(Based on NICE Guideline NG248)

1. Identifying Gambling-Related Harms

• Routine Screening: Ask about gambling when discussing smoking, alcohol, or substance use, especially during general health checks or service registrations.
• Targeted Screening: Ask patients at higher risk, including those with:
  • Mental health conditions (e.g., depression, anxiety, PTSD, ADHD)
  • Substance use issues (especially alcohol or cocaine)
  • Medications affecting impulse control (e.g., dopamine agonists, aripiprazole)
  • Financial concerns, homelessness, or involvement in the criminal justice system
  • Family history of gambling issues

2. Initial Support & Referral

• Encouragement & Normalization: Acknowledge that gambling-related harms are common and recovery is possible.
• Motivational Interviewing: Use brief motivational interventions to encourage individuals reluctant to seek help.
• Immediate Referral: Provide information on available support services (e.g., NHS gambling support, helplines, and peer support groups).
• Suicide Risk Assessment: Recognize gambling as a major risk factor for suicidal thoughts and take urgent action if necessary.

3. Treatment and Intervention Strategies

• Self-Exclusion & Financial Controls: Advise patients on practical steps like:
  • Blocking gambling websites and marketing messages
  • Self-exclusion programs for betting venues
  • Setting bank restrictions on gambling transactions
  • Seeking financial advice for debt management
• Psychological Interventions:
  • Cognitive Behavioral Therapy (CBT): Offer group or individual CBT for gambling disorder.
  • Peer Support: Encourage participation in peer support groups.
  • Relapse Prevention: Educate on identifying triggers, using self-control techniques, and planning for lapses.
• Pharmacological Treatment: Consider naltrexone if psychological interventions alone are ineffective.

4. Support for Families and Affected Others

• Providing Guidance: Educate families on supporting their loved one while protecting their own well-being.
• Emotional & Practical Support: Offer family members access to counseling and financial assistance services.

Implementing These Strategies During Consultations

• Adopt a Non-Judgmental Approach: Acknowledge stigma and encourage open discussions about gambling habits.
• Use Direct, Simple Questions: Ask, “Do you gamble?” or “Are you worried about your own or someone else’s gambling?”
• Offer Immediate, Actionable Advice: Provide patients with self-help tools, helpline numbers, and treatment options.
• Personalize Care Plans: Tailor interventions based on the severity of gambling-related harms and co-existing mental health conditions.
• Follow-Up & Relapse Prevention: Schedule follow-ups to check progress, reinforce strategies, and address any setbacks.