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

Lucy Dorey; Darren R Christensen; Richard May; Alice E Hoon; Simon Dymond

doi:10.1186/s12954-022-00600-0

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

Harm Reduct J. 2022 Feb 25;19(1):19. doi: 10.1186/s12954-022-00600-0.

Authors

Lucy Dorey¹, Darren R Christensen^{2

3}, Richard May⁴, Alice E Hoon⁵, Simon Dymond^{6

7}

Affiliations

¹ School of Psychology, Swansea University, Singleton Campus, Swansea, SA2 8PP, UK.
² Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada.
³ University of Melbourne, Parkville, VIC, 3010, Australia.
⁴ School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, CF371DL, UK.
⁵ Swansea University Medical School, Singleton Campus, Swansea, SA2 8PP, UK.
⁶ School of Psychology, Swansea University, Singleton Campus, Swansea, SA2 8PP, UK. s.o.dymond@swansea.ac.uk.
⁷ Department of Psychology, Reykjavík University, Menntavegur 1, Nauthólsvík, 101, Reykjavík, Iceland. s.o.dymond@swansea.ac.uk.

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.

Keywords: Contingency management; Gambling; Qualitative; Thematic analysis; Treatment.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Behavior Therapy
Gambling* / therapy
Humans
Motivation
United Kingdom