Early Disengagement from Gambling Treatment
Insights from Clients and Practitioners
Bibliographic Data
| ID | 24228985 |
|---|---|
| Authors | C O Hawker, N A Dowling, A C Thomas, Stephanie S Merkouris (0000-0001-9037-6121) |
| Year | 2026 |
| Volume | 42 |
| Issue | 3 |
| Pages | 1111-1139 |
| Publication date | 2026-03-03 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Journal of Gambling Studies (JOURNAL) |
| Journal identifiers | ISSN: 1050-5350 • E-ISSN: 1573-3602 |
| Publisher | Springer Science and Business Media LLC (PUBLISHER) |
| DOI | 10.1007/s10899-026-10484-5 |
| PMID | 41776144 |
| OpenAlex | W7133297230 |
| Language | EN |
| References cited | 55 |
Early disengagement may undermine the effectiveness of evidence-based gambling treatment, yet limited research has examined why clients disengage and how services can better support retention. This exploratory mixed-methods study investigated reasons for early disengagement, its potential consequences for clients, and practical strategies to improve retention in real-world gambling services. Data were drawn from a two-timepoint client survey (pre-treatment and one-month follow-up), and a practitioner survey and hui (group discussion), capturing complementary perspectives. Participants were 67 clients ( M age =36.7; 59.7% male; 91.0% with mild-to-extreme gambling symptom severity) and 15 practitioners ( M age =48.3; 20.0% male; 66.7% counsellors) from New Zealand gambling specialist services. Across clients and practitioners, common reasons for early disengagement included logistical barriers, low motivation and external support, co-occurring mental health issues, concern about missing gambling, and gambling-related financial stress. Practitioners also highlighted early goal attainment, non-linear engagement, and systemic barriers. At follow-up, early disengagement was generally associated with making less gains in gambling, psychological, and broader addiction outcomes and greater professional help-seeking for non-gambling issues, compared with clients who completed or remained in treatment. Practitioners noted, however, that even brief engagement can build insight and readiness for future help-seeking. Clients and practitioners identified multi-level strategies to strengthen early retention, centred on relational quality (e.g., empathy, motivational style, peer/group support), proactive contact (e.g., welcome calls, reminders), service flexibility (e.g., multiple delivery formats, after-hours options), and workforce capacity (e.g., culturally responsive training). These findings provide a foundation for future research to evaluate the effectiveness and feasibility of treatment retention strategies in routine care.
client motivation · culturally responsive training · customer perspective · financial stress · gambling addiction · gambling treatment · Help-seeking · Peer support · practitioner perspectives · service flexibility · treatment retention · Gambling Behavior and Treatments · Psychotherapy Techniques and Applications · Substance Abuse Treatment and Outcomes
Anxiety Disorders in Primary Care
Psychometric properties and clinical utility of brief measures of depression, anxiety, and general distress
The role of the therapeutic alliance in the treatment of substance misuse
Whatever happened to qualitative description?
You want to measure coping but your protocol’ too long
The Effect of Compliance-Improving Interventions on the Cognitive-Behavioural Treatment of Pathological Gambling
The Iowa Gambling Treatment Program
Retention in Outpatient Psychological Treatment Services for Gambling
Dropout or Early Treatment Response Among Gamblers with Depressive Symptoms
Keeping clients connected
Person-centred interventions for problem gaming
Development of a culturally attuned psychiatric outcome measure for an indigenous population
The Patient Health Questionnaire-2
Mapping and conceptualizing recovery capital of recovered gamblers
| Highly cited | No |
|---|