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This study assessed the effectiveness of Queensland gambling exclusion programs as a mechanism to minimise gambling-related harm, whether these effects are sustained over time and whether self-exclusion is more effective when combined with counselling and support. Research methods comprised a literature review, desktop review of Australian and international exclusion programs, interviews with peak gambling industry associations, interviews with 18 Queensland Gambling Help counsellors, and interviews and surveys with 103 problem gamblers at three assessment periods approximately six months apart. In contrast to recent international trends, Australian self-exclusion programs including those in Queensland are typically venue-administered, require on-site exclusion from individual venues, do not enable exclusion from multiple venues in one application, rely on photographs for detection, impose penalties for excluders for breaches and for venues that fail to detect breaches, and provide comparatively minimal connections to counselling. While strengths of the self-exclusion programs were their widespread availability and the supportive approach of some venue staff during program registration, several weaknesses and barriers to uptake were identified. Potential improvements include better publicity, stigma reduction efforts, off-site registration, multi-venue exclusion, involving counsellors in the registration process, a more streamlined registration process, improved venue staff training, better monitoring and detection methods for breaches, more consistent application of penalties for breaches, and responses to breaches that provide more support in addressing the gambling problem. Surveys of self-excluders revealed significant improvements after self-excluding in relation to abstinence from most problematic gambling form, gambling expenditure, gambling-related debt, perceived problem gambling severity, PGSI score, gambling urge, general health and gambling-related consequences. These improvements occurred soon after self-exclusion and were sustained for the 12 months of assessment. The study also compared changes in outcome measures between excluders, and non-excluders who had received counselling for their gambling problem. No significant differences were found on any outcome measures at Times 2 and 3, except that excluders were more likely to have abstained from their most problematic gambling form. Results indicate that, overall, participants benefited equally from self-exclusion and counselling, either individually or combined, in terms of problem gambling symptoms and reduced gambling-related harms. Nevertheless, self-exclusion provides an alternative to counselling that was equally effective, at least in the first 12 months, as self-exclusion and counselling combined, and counselling alone. Given low rates of professional help-seeking, self-exclusion provides an important harm minimisation option with at least short-term benefits for many participants.
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