ORIGINAL PAPER One Decade of Self Exclusion: Missouri Casino Self-Excluders Four to Ten Years after Enrollment Sarah E. Nelson • John H. Kleschinsky • Richard A. LaBrie • Sara Kaplan • Howard J. Shaffer Published online: 21 November 2009 Ó Springer Science+Business Media, LLC 2009 Abstract For more than a decade, casinos around the world have offered self-exclusion programs (SEPs) to gamblers seeking help with their gambling behavior. Despite the proliferation of SEPs, little is known about the long-term outcomes for gamblers who utilize these programs. The current study assessed the experiences of a sample (N = 113) of Missouri self-excluders (SEs) for as long as 10 years after their initial enrollment in the Missouri Voluntary Exclusion Program (MVEP). Most SEs had positive experiences with MVEP and reduced their gambling and gambling problems after enrollment. However, 50% of SEs who attempted to trespass at Missouri casinos after enrollment were able to, indicating that the benefit of MVEP was attributable more to the act of enrollment than enforcement. SEs who engaged in complementary treatment or self-help groups had more positive outcomes than those who did not, suggesting that SEPs ought to encourage and provide information about additional support and treatment options to participants. Keywords Gambling Á Pathological gambling Á Casino Á Self exclusion Á Program evaluation Introduction Accompanying the expansion of gambling opportunities during the past few decades is a growing concern that the increased gambling exposure will cause escalating numbers of people to gamble excessively and suffer from gambling-related problems (e.g., Abbott and Volberg 1994; Volberg 2000). Given these potential harms, a growing number of casinos S. E. Nelson (&) Á J. H. Kleschinsky Á R. A. LaBrie Á H. J. Shaffer Division on Addictions, Cambridge Health Alliance, 101 Station Landing, Medford, MA 02155, USA e-mail: snelson@hms.harvard.edu S. E. Nelson Á R. A. LaBrie Á H. J. Shaffer Harvard Medical School, Boston, MA, USA S. Kaplan Columbia University, New York, NY, USA 123 J Gambl Stud (2010) 26:129–144 DOI 10.1007/s10899-009-9157-5