How does the stigma of problem gambling influence help-seeking, treatment and recovery? A view from the counselling sector

Problem gambling attracts considerable public stigma and can cause significant self-stigma. However, little research has investigated the role of stigma during treatment-assisted recovery from problem gambling. This study aimed to examine gambling counsellors’ perspectives on whether and how the stigma associated with problem gambling influences problem acknowledgement, help-seeking, treatment and recovery. In-depth interviews with nine gambling counsellors from Victoria, Australia, were analysed to extract shared meanings of experiences using interpretative phenomenological analysis. Counsellors indicated that the burden of problem gambling is typically increased by the addition of stigma and its impacts. This stigma is created and maintained by a lack of public understanding about problem gambling and its causes, and internalization of self-stigmatizing beliefs, leading to delayed help-seeking, anxiety about attending treatment, concerns about counsellor attitudes, and fear of relapse. Counsellors maintained that, before effective gambling treatment could occur, they needed to help clients overcome their self-stigmatizing beliefs to establish confidence and trust in the counsellor, restore self-esteem, enhance stigma coping skills and foster a belief that recovery is possible. Harnessing support from significant others and preparing clients for relapse were also important inclusions to lower stigma. Addressing stigma early in treatment can help to improve treatment adherence and recovery.