Trigger warning: This article mentions suicide. If you, or someone you know, needs immediate support, contact Lifeline on 13 11 14.
Article summary:
- Widespread gambling affects 38% of Australians, with significant social and financial costs.
- Men aged 18-34 are most vulnerable, and gambling addiction often coexists with mental health issues like anxiety and depression.
- Techniques like Motivational Interviewing (MI) and Cognitive Behavioural Therapy (CBT) help clients understand and manage their gambling behaviours.
- Psychologists should collaborate with financial counsellors and create a non-judgmental environment for effective long-term recovery.
- APS has been funded by the NSW Office of Responsible Gambling to develop resources for psychologists on gambling-related harm. If you have expertise in gambling support and prevention, we invite you to join a co-design group which will inform resource development.
Gambling has long been woven into the fabric of Australian culture. In fact, a recent BBC article described Australians as the world's biggest gamblers, with the country home to a staggering one-fifth of all electronic gaming machines (EGMs) globally.
Historically, a key driver of this was Australia's decision in the 1980s to deregulate the gambling industry. This shift allowed slot machines, once confined to casinos, to be easily accessed in pubs and clubs across densely populated areas.
Today, research suggests that 38% of Australians engage in gambling weekly, contributing to $2.5 billion spent on legal gambling annually. The Australian Institute of Health and Welfare estimates the social cost of gambling – encompassing financial, emotional, psychological and productivity losses – amounts to $7 billion in Victoria alone.
"There is a proportion of our society that is vulnerable to the financial and psychological impacts of problem gambling," says APS President Dr Catriona Davis-McCabe.
"This vulnerability extends beyond just the individuals who gamble. As psychologists, it's critical we understand the scope of this issue – not only the direct impact on the gambler but also the emotional and financial toll it takes on those around them."
Understanding gender and age risk factors
Differences in gambling risk levels are evident across gender and age groups.
For example, a greater proportion of men (53%) are at risk compared to women (38%). The 18-34 age group, in particular, shows a concerning trend, with 71% of men and a significant number of women in this cohort being at risk.
One of the most widely used tools for measuring gambling harm is the Problem Gambling Severity Index (PGSI).
This tool consists of nine questions that assess a person's gambling behaviour over the past 12 months. Scores range from 0 to 27, grouping individuals into four categories: non-risk, low-risk, moderate-risk and problem/high-risk gamblers. A score of one or more indicates that the individual is at risk for gambling-related harm.
Research from 2022 found that nearly half (46%) of Australians are at risk or already experiencing gambling harm of some sort.
However, Dr Davis-McCabe emphasises the importance of looking beyond this tool.
"While the PGSI is a valuable measure, it's essential for psychologists to consider other psychosocial factors that may contribute to gambling behaviour. The PGSI alone doesn’t always capture the full picture."
Whitehead adds that the PGSI also often faces criticism for failing to pick up moderate levels of gambling and their impact.
There are also myriad underlying mental health challenges that arise alongside gambling issues.
For example, gambling addiction rarely exists in isolation. A study, cited in the Sydney Morning Herald, conducted by The Alfred Hospital in 2010 found that 17% of people presenting with suicidal ideation were identified as "problem gamblers".
Additionally, separate research suggests that around 40% of individuals with gambling problems also experience anxiety and/or depression.
"Then there are also sometimes substance abuse challenges that clients are facing too," says Dr Davis-McCabe.
“Psychologists should make it a point to include specific questions about gambling during intake, even if the client doesn’t initially present with gambling concerns. Asking, ‘Have you ever had difficulty controlling your spending on gambling?’ can reveal a lot and help uncover hidden issues that might otherwise go unnoticed.”
Recognising when a client is struggling with gambling addiction can be challenging. Jordan Whitehead MAPS, a registered psychologist with over 15 years' experience treating addiction, shares some key signs psychologists can look for.
"Changes in mood are often a strong indicator – extreme highs or lows, withdrawal, or distraction. Deceptive behaviours, like hiding financial statements or lying about their whereabouts, are also common.
"We often get calls from partners who initially thought their spouse was having an affair due to secretive behaviour, only to discover a gambling problem."
The rise of gambling advertising and online platforms
Whitehead has seen a demographic shift in gamblers over the years.
"When I first started working in this space, most of the clients were women struggling with EGM addictions. Now, I'm seeing more young men grappling with online sports gambling and even cryptocurrency," says Whitehead.
She believes that deregulation of gambling advertising has exacerbated the issue.
"Once they deregulated gambling advertising, allowing companies to advertise freely, things got worse," she explains.
While a 2023 government committee report into problem gambling, of which APS was a prominent voice in shaping, suggested a total ban on gambling advertising, lobbying efforts from groups with a vested interest, such as media and sporting groups, have led the government to instead consider softer measures, such as reducing the frequency of ads during family-friendly programming.
“More needs to be done to protect vulnerable Australians from harm and to reduce instances of problem gambling for future generations,” says Dr Davis-McCabe.
Tailoring therapeutic techniques to the client
"Supporting clients through gambling addiction requires a multifaceted approach, combining psychological support with practical, financial and social interventions," says Dr Davis-McCabe.
“One of the most important things psychologists can do is create a non-judgmental, supportive space where clients feel safe to discuss their gambling behaviour. Many people experiencing gambling harm feel a deep sense of shame, so building trust is essential in helping them open up.”
The therapeutic approach to gambling addiction varies depending on the stage of the client's addiction. For clients in the early stages, education and prevention are key.
Whitehead recommends a compassionate approach.
"I'd say something like, 'It sounds like you've given yourself a scare, and I’m glad you're seeking help before things spiral out of control.' The focus should be on encouragement and motivation."
For long-term gamblers who may have relapsed, the focus shifts to managing hopelessness and reframing the situation.
"I’ll often say, 'Let’s treat this as a learning experience and put steps in place to prevent it from happening again.'"
To support clients with those critical behavioural changes, Whitehead frequently uses Motivational Interviewing (MI) to guide clients through their ambivalence about change.
"MI helps clients explore where they are in the change process and consider the consequences of not changing. It's a gentle way to encourage self-reflection without overwhelming them."
Dr Davis-McCabe says, "Rather than pushing for immediate results, MI helps to guide them to reflect on the impact of their behaviour and what they want their future to look like. This method helps them take ownership of their decisions, which is vital for long-term recovery.”
Cognitive behavioural therapy (CBT) is another useful tool for addressing irrational beliefs around gambling, says Whitehead.
"CBT helps challenge distorted thinking, like maximising wins and minimising losses, or relying on superstitions, like tapping a machine for luck."
For clients not ready to quit entirely, harm minimisation strategies, such as setting limits on gambling time and money, can be effective.
"I often suggest clients take small steps, like reducing their gambling gradually. This can make the process less intimidating," says Whitehead.
A key part of supporting clients with gambling addiction is connecting them with financial counsellors.
"Many clients are in severe financial trouble, so it's important to bring in professionals who can help with debt management and payment plans," says Whitehead.
Financial counsellors can negotiate with creditors on behalf of clients, such as requesting moratoriums on debt or advocating with banks for better terms.
"It’s vital for psychologists to know when to refer clients to these services. We can’t handle that level of financial complexity ourselves."
Dr Davis-McCabe agrees, stating: “It’s essential for psychologists to collaborate with financial counsellors and other professionals. Clients dealing with gambling addiction often face serious financial problems, and we need to ensure they have access to expert advice on debt management and financial recovery.”
Supporting clients through gambling addiction is not just about addressing the behavioural aspects of gambling; it involves understanding the complex interplay of psychological, social and financial factors.
"This is why early intervention and a multidisciplinary approach are essential in addressing the full range of consequences that come with problem gambling."
Useful resources