Table 5.

Descriptions to themes generated in qualitative synthesis of treatment processes

Core themes

Information and understanding: Refers to gaining a better understanding of the gamblers behavior, and heightened mutual comprehension and self-awareness. Approached through psychoeducation and open communication.

Social Support: Includes mutual support within dyad, professional support received in treatment, and social support facilitated through treatment (i.e. peer support groups or online forum discussions).

Coping skills: Provision of strategies for communication, emotion regulation, problem-solving, reinforcing non-gambling, avoiding reinforcement of gambling, self-care, changing maladaptive cognitions and learning to utilize available social support.

Communication: Development of communication patterns to become more reciprocal, open and honest. Proposed to be a key factor in achieving sustained change in relation to gambling and interpersonal problems.

Strain: Negative emotions and thoughts that were attributed to gambling or interpersonal problems. Addressing strain was often a target of interventions.

Additional themes

Gambling behavior: Prominent when the gambler is involved in treatment, where abstinence may be a motivator to treatment entry and part of treatment goals. Abstinence and relapse may influence treatment drop-out. a, b, c, d

Interpersonal nature of the problem: Prominent in couple's treatment, where treatment goals relate to improving communication and mutual comprehension and utilizing relationship as a natural source of support. a, c, d, e, f, g

Motivation to change: Relates to how CSO involvement influences gambler motivation. Gambler motivation towards change was also described to influence treatment adherence independently of the CSO. a, b, c, e

Comorbidity: Refers to participants dealing with multiple conditions that complicate the treatment process. c, e

Personal history: Refers to addressing past hardships as part of the treatment process. This also includes the exploration of intergenerational trauma and past communication patterns. a, c, d, f, g

Cognitive functioning: Refers to the processing styles participants have which may influence what avenues are fruitful in treatment (e.g. ability to address past relationships). a

Barriers: Refers to life circumstances (e.g. divorce) and resource related factors (e.g. time requirements for face-to-face participation) that influence treatment engagement. b, c

Content and format: Subtheme to support, which highlights the potential benefits and pitfalls to different ways of delivering treatment. Partially dependent on personal preferences. a, b, c, d

All included reports contributed to the core themes. Reports that contributed to additional themes are indicated with superior letters: ^a Bastardo Gaelzer, 2019; ^b Nilsson, 2020; ^c Shi, 2021; ^d Tremblay et al., 2018; ^e Kourgiantakis et al., 2018; ^f Lee, 2012; ^g Lee, 2015; For elaborated descriptions to themes see Supplementary material 2. (osf.io/hr7s6/).