What makes people with gambling disorder undergo treatment? Patient and professional perspectives.

Aims: The aim of the article is to identify factors which bring people with gambling disorder to undergo treatment. We are interested in exploring motives that trigger change; identifying factors determining choice of facility; recognising barriers and facilitators appearing during treatment.

Design: Semi-structured interviews were conducted in Poland with people with gambling disorder, as well as with social workers, therapists, General Practitioners (GP) and psychiatrists. Purposive sampling was applied in selecting respondents. In total, 90 interviews were completed.

Results: Internal and external motives that trigger change were identified. Among the internal motives were individuals' own reflections often combined with a sense of guilt, and among the external motives, pressure from significant others, financial problems, law problems and somatic and mental problems. The choice of facility was made by those suffering from gambling disorder or by close family members. Factors which influenced the choice of clinics were availability (distance to the facility, sessions schedule), quality of infrastructure, assured anonymity, opinions on provided assistance, the renown of such a facility, apparent experience in treatment of gambling disorder, and the context behind the problems experienced. Individual (related to emotions and convictions,) and structural barriers (related to the treatment offer, infrastructure, personnel, and therapy programme) were identified along with the facilitators in the access to treatment.

Conclusions: The identification of circumstances and determinants may contribute to improvements in the availability and quality of assistance provided, which could result in an increase in the percentage of patients undertaking treatment. There is a need for education aimed at increasing awareness of the problem and the possibilities of assistance as GPs and social workers very rarely recognise gambling disorder among their clients.