The impact of harmful gambling on Concerned Significant Others
Contents 3
Introduction
3 Gambling amongst serving military personnel and veterans 4 How military life affects spouses and partners 5
Health Harms to Concerned Significant Others
6 Just how wide-spread can the impact be? 6 What stops Concerned Significant Others seeking help? 7 Family members’ recommendations to people who provide support 8 Treatment for the Concerned Significant Others of gamblers 9 What might Concerned Significant Others learn and talk about during treatment? 10 Further information 10 References
Introduction The Veterans HABIT study is investigating the impact of harmful gambling on the lives of UK military veterans and their Concerned Significant Others. These are the people with close personal relationships to harmful gamblers, that might include, family members, colleagues or friends. There is a lot to learn from the non-veteran population that may support those providing help for Concerned Significant Others of military veterans. This document is a review of some existing research on the impact harmful gambling can have on Concerned Significant Others.
Gambling amongst serving military personnel and veterans The last 11 years has seen a surge in research identifying that veterans are a population vulnerable to harmful gambling1. Why veterans are at a greater risk than non-veterans is complex, their relationship between harmful gambling and gambling to cope with distress has been shown to be significantly stronger than nonveterans. Also, veterans experiencing PTSD and complex PTSD can be at increased risk of problem gambling1.
Researchers feel that more routine screening questioning around gambling problems should be undertaken by those supporting current and former military personnel. 3
How military life affects spouses and partners Female spouses of service personnel may experience unique stressors because of their partner’s military service. Studies have demonstrated how these experiences can increase family stress and contribute to poor mental health and well-being among military spouses/partners. Compared to women from the general population, military spouses/partners were significantly more likely to meet criteria for probable depression, were significantly more likely to meet criteria for hazardous alcohol consumption and more likely to report episodes of weekly, daily or almost daily bingedrinking than women in the general population2.
We know that military life can negatively affect the health of the significant others of serving personnel and veterans2. We also now know that UK Armed forces veterans are at a heightened risk of gambling problems1.
More attention is needed on the support needs of the significant others of veterans experiencing harmful gambling.
When someone’s relationship with gambling becomes harmful, the negative impacts can be very severe. It can affect their relationships, finances, emotions, psychological health, work or studies, culture, and influence their involvement in crime3,4. Although those excessively gambling are the first to experience harm, often some of the ill effects are also experienced by their friends, family, teammates, employers or anyone they have a close personal relationship with4,5.
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These Concerned Significant Others can experience as many gambling related harms to the gambler, but they can occur in different areas. For example, Concerned Significant Others are more likely to experience relationship, emotional and psychological problems5.
Health Harms to Concerned Significant Others In a group of over 200 concerned significant others of harmful gamblers, multiple health harms were reported. These included: reduced physical activity (64%), increased alcohol (30%) and tobacco consumption (33%) and eating too much (56%) or too little (44%), as a consequence of their loved one’s problem gambling. 16% reported that their loved one’s problem gambling had contributed to acts of self-harm and 8% stated that it had contributed to attempted suicide6.
64%
30%
33%
reduced physical activity
increased alcohol consumption
increased tobacco consumption
56% ate too much
44% ate too little
16% self-harmed
8% attempted suicide
Multiple detriments to family members’ finances, work and/ or education and relationships were also recorded. Such impacts often extended beyond the period of their loved one’s problem gambling, causing long-term harm. Collectively, evidence illustrates that family members experience a host of different harms as a consequence of their loved one’s problem gambling, and that such harms are often serious and sustained6.
Just how wide-spread can the impact be? A typical gambler can affect six others around them7 This value was realised in a study which asked over 2,000 Concerned Significant Others and over 3,000 gamblers how many people are affected. People who gamble think their gambling impacts fewer people than the people who are affected by it. A lower average estimate of four was given by gamblers7. The biggest difference between how many people gamblers and concerned significant others felt were affected was with ‘low risk gamblers’ with a Problem Gambling Severity Index score of 1-2. They reported on average that almost no one is affected, but their affected others reported an average of one and a half and as high as more than two people7.
What stops Concerned Significant Others seeking help?
“I don’t know why I was ashamed when it wasn’t even my fault. I still to this day don’t even understand.” 6
Family members’ recommendations to people who provide support Family members have identified a number of ways in which individuals, families and others affected by harmful gambling may be better helped and supported.6
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Initiating conversations about
gambling and its consequences. For providers of mental health and relationship support, questions about exercise, alcohol consumption, and diet are run of the mill. Not many support providers consider or feel comfortable questioning people whether gambling is causing an issue in peoples’ lives.
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elp people realise the impact to H reduce shame and stigma. Develop documents like this to help people extend or create their understanding of harmful gambling and its impact on individuals and families.
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E ducate clinical staff so that they have an understanding of harmful gambling and its effects, and are better able to signpost families to appropriate gambling services.
“If you go to the GP and say you’re drinking a lot, they’ll do things to help you, but I think there’s a stigma around [gambling] so people don’t want to admit it. I don’t think GPs are even equipped to know what to do.”
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Appreciate the value of peer-peer support.
“Support from people who have been there, done that, can offer help if you need it. I know for spouses there’s always help, at least with the finances in terms of how to set up your finances, which is super helpful for partners because they do run the risk of losing their home and the roof over their head, especially when they have young kids and stuff. We have a lot of that. For us with children, it’s just a shoulder to cry on and people give you encouragement and you can text them and say, ‘Hey, guess what? I did this today, I’m so proud of myself’”
Treatment for the Concerned Significant Others of gamblers COMMON TREATMENT STYLES8 Congruence Couples Therapy (CCT) This approach helps gamblers and their spouses reconnect in four important areas: within themselves, with each other, with their families, and with their sense of meaning or purpose.
Integrative Couple Treatment for Pathological Gambling (ICT-PG) There may be a focus on trying to process forgiveness for the Concerned Significant Others. They may aim to improve communication and problem-solving skills. Discussions could include shared moments of mutual support during difficult times linked to gambling and their impacts on the couple’s life.
Individualised counselling Patients’ unique thoughts, feelings and behaviours will be discussed in a safe, non-judgemental context to support them being able to consider how changes may be made to improve their living situation.
Behavioural Couples Therapy & Cognitive Behavioural Therapy (BCT & CBT) These types of treatment aim to change the thought and behaviours that form the basis of the gambling behaviour. Both use a process of exposure to the behaviour patients want to reduce and teaches skills to reduce their urge to gamble.
Community reinforcement and family training (CRAFT) Teaches Concerned Significant Others how to support someone with a gambling problem and how to improve communication with them. This approach is commonly used with concerned significant other of people who are refusing treatment or refusing to admit they are not in control of their gambling behaviours. 8
There is no one-size fits all: We need tailored interventions that fit people’s specific needs.8
What might Concerned Significant Others learn and talk about during treatment?8
Information and understanding • Psychoeducation about problem gambling • Additional psychoeducation • Protecting finances • Available services • Understanding self and gambler
Coping skills • Reinforce non-gambling behaviour • Avoid reinforcing gambling • Encourage treatment • Coping strategies • Problem solving skills • Dealing with adversities • Self-care • Motivational enhancement • Plan for potential crisis
Social support • Advice and information • Therapeutic response • Building and maintaining support network • Peer support • Couples’ mutual support
Communication • Communication skill training • How to talk about gambling and avoid resistance • Broaden and deepen communication patterns within couple
Other • Realistic expectations • Goal setting • Self-monitoring • Review of content • Future planning [CTA text here]
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Further information To view other outputs from the Veterans’ HABIT study visit the Gambling Research, Education and Treatment Centre at www.greatcentre.org To cite this document in APA 7th edition: Veterans’ HABIT Study. (2025). The impact of harmful gambling on concerned significant others. Anglia Ruskin University.
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ulloch C, Browne M, Hing N, Rockloff M, Hilbrecht M. How gambling harms the wellbeing of family T and others: A review. International Gambling Studies. 2022;22(3):522–540. https://doi.org/10.1080/144 59795.2021.2002384. Accessed Mar 6, 2025. doi: 10.1080/14459795.2021.2002384.
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anks J, Andersson C, Best D, Edwards M, Waters J. Families living with problem gambling: B Impacts, coping strategies and help seeking. Sheffield University. 2018:1–93. https://shura.shu. ac.uk/23407/1/Families%20Living%20with%20Problem%20Gambling.pdf. Accessed Apr 23, 2025.
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oodwin BC, Browne M, Rockloff M, Rose J. A typical problem gambler affects six others. G International Gambling Studies. 2017;17(2):276–289. https://doi.org/10.1080/14459795.2017.1331252. Accessed Mar 5, 2025. doi: 10.1080/14459795.2017.1331252.
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E dgren R, Pörtfors P, Raisamo S, Castrén S. Treatment for the concerned significant others of gamblers: A systematic review. Journal of Behavioral Addictions. 2022;11(1):1–25. https://akjournals. com/view/journals/2006/11/1/article-p1.xml. Accessed Mar 3, 2025. doi: 10.1556/2006.2021.00088.
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