From coming to terms with the gambling problems to post-traumatic growth: A novel nine-stage theoretical model of recovery from gambling disorder

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Abstract
Background and aims: The concept of recovery is gaining increasing relevance in gambling disorder (GD). Rooted in the users' movement, recovery is viewed as a process involving non-medical and subjective dimensions. However, qualitative research on this topic remains limited, and no consensus exists on its definition. This study aimed to develop a theoretical model of recovery, examining stages, dimensions, and conditions shaping recovery trajectories from a holistic, patient-centred perspective. Methods: Semi-structured interviews were conducted with 10 self-defined recovered gamblers and 10 self-defined currently recovering gamblers. Data were analysed using an inductive and comparative approach based on constructivist grounded theory (CGT). Results: A novel nine-stage theoretical model of recovery was developed: (1) Coming to terms with gambling problems; (2) Framing GD as a medical condition; (3) Acknowledging accountability; (4) Deciding to change and making an initial commitment to recovery; (5) Constructing one's recovery goal; (6) Maintaining long-term commitment; (7) Reclaiming autonomy and agency; (8) Rebuilding through recovery; and (9) Post-traumatic growth. The model identifies key dimensions that shape progression and conditions (facilitators and barriers) associated with each stage. Both groups mentioned all stages, though experiences differed depending on recovery status. Shared and group-specific facilitators and barriers were observed across stages. Discussion: Findings show that recovery is a multidimensional process, extending beyond behavioural change to include meaning-making processes and identity renegotiation. Conclusions: Results emphasise the need for a holistic, patient-centred approach. Qualitative research offers insights to inform tailored, recovery-oriented interventions and contribute to a unified, multi-stakeholder definition of recovery.

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