Gambling Harm Treatment and Support in Scotland: Current provisions and future directions
Findings from a study providing a comprehensive, system level understanding of gambling harm treatment and support services in Scotland. The study combined desk based service mapping, a survey, interviews, geographic mapping and intervention effectiveness evidence update.
Chapter 2: Methodology
2.1 Study design
The study employed a mixed-methods design, combining multiple sources of data to develop a comprehensive understanding of gambling harm service provision in Scotland. The approach comprised:
- desk-based mapping of services
- an online survey of organisations
- semi-structured qualitative interviews with service providers and stakeholders
- geographic analysis of service accessibility, and
- an evidence review of intervention effectiveness.
These components were designed to complement one another, allowing for triangulation between data sources and supporting both descriptive and analytical insights.
This study received ethical approval from the Scottish Centre for Social Research (ScotCen) Research Ethics Committee.
2.2 Mapping and eligibility criteria
An initial mapping exercise identified organisations providing gambling harm treatment and support in Scotland.
The desk-based stage drew on organisational websites, public-facing directories and sector-relevant sources to identify voluntary and community organisations across Scotland offering dedicated gambling harm treatment and support programmes. Sources consulted included the Scottish Council for Voluntary Organisations (SCVO) database, NHS inform, A Local Information System for Scotland (ALISS), Companies House, and the Scottish Charity Regulator (OSCR), alongside targeted web searches using terms related to gambling harm, gambling support, and gambling treatment services in Scotland.
Organisations were included where evidence of a specific, named gambling programme or service could be verified through publicly available information, rather than general health or addiction provision in which gambling may incidentally feature. Data were stored in a password-protected Excel spreadsheet that recorded each organisation's name, email address, telephone number, postal address, and geographical location within Scotland. Both specialist gambling services and organisations providing broader support (e.g. advice services, homelessness services, peer support groups) were included where they contributed to the wider ecosystem of support for gambling harms.
Data were verified through phone calls and emails and cross-checked against organisational websites and social media. A total of 55 services and organisations were identified through the initial mapping.[9]
As per the project terms of reference (ToR) agreed with Scottish Government, eligibility criteria were applied to our provisional list to identify relevant organisations for subsequent stages of the project. The criteria were:
a) organisations had to provide formalised treatment or support for gambling harm as structured services, not incidental signposting;
b) to have been actively delivering those services within the three months prior to the mapping, and
c) whilst physical presence in Scotland was not required, organisations needed to be serving Scottish residents substantively, i.e. at least 10% of their service users had to be Scottish residents (set at a level broadly proportionate to Scotland's share of the British population).
2.3 Survey
An online survey (see Annex 1 for survey questionnaire) was distributed to 38 identified organisations to collect structured information on:
- service types and delivery models
- geographic coverage
- referral pathways
- workforce composition
- service users
- data collection practices
We received 7 incomplete and 26 completed responses (68.4% effective response rate). Following eligibility screening, one incomplete and thirteen completed responses met the eligibility criteria (N=14). All incomplete responses were reviewed, and no evidence of systematic bias (e.g., specific questions consistently leading to dropout) was identified. One organisation discontinued the survey at a late stage (Q26). As this organisation met the eligibility criteria, and following consultation with the Scottish Government, it was invited to participate in the interview stage (which it did). The survey data it had provided, triangulated via the subsequent interview, were included in the analysis presented in this report.
Among the 13 ineligible responses, eight Scotland-based providers were excluded based on the limited duration of their gambling-specific project delivery. All five England-based providers were excluded due to the low proportion of Scotland-based beneficiaries (2–5% for two providers, 6–10% for three providers).
2.3.1. Data reliability and interpretation
Triangulation of survey responses with data from the subsequent in-depth interviews revealed variability in how participants had interpreted and responded to the survey questions. Some participants revised or clarified survey responses during interviews, suggesting limitations in data accuracy of the online survey. For example, participants admitting during the interviews being unable to answer the questions about the client load by types of service. In one case, a UK-wide treatment provider reported UK-level figures both in questions on client load and workforce capacity.
Survey findings presented within this report should be treated as indicative, and are interpreted in conjunction with qualitative data.
2.4 Qualitative interviews
Eligible organisations who completed the survey, either partially or in full (N=14), were asked to indicate whether they would be interested in taking part in a follow-up interview. In total, ten organisations took part in the in-depth interviews. Following the interview stage, one organisation was reclassified as ineligible on the basis of information provided during the interview. This organisation was subsequently excluded from both the survey and interview analyses.
The interviews explored (see Annex 2 for Interview guide):
- service delivery in practice
- pathways into and through support
- workforce and training
- data and evaluation practices
- system-level challenges
The qualitative data were analysed thematically following the framework analysis methodology[10] using a coding framework developed by the research team. The analysis focused on identifying cross-cutting patterns and system dynamics rather than describing individual organisations. Interviews also provided important contextual insight into how organisations operate within current funding and commissioning arrangements.
To note, several participants expressed uncertainty about future funding and queried whether the mapping exercise would inform commissioning decisions. This suggests that responses may have been shaped, in part, by perceived implications for funding, introducing a potential element of social desirability bias which has been considered during analyses.
The final dataset underpinning the analysis presented in this report comprised thirteen survey responses and nine interviews, with an effective sample of 13 organisations (N=13).
2.5 Geographic analysis
Geographic accessibility of services was analysed using GIS methods, examining travel distances to services in relation to population distribution and socioeconomic indicators (see Annex 3 for methodological details and full findings).
This analysis provides insight into the spatial distribution of services and highlights areas where access may be limited, particularly for populations at higher risk of gambling harm.
2.6 Evidence of intervention effectiveness review
To address RO1 we undertook a targeted and structured review of recent evidence to update evidence on treatment efficacy originally presented within the Lancet Public Health Commission on Gambling (LPHCG). See Table 2 of the LPHCG report[11].
To do this, we first drew on the most recent guidance from the National Institute for Health and Care Excellence (NICE) [12] [13] [14] [15], which provides an updated synthesis of evidence on the prevention and treatment of gambling-related harms. This served as a primary reference point to identify newly consolidated or re-evaluated intervention categories.
Second, we conducted forward citation searching using Google Scholar. Specifically, we identified the nine review articles that underpinned the original LPHCG’s Table 2 and systematically searched for subsequent review studies (published from 2024 onwards) that cited these sources. This enabled us to capture emerging syntheses building directly on the LPHCG’s evidence base.
Third, we performed an additional structured search in PubMed using the following parameters: ((gambling[Title/Abstract])
Across these steps, a total of eight review studies published since 2024 (including the NICE review) were identified and used to refine and extend the evidence gradings for the intervention categories presented within the LPHCG.
To assess the extent to which these evidence-based measures are currently implemented in Scotland, we triangulated multiple data sources. This included findings from our primary data collection. These data were supplemented by comparative policy and system-level insights from the Global Gambling Control Scorecard [16], enabling cross-validation of reported provision and identification of gaps.
Contact
Email: gambling@gov.scot