Socio-demographic characteristics of participants
The 63 participants were predominately female (87%), with 30% aged under 30 years, 30% aged between 30 and 39 years, 27% aged between 40 and 49 years, and only 13% aged over 50 years. Participants were most often intimate partners (70%), with smaller numbers of children (13%), friends (6%), parents (5%) and other relatives (6%). Participants represented all states across Australia, and most often identified as Australian ethnicity (78%), followed by Asian (8%), European (6%), Oceania (5%) and African (3%). They most often reported family member engagement in non-strategic forms of gambling (such as electronic gaming machines, lotteries, bingo and Keno; 59%) than strategic forms of gambling (i.e., wagering, casino gambling, sports betting; 41%). Almost 55% of participants stated the gamblers’ preference was to gamble in a venue, and only 5% reported the preferred method was to gamble via the internet. The remaining participants (40%) were unable to identify the preferred method.
Almost three-quarters of participants (74%) were speaking with a professional for the first time about the gambling problem, with 16% previously receiving counselling and 10% currently seeking other forms of treatment for the gambling problem. Those who previously sought help for the gambling problem had accessed face-to-face (56%) and telephone (44%) counselling. Most real-time chat sessions occurred outside traditional business hours, including evenings and weekends (68%). Most participants (91%) indicated that they would recommend web-based counselling to someone concerned about a gambling issue.
To determine the representativeness of the current sample, participants’ demographics were compared with the total population of 366 family and friends who completed a real-time chat counselling session with Gambling Help Online between December 2010 and September 2012. Chi-square analysis indicated that there were significantly fewer participants under 30 (χ2 (1) = 8.66, P = .004), significantly more participants aged 40 to 50 years (χ2 (1) = 8.02, P = .007), and significantly fewer people identifying as Australian compared with the total population (χ2 (1) = 6.10, P = .14). In addition, significantly more participants did not know the preferred method of gambling (χ2 (1) = 4.55, P = .036). There were no significant differences between groups in terms of gender, type of gambling, treatment seeking status, or time of contact.
Reasons for choosing web-based counselling
Ease of access
The most widely reported reason for using and recommending web-based counselling was ease of access (reported by 41.3% of participants). For family and friends affected by another person’s gambling, easily accessing help that was convenient was important. For others, ease of access that was immediate meant that highly motivated individuals could act immediately without waiting for an appointment.
Because it is so easy to access and so available. Not like face-to-face counselling where you have to make appointments or telephone counselling where they might not be available all hours (partner, 25–29, female).
Indeed, this combination of immediacy and 24-hour access meant that help was available when it was needed. Some participants reported feeling desperate to receive advice on how to manage a gambling problem late at night.
For others, there were issues around the cost of help-seeking. This was either due to not having a telephone landline or being restrained in their mobile phone billing arrangements, such as having pre-paid devices. Indeed, participants noted 1800 helpline calls were not free and were prohibitive to use from a mobile device.
Financial limitations, I only have a prepaid mobile phone, didn’t want my partner to hear me (partner, 40–44, female).
Privacy and anonymity
As described above, there were issues around privacy and anonymity (17.5%). Privacy and confidentiality most often related to not being able to discuss concerns over the phone. Discrete and private conversations were a concern where the participant did not want to be overheard by work colleagues or the person with the gambling problem.
Because I have a very busy work schedule and find it hard to talk without my partner around (partner, 20–24, female).
In addition to some participants being concerned about being overheard, others were concerned about not being identified. Anonymity emerged as a reason for web-based counselling in terms of feeling safe behind a screen with no names exchanged and as a good way to be honest and get honest answers without being personal. Indeed, issues around anonymity were expressed in terms of reducing barriers related to the shame and stigma of problem gambling.
I’m the partner of a problem gambler; it’s hard to realise that you’re not a bad person to also need help. The anonymity of online assists in opening up [talking about the problem] (partner, 20–25, female).
Therapeutic medium
The therapeutic medium appears to assist with self-disclosure and comfort (reported by 23.8% of participants). This was typically around being able to talk openly and honestly without feeling embarrassed. This was expressed as a general difficulty in talking with people and, specifically, around the gambling problem.
First time I’ve done this over the internet; find it hard to talk to people in person, especially when I don’t know them. Guess I needed to vent and share with someone what I was going through (daughter, 20–24, female).
In addition, being able to communicate raw and overwhelming emotion was viewed as easier online. Participants described ease of communication and concern that they would be incomprehensible on the telephone or face-to-face as they were crying and shaking. They also indicated a preference for writing over talking, suggesting it was easier to write concerns down rather than speak them aloud.
I liked the idea of online because I could write out exactly how I felt and all my thoughts at once (partner, 20–24, female).
Underpinning many of these responses was an assumption participants were comfortable with technology. Indeed, one explicitly made a statement regarding the relationship between comfort and technology.
If you are comfortable with online communication, it is less confronting than actually talking to someone (partner, 40–44, male).
Service system access
Service system access for the gambler as well as the participant was a commonly reported reason for using web-based counselling (11.1%). Some participants stated that web-based counselling was a way to access the service system for information and guidance on managing the impact of problem gambling. For these participants there was no need for other services: I am the partner of a gambler looking for support; didn’t need face-to-face counselling. For others, information, advice and referral were sought for the gambler. Where referral to services was being sought for the gambler, participants said they would recommend web-based counselling as a good place to start.
Because it opens up the door and lets a problem gambler know that there are people there to help you whenever (parent, over 65 years, male).
Participants also described web-based counselling as not just a place to start but a way to ease gamblers into talking about their problem. Indeed, one participant described the features of web-based counselling as a method to access information on the suite of treatment options.
Because they can quickly, easily and without judgement access all the information they need to move forward (partner, 20–24, female).
Helpfulness
While few family and friends explicitly stated that they initially used web-based counselling because it would be more helpful than telephone or face-to-face (4.7%), having experienced the service they now regarded this as a reason for recommending it to others (34.9%). Helpfulness included being generally helpful in terms of the counsellor providing an empathic non-judgemental approach where the participant felt heard and understood.
Good to be able to have advice and support - non judgemental and available whenever it’s needed (partner, 30–34, female).
In addition, professional advice and guidance included the provision of helpful, valuable expertise and support. Access to knowledge and information in a timely manner also assisted in identifying next steps.
It was helpful to sort out ideas in my head and give me some direction and guidance for the future (partner, 20–25, female).
For a small proportion of participants (n = 5), web-based counselling did not meet their expectations and it was deemed unhelpful. This was typically due to them perceiving they were being provided with insufficient help, not feeling heard, and experiencing language difficulties communicating with counsellors.