Priorities for Intervention Content to Support Families and Friends Affected by Gambling Harm: A Mixed Methods Study of Clinician and Researcher Perspectives

Harmful gambling impacts not only the person who gambles but also their partners, families, and friends (affected others; AOs). Although interventions for AOs exist, effectiveness is modest, with little evidence available to guide the selection of intervention content. Behaviour change techniques (BCTs), the active ingredients of behaviour change interventions, provide a framework for identifying and prioritising intervention content for AO interventions. This mixed methods study therefore aimed to: (1) identify BCT groups considered most important by gambling clinicians and clinical gambling researchers for inclusion in interventions that either support the AO's own wellbeing (AO-focused) or support the person who gambles (gambler-focused); and (2) explore gambling clinicians' views on why these BCT groups were prioritised. Gambling clinicians (n = 37) and clinical gambling researchers (n = 19) from multiple countries ranked their top five of 23 BCT groups for inclusion in each intervention type, and a subset of clinicians (n = 15) participated in follow-up interviews. Social support, financial management, and restoring a balanced lifestyle were prioritised across both intervention types, alongside communication training for AO-focused interventions, and goals and planning for gambler-focused interventions. Clinician interviews highlighted rationales for these priorities but also a tendency to reorient AO-focused support around the person who gambles, reflecting uncertainty about who constitutes the primary client in AO interventions, and to view support for AOs and the person who gambles as intertwined. Findings highlight a need for future interventions to make their intended target explicit, and to address AO wellbeing in its own right alongside AOs' their capacity to support the person who gambles.