ギャンブル問題の1年以上の非再発を可能にした家族員の関わりなどの要因

Factors Such as the Involvement of Family Members That Enabled the Maintenance of Abstinence From Gambling Problems in the Home for More Than One Year

要旨

　目的：ギャンブル問題の1年以上の非再発を可能にした家族員の関わりをはじめとする要因を明らかにする．

　方法：家族会員17名への半構造化面接の内容を質的記述的に分析した．

　結果：家族員への聞き取りの結果から11のカテゴリが抽出された．家族支援が認知行動療法に基づき認知・行動の変容を促していることを参考に抽出されたカテゴリを1．現実認識2．基礎的な行動の変化3．発展的な行動の変化4．意識の変化の4つのグループに整理した．家族が共依存の悪影響を認識し，家族への支援を受け入れ，当事者との境界線を明確にし，共依存関係から脱していく行動変化の中で，当事者の成長の受容や，家族と当事者の回復の相互作用の認識などの意識の変化にも繋る様子が見てとれた．

　考察：家族員が問題点を認識し行動や意識における変化の表れが非再発に影響していた．本結果は，ギャンブル障害治療における家族支援の重要性を支持する．

　Aim: This study aims to identify factors such as family involvement that enabled the abstinence of gambling problems for more than one year.

　Method: We conducted semi-structured interviews with 17 members of the mutual-support group for families of gambling disorder(GD) patients and administered a qualitative descriptive analysis.

　Result: We extracted eleven categories from the results of interviews with family members. We organised these categories into four groups: 1. Recognition of reality, 2. Fundamental behavioural modifications, 3. Advanced behavioural adjustments, and 4. Shifts in awareness, based on the fact that family support promotes the change in cognition and behaviour through the concept of cognitive-behavioural therapy. We observed that the families of GD patients not only recognised the codependency situation and its adverse consequences but also accepted support for themselves and delineated clear boundaries with the patients. Moreover, in the process of behavioural changes to get out of the codependence, they accepted the patients' growth and recognised the interaction between the recovery of families and patients.

　Discussion: The family's recognition of the problem and the manifestation of changes in their behaviour and awareness contributed to abstinence from domestic gambling problems. These findings support the importance of family support in the treatment of GD.