Evaluation of Residential Rehabilitation Services for Gambling Disorder with Complex and Co-morbid Presentation

1. Overview

Adferiad Recovery has been commissioned by GambleAware to provide residential rehabilitation for adults presenting with gambling disorder and complexities, including, but not limited to co-morbid alcohol and/or substance use disorder. The service is delivered in partnership with Gordon Moody, a Midlands-based organisation that provides treatment for those whose lives have been severely affected by gambling addiction.

Informed by the needs of those with lived experience throughout the service design process, the two organisations have developed a common assessment framework, robust clinical governance and safeguarding measures to underpin the delivery of the plan. The model allows individuals to direct their own treatment and proceed at their own pace, recognising that recovery is not linear. Service users, along with their families and loved ones, are actively involved in the care planning process, creating a system that is person-centred, goal-orientated and strengths-based.

Though tailored to the individual, the treatment broadly encompasses the following:

• Medically managed detoxification
• Acute mental health support/rehabilitation
• Residential rehabilitation for gambling

As an innovative service, it is crucial that an evaluation of the Residential Rehabilitation service takes place to understand what works and what can be improved to ensure it has the maximum positive impact.

2. The Evaluation

The primary purpose of this evaluation piece is to provide a comprehensive assessment of the effectiveness of the Residential Rehabilitation service. This is to be achieved through process evaluation, looking specifically at the different pathways into and out of the service and the service user experience. In addition, an impact evaluation will take place to generate learning around the impact of the service on groups with different demographic factors (i.e., ethnicity, gender and sexuality), health status, adverse life experiences, substance use and socioeconomic position.

GambleAware is also particularly interested in insight concerning the perceptions and experiences of stigmatisation throughout the service and how this differs by intersectional stigmatised identity. A recent scoping study commissioned by GambleAware[1] found that stigma was a barrier to help-seeking amongst people who struggle with gambling.

This evaluation will develop new insight and capture learning around what works well and less well – for whom and how.

3. Methods

The evaluation will take a realist evaluation approach, a theory-based approach which will respond to the individual reality experienced by people subject to an intervention. Primary qualitative data collection in the form of longitudinal case studies and depth interviews will take place, alongside the collection of secondary, monitoring and project data.

[1] Building Knowledge of Stigma Related to Gambling and Gambling Harms in Great Britain (2022) available online at https://www.gambleaware.org/sites/default/files/2022-07/GambleAware%20Stigma%20Final.pdf