What does it mean to recover from a gambling disorder? Perspectives of gambling help service users

Background: There is no consensus on how to best define recovery in gambling disorder. This minimizes clinicians' abilities to apply optimal treatment goals and contributes to inconsistency in the use of outcome variables to evaluate interventions. Current understanding of recovery is largely based on professional opinion and theoretical models of gambling disorder. This study aimed to examine core features of recovery identified by service users with lived experiences. Methods: Thematic analysis was applied to qualitative data from 32 face-to-face interviews. Interviewees were at various stages of help-seeking for gambling problems mostly related to electronic gaming machines via self-exclusion and/or specialized gambling counseling. Results: Recovery was perceived by the participants as a continuous process that encompasses periods of improvement and decline. Several key themes of recovery emerged; participants highlighted the importance of developing insight into the psychological and environmental processes that contribute to their gambling problem. Insight helped participants feel empowered to successfully manage their gambling urges and behavior. Recovery extended to building a meaningful life beyond gambling, which involved engagement in alternative activities and fostering strong social relationships. It included stabilization of personal finances and achieving general psychological health and wellbeing. Conclusions: Findings challenge acute symptom-focused models of recovery by broadening the definitional boundaries to include sustained improvements across multiple psychosocial dimensions. Greater emphasis should be given to service user-defined elements of recovery in treatment and research. The long-term perspective of the recovery process has implications for extending standard follow-up assessment intervals in gambling treatment studies.