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Exclusion is an Effective Treatment Tool

Exclusion is acknowledged in the international research as an effective treatment tool. It is also noted however, that the current exclusion systems have significant limitations due to:

• The difficulty gambling venue staff have in identifying excluded persons; and

• The need for the exclusion system to cover a large number of venues in order to prevent the excluded person from gambling at an alternative nearby venue.

In New Zealand, the difficulty venue staff have with identifying excluded persons has been addressed by encouraging people who want to exclude, to exclude only for a short period of time (three to six months) and only at a small number of venues. This reduces the number of excluded persons at each venue and attempts to make the system more manageable and enforceable.

The Problem Gambling Foundation of New Zealand's Fact Sheet 06 on Self-exclusion records that exclusion is an effective tool but notes that it should be reserved for only high risk clients for administrative reasons. The fact sheet states:

Initial results from NZ research suggests that this option [self-exclusion] is an effective treatment tool for people with gambling issues. However care needs to be taken that it is used for the right clients so that the system isn't overloaded.

To be effective it is important that venues don't have too many people to monitor. Thus self banning should not be a first choice treatment option. It is indicated for complicated clients such as those with a history of head injury, coexisting mental health disorders such as schizophrenia, substance abuse disorders, depression or mania, and clients receiving medication for Parkinson's disease.

In the 2007 study by Dr Philip Townshend, Self-Exclusion in a Public Health Environment: An Effective Treatment Option in New Zealand. International Journal of Mental Health Addiction. 5 (4): 390-395,

In 2007 Dr Philip Townshend undertook a study the effectiveness of self-exclusion as a treatment option in New Zealand. The outcome of the study is reported in Dr Philip Townshend's paper in the International Journal of Mental Health Addiction, 5 (4): 390-395, Self-Exclusion in a Public Health Environment: An Effective Treatment Option in New Zealand. The study found that self-exclusion is an effective treatment tool and was more effective in New Zealand than has been reported in other jurisdictions. Dr Townshend's paper noted:

The findings suggest that self-exclusion is an effective treatment tool for the group of clients who have extreme difficulty controlling their gambling in other ways, and may be more effective in the public health gambling environment.

(page 1) …

The public health approach to gambling and problem gambling are defined in legislation and reflected in all aspects of the management and treatment of problem gamblers in New Zealand. This approach has led to a product safety approach to self-exclusion which places some of the responsibility for problem gambling and the effectiveness of self-banning on gambling venues.

Initial results from a small scale study give rise to optimism that in a public health environment that self-exclusion may be more effective than has been reported in other jurisdictions.

(pages 6 and 7)

Dr Townshend's paper also reviewed some of the prior international studies and summarised the positive findings as follows:

Using Lesieur, Blume's SOGS screening tool (1987), Ladouceur et al (2000) examined 227 casino self-excluded gamblers and reported that 95% were probable pathological gamblers with a SOGS measurement of 5 or more. They reported that for this very problematic group of gamblers self banning was an effective treatment strategy, with 30% of gamblers reporting total abstinence for the duration of their self-exclusion period. They also noted that only 10% of their sample had used professional helping services and yet achieved a higher result than was reported in a contrasting study by Stewart, Brown (1988) where 8% of clients were abstinent after one year of attending Gamblers Anonymous meetings.

These results led Ladouceur to conclude that self-exclusion was a useful tertiary treatment tool that could be enhanced by promotion and better enforcement by gambling venues. A conclusion supported by the Australian Productivity Commission (1999) who suggest that "overall self-exclusion is a useful adjunct to responsible gambling policies" (p.16.67).

Both the value of self-exclusion and the observation from gamblers and gambling venues that it could be enhanced by better enforcement was noted in a report prepared by the South Australia Centre for Economic Studies (2003). This suggests that problem gamblers who used self-exclusion found it to be a useful self initiated treatment tool to "reduce the harmful effects that problem gambling can have on the individual and the community" (p.7). These authors also noted that self-exclusion derives its effectiveness from the integrity (either actual or perceived) of enforcement.

In 2010, the Auckland University of Technology's Gambling and Addictions Research Centre prepared a report titled Formative Investigation into the Effectiveness of Gambling Venue Exclusion Processes in New Zealand. The AUT Report confirmed the value of exclusion as an intervention tool but again noted that several areas (particularly detection and enforcement methods) required improvement. The AUT Report stated:

Exclusion of patrons from gambling venues is potentially an effective early intervention for minimising harm from excessive gambling since it may contribute to the treatment and/or recovery of people with developing and established gambling problems.

(page 4) …

Over and above the question areas already discussed, survey participants were asked how their gambling had changed since signing their exclusion contract. Several positive impacts were reported including gambling less in terms of time and expenditure, quitting gambling, and attending (or recently attending) a gambling treatment service. Other positive effects were that taking out exclusion contracts was associated with a sense of relief for some people and a first supporting step until they could access counselling. On the whole, survey participants viewed the process of excluding to be positive in terms of venue staff approach and behaviour. In particular, participants appreciated feeling supported and encouraged by venue staff once they had decided to exclude.

Thus, overall there appear to be many positive and beneficial aspects to the current exclusion processes indicating that the fundamental concept is sound and the current processes in place have a good foundation. However, the study found several areas where improvement to the processes would be beneficial, with suggestions originating from key stakeholders as well as survey participants.

(page 75)