonged engagement, use of an independent coder, peer debriefing, triangulation of data sources, thick description, and an audit trail.

Findings: Family members and PG individuals described three key themes that were connected to their perceptions of services received at the treatment center: 1) information about PG and PG treatment, 2) feeling supported by clinicians and receiving supportive services, and 3) learning skills to cope with PG.  Families described high, moderate, and low levels of involvement in treatment.  Families with high involvement in PG treatment described receiving ample information, supportive services, and they learned coping skills through the PG services.  For families with moderate levels of involvement there were low to moderate levels of information, moderate levels of supportive services, and only PG individuals stated that they had developed new coping skills.  Families with low involvement described not receiving adequate information, they did not find the services supportive, and they had not developed coping skills in treatment. 

Conclusion and Implications: The results showed that for these families there were facilitators and/or barriers to family involvement in PG treatment that were related to services or service providers.  The findings are consistent with mental health literature on family psychoeducation that highlights the importance of offering information, support and coping skills (“The Big Three”) to all families (Lucksted et al., 2012) to enhance treatment outcomes for the PG individual and family.