Research has not fully explored factors that influence types of help used from the suite of available options once problem gamblers reach an action stage of change. This study aimed to explore critical factors influencing choice of help (or interventions) once people have decided to address their gambling problem. Particular emphasis was on counselling and self-exclusion, given their demonstrable effectiveness for most users. Interviews were conducted with 103 problem gamblers taking action to address their gambling problem. Inductive analysis revealed nine critical influences on type(s) of help chosen, presented as a grounded theory model. Independent variables were goals of taking up the intervention, problem gambling severity, and level of independence/pride. Six mediating variables helped to explain relationships between the independent variables and choice of intervention. Understanding key influences on choice of gambling help can illuminate how to encourage further uptake and better align interventions with gamblers' preferences, to reduce barriers to help-seeking.

This study assessed the effectiveness of Queensland gambling exclusion programs as a mechanism to minimise gambling-related harm, whether these effects are sustained over time and whether self exclusion is more effective when combined with counselling and support. Research methods comprised a literature review, desktop review of Australian and international exclusion programs, interviews with peak gambling industry associations, interviews with 18 Queensland Gambling Help counsellors, and interviews and surveys with 103 problem gamblers at three assessment periods approximately six months apart. In contrast to recent international trends, Australian self-exclusion programs including those in Queensland are typically venue-administered, require on-site exclusion from individual venues, do not enable exclusion from multiple venues in one application, rely on photographs for detection, impose penalties for excluders for breaches and for venues that fail to detect breaches, and provide comparatively minimal connections to counselling.

This paper draws on a process evaluation of Queensland' self-exclusion program to examine how people use the program, motivations for self-excluding, barriers to use, experiences and perceptions of program elements, and potential improvements. Detailed, reflective, first-person accounts were gathered through interviews with 103 problem gamblers, including excluders and non-excluders. Identified strengths include the program's widespread availability. Many self-excluders reported positive experiences with responsive, knowledgeable, respectful venue staff. Major weaknesses include low publicity, limited privacy and confidentiality, the need to exclude individually from venues, and deficiencies in venue monitoring for breaches, which hinder the program's capacity to meet harm minimisation objectives. While the program reaches some problem gamblers, others are delayed or deterred from self-excluding by low awareness, shame and embarrassment, difficulties of excluding from multiple venues, and low confidence in venue staff to maintain confidentiality and provide effective monitoring. Potential improvements include wider publicity, off-site multi-venue exclusion, and technology-assisted monitoring.