Introduction
Features and Foundation Principles of Self-exclusion Programs
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for nominated venues, they agree not to enter gaming areas, not to play gaming machines or not to enter the venue at all
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authorising staff to stop them from entering or remaining in a gaming area or venue that they are excluded from
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authorising for photographs and personal details to be taken and disseminated to relevant venues and for venues to display the photographs
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waiving the right to sue nominated venues, their staff or the program administrator on the grounds of assault, defamation or failing in a duty of care to exclude
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accept their personal responsibility to stay away
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acknowledge that nominated venues or their staff have no legal duty implied by the self-exclusion deed.
Literature Review: The Effectiveness of Current Self-exclusion Programs
Study | Target population | N (% male) | Mean age (years) | Outcome measures | Main effects | Comments |
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Ladouceur et al. (2000) | Self-excluders from a Quebec casino | 220 (62 %) | 41 | Survey of characteristics, SOGS, gambling habits and experience with SE | 95 % of participants PG 74 % decided to use SE on own initiative 94 % with no prior experience had positive opinion 80 % with prior experience had positive opinion 97 % felt they would be successful in staying away Prior experience with SE (n = 53): 36 % returned to casino 50 % gambled on other games 30 % stopped gambling once enrolled | Prior to SE: 83 % wanted to stop but were unable to 10 % had met with a psychologist about PG |
Schrans et al. (2004) | Gaming venue employees in Nova Scotia | 150 | Observation of program policy compliance for test venues with confederate self-excluders | Gaming venue staff were unable to accurately detect self-exclusion breaches 58 % of breach reports were “false negatives” 77 % of breaches were not detected | Evaluation of program test in small area No evaluation of real self-excluders | |
Croucher et al. (2006) | Self-excluders in New South Wales (Australia) | 135 (64 %) | Mostly aged 30–60 | Survey to evaluate efficacy of self-exclusion and characteristics of self-excluders | Large majority strongly supported self-exclusion program 70 % of participants reduced gambling expenditure by half 75 % started gambling within 6 months of agreement 67 % of those who breached agreements were identified | Small sample size |
Nower and Blaszczynski (2006) | Self-excluders from Missouri casinos | 2670 (51 %) | Males 27 (SD = 11) Females 34 (SD = 12) | Characteristics of self-excluders obtained from roster Demographic questionnaire | Self-excluders most likely to play EGMs Females more likely to be older and not working, and have shorter period between gambling onset and self-exclusion | No contact or reports from self-excluders |
Townshend (2007) | Self-excluders in New Zealand | 35 (60 %) | 18–73 years | Survey of self-excluded gamblers following treatment | Sig. reduction in problem gambling severity Improved control over gambling 76 % abstinent from gambling | Small, non-representative sample Results combined with treatment effect |
Ladouceur et al. (2007) | Self-excluders from 3 Quebec casinos | 161 (60 %) | 44 (SD = 12) | Telephone interview of 6, 12, 18 and 24-months | 73.1 % of participants PG 63 % believed SE would be effective At FU urge to gamble was sig reduced in first 6-months, perception control sig. increased PG reduced At 6-month FU 22–40 % had breached, 12-months 10–27 % and 18-month 27 % Some patrons were not identified when they breached contract | High drop-out rates |
Tremblay et al. (2008) | Self-excluders from a Montreal casino | 116 (68 %) | 47 (SD = 15) | Survey of satisfaction and perceptions of mandatory meetings for SE | 75 % wanted SE program that included a meeting but only 37 % of these attended meeting 70 % came to meeting required to end SE General positive evaluation of program Program completers had sig reduced time and money spent gambling and negative consequences of gambling, PG, anxiety and depression sig. reduced | |
Responsible Gambling Council (2008) | Individuals with self-exclusion experience in 7 Canadian provinces | 76 (47 %) | 52 | Survey of demographic information and gambling behaviour | Gambling behaviour reduced following self-exclusion and 30 % of participants did not gamble at all during ban 33 % of participants breached their bans and 70 % of these were undetected 59 % of participants gambled at venues not covered by agreements during bans | Non-representative sample |
Nower and Blaszczynski (2008) | Self-excluders from Missouri casinos | 1,601 (50 %) | 41 | Characteristics of self-excluders obtained from roster Demographic questionnaire | Older adult self-excluders began gambling later in life, experienced problems around age 60, preferred nonstrategic gamblers and self-excluded to prevent suicide | Use of categorical variables and few screening tools |
Nelson et al. (2010) | Self-excluders from Missouri casinos | 113 (45 %) | 501 (SD = 10) | Telephone interview of characteristics, questions about gambling, substance use, treatment and functioning, and SOGS | Most had positive experiences, reduced gambling and gambling problems 50 % of participants who attempted to breach were able to do so Participants who enrolled in treatment had more positive outcomes than those who did not | Followed participants for as long as 10 years |
Hayer and Meyer (2011a) | Self-excluders from European casinos | 154 (72 %) | 41 | Survey of demographic information, gambling behaviour and thoughts on SE at baseline, 1,6, and 12 months after SE | SE is used as a harm-minimisation tool SE was associated with a reduction in gambling behaviour, problem gambling severity and increase in psycho-social functioning | Small number of participants in follow-ups |
Hayer and Meyer (2011a) | Self-excluders from an Internet gambling site | 178 (69 %) | 36 | Survey of demographic information, gambling behaviour and thoughts on self-exclusion at baseline, 1,6, and 12 months after SE | Majority of SE orders are related to problem gambling, although others exclude due to prevention and annoyance Preliminary evidence supports favourable outcomes of self-exclusion SE is related to a decrease in the level of willingness to stop gambling online | Small number of participants in follow-ups |
Hing et al. (2011) | Regular gamblers recruited via telephone, in venues, telephone helpline and in treatment | 730 (55 %) | 63 % over 45 years | Survey of demographic information, gambling behaviour, awareness, preferences, motivators, barriers and use of help-resources, and PGSI | Low awareness of SE as a help resource Problem gamblers were more aware of SE | Non representative sample |
Abbott et al. (2011) | Self-excluders from hotels and clubs interviewed via telephone | 60 (34 %) | 53 | Interview about motivators and barriers for SE and experience with the SE program | Majority were comfortable joining SE program Participants motivated by distress, crisis, and loss of control, but admitting they need help sig. barrier | Small, non-representative sample |
Quebec
Nova Scotia
Canada
Missouri
Australia
New Zealand
Europe
Discussion
Recommended Elements of Self-exclusion
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Clear information about self-exclusion programs and promotion of programs to increase utilisation. Promotion should include venue-based strategies as well as information provided in the general community and through health and mental health centres, legal offices, and other relevant support services. Relevant professional should all be informed about the program so that they may refer clients as appropriate.
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To maximise the uptake of self-exclusion agreements, individuals should be able to enact self-exclusion agreements directly at gaming venues and also when off-site. The registration process should be conducted in a respectful manner, in a private setting and should be relatively quick and easy. If registration is perceived to be too difficult or complex, this may act as a barrier to self-exclusion. Self-exclusion agreements should be able to be enacted with treatment providers, counsellors or other suitable health and legal professionals. Self-exclusion agreements may also be initiated by individuals using Internet-based protocols that include webcams for photograph identification, by visiting suitable government agencies or mailing in applications and photographs.
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Programs must offer a range of time periods for exclusion. There is a lack of empirical evidence to suggest what length of ban is most effective in assisting individuals to control their gambling. Although longer bans may be more effective in providing individuals with the time needed to overcome their gambling-related problems, these may deter some individuals from registering for programs. It is suggested that self-exclusion agreements be a minimum of 6 months to allow individuals sufficient time to enter treatment if desired or deal with their gambling problems.
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Operators must remove all self-excluded persons from the mailing list and stop offering incentives during the period of self-exclusion. Individuals must not be reinstated on any mailing lists even after their self-exclusion period has expired unless they have specifically applied and been approved to re-enter the venue.
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Resources must be provided to assist self-excluded persons take further steps to control their gambling including appropriate information and education resources as well as referrals to formal counselling, treatment or self-help programs. Not all people seeking self-exclusion want or are receptive to professional help (Ladouceur et al. 2000, 2007; Tremblay et al. 2008). Hence, mandatory counselling may not be effective and may deter some individuals from entering into self-exclusion agreements. Internet-based treatment and self-help interventions may be particularly useful for those who would benefit from formal help, but are unwilling or unable to attend in-person sessions (Gainsbury and Blaszczynski 2011a, b).
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Operators must take active steps to identify and remove self-excluded persons who return to gaming facilities. It is reasonable to require that all patrons must show appropriate identification before they are admitted to gaming venues to prevent breaches. This would enable computerised identification checks for enforcement of self-exclusion. Checking identification has become part of standard practices for many businesses (e.g., buying alcohol, boarding planes), is accounted for in customer and queue management and is accepted by consumers.
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A reinstatement process should occur before the self-excluded individual is permitted re-entry into gaming facilities. When the finishing date of their ban is approaching, self-excluded individuals should be contacted with appropriate information and details should be provided of what is required to reinstate entry. A re-entry session may be held and run by an external organisation to avoid self-excluders having to visit gaming venues. Alternatively, individuals should be able to extend their ban for a renewed time period and have a new photograph taken to ensure that it is current. Again, this process should be provided away from gaming venues to avoid triggering gambling behaviour and referrals should be provided for treatment services.
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Operators must have an effective training program for all staff who have a role in enforcing the self-exclusion program, including refresher training. The training program should include how to identify individuals who may have a gambling problem and how to adhere to all components of the self-exclusion program.
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Self-exclusion programs should be monitored and evaluated to ensure programs are effective, have no unintended harmful consequences and are conducted in compliance with the required processes. The limitations of the current literature and few evaluative studies conducted highlight the need to develop a systematic process for the evaluation of self-exclusion programs. A transparent system of monitoring and auditing a self-exclusion program would reduce any perceived conflict of interest by operators and clearly demonstrating a programs’ effectiveness may increase utilisation.