BACKGROUND: Gambling harm is a significant public health issue affecting individuals, families and communities. In Australia, gambling is deeply embedded within everyday life, supported by the widespread availability of gambling products and industry marketing. This saturation has normalised gambling, obscuring its risks and creating barriers to recognising harm and seeking help. While clinical treatment pathways remain important, many individuals recover outside of formal services. There is increasing recognition that understanding and supporting recovery requires centring lived experience perspectives and adopting a broader public health and social determinants approach. This study sought to document gambling harm recovery journeys through lived experience. METHODS: This qualitative participatory study used photo elicitation and in-depth interviews with 13 adults in Victoria, Australia, who self-identified as being in recovery from gambling harm. Participants were asked to capture photographs and reflect on key aspects of their recovery journey, including help and support seeking, facilitators and barriers to recovery and social and environmental influences. Reflexive thematic analysis was conducted collaboratively by researchers and lived experience experts to identify shared patterns of meaning. RESULTS: Three key themes were developed: rebuilding identity and connection in recovery, navigating structural barriers and everyday triggers, and living with grief, loss, and ongoing vulnerability. Recovery pathways were nonlinear and shaped by individual, socio-cultural, environmental and commercial determinants. Participants described stigma, the pervasive presence of gambling marketing, and ineffective regulatory protections as significant barriers to recovery. Facilitators of recovery included peer support, reconnecting with meaningful activities and developing strategies to avoid gambling environments. CONCLUSION: Findings reinforce the need to move beyond individual-focused harm prevestrategies towards systemic reforms that address the commercial and environmental determinants of gambling harm that impact recovery efforts. Strengthened regulation, expanded access to peer-led and community-based supports, and greater integration of lived experience into policy and service design are critical for supporting recovery. Participatory methods offer valuable opportunities to capture the complexity of recovery journeys and inform public health responses. LIVED EXPERIENCE CONTRIBUTION: People with lived experience of gambling harm were employed as researchers on this study. They contributed to the study design, data collection and interpretation, co-authoring of the academic article and dissemination of the findings.
McCarthy et al. (Mon,) studied this question.