Chasing the Win

“With a swipe of a phone screen and a digital bet placed, the availability and exposure to gambling is ever increasing.”

104783 Gambling Disorder: Assessment, Diagnosis, and Evidence-Informed Interventions

Live Event

Tue, Nov 17th, 2026

8:00am – 11:15am US Pacific Time

3 CE Hours Evidence Based Interventions, MI

This training provides mental health professionals with a practical, clinically focused overview of Gambling Disorder and its impact on individuals, families, relationships, and overall functioning. Participants will examine the diagnostic features and common clinical presentations of Gambling Disorder, including patterns of gambling behavior, associated consequences, and factors that may complicate assessment and treatment. The course will explore strategies for conducting...

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"Just one more. That’s it." 

How many of you can relate? Just one more cookie. Just one more episode. We all can probably remember a time when “just one more” entered our mind. This phrase also enters the mind of someone with a compulsive gambling problem. Just one more bet, one more spin, one more chance to ‘win big’.

Gambling is not unlike other addictions such as food, sex, screens, or substances. Addiction is defined by the American Society of Addiction Medicine as “a chronic, relapsing condition characterized by compulsive engagement with a substance or behavior despite harmful consequences, often involving impaired control, persistent urges or cravings, and continued use or engagement despite significant problems in functioning”.

Current Statistics on Gambling

Recent estimates suggest gambling-related problems affect a substantial number of adults. The National Council on Problem Gambling estimates that about 2.5 million U.S. adults, or 1%, experience a severe gambling problem in a given year, while another 5–8 million adults, or roughly 2%–3%, experience mild to moderate gambling problems. In NCPG’s 2024 survey, 8% of U.S. adults—nearly 20 million people—reported at least one indicator of potentially problematic gambling occurring many times in the past year, although this should not be interpreted as the prevalence of DSM-5-TR gambling disorder. A 2024 systematic review and meta-analysis estimated that 1.41% of adults globally engaged in problematic gambling during the previous 12 months, with prevalence varying depending on the population and measurement method.

The “old school” form of gambling often involved traveling to physical locations such as casinos, horse racing tracks, or underground betting parlors. The explosion of technology and Internet use has significantly changed how people not only interact with gambling, but also how they develop addictions to gambling. With a swipe of a phone screen and a digital bet placed, the availability and exposure to gambling is ever increasing. The colors, graphics, and misguided seduction of “you can win $5,000 on your first bet” psychologically draw in vulnerable people who have time, money, and a belief that they can beat the house and walk away with a hefty profit. At the end of the day, the expression “the house always wins” is at play here – even though the gambler believes that they have the upper hand.

Gambling is no longer just comprised of poker chips and slot machines. Sports betting has grown substantially in the United States in recent years, especially the amount wagered through legal sportsbooks. Americans placed $166.94 billion in legal sports wagers in 2025, up 11% from 2024; sportsbook revenue also rose 22.8% to $16.96 billion. These are measures of market activity, not the number of people with gambling disorder. 

The picture for how many people bet is more nuanced. A National Council on Problem Gambling survey found that 23% of U.S. adults reported sports betting in 2024, compared with 20% in 2018, but below the 26% reported in 2021. Online gambling participation rose from 15% in 2018 to 22% in 2024. Sports betting has expanded rapidly in availability and dollars wagered, particularly online; that does not by itself show that gambling disorder has increased at the same rate.

The Gambler: Profiles and Behaviors

Consider the following gambling profiles, which demonstrate the diversity in age, gender, and problematic gambling behaviors:

• Marcus, 46 – Casino Gambling

Marcus, a Black married father of two, visits a casino several times a month, primarily playing blackjack and slot machines. Over the past year, he has begun chasing losses, withdrawing money from savings without telling his spouse, and staying at the casino much longer than planned.

• Linda, 68 – Lottery & Online Gambling

Linda, a retired Vietnamese American woman who lives alone, initially began buying lottery tickets and scratch-offs for entertainment after her husband died. She now spends several hundred dollars each month on tickets and online casino games, frequently gambling when lonely or distressed and minimizing the amount she spends when her adult children ask.

• Tyler, 27 – Sports Betting

Tyler, a single White male and avid sports fan, began using mobile sportsbooks to place occasional bets on NFL and NBA games with friends. He now bets almost daily, uses increasingly complex parlays to recover losses, checks betting apps throughout the workday, and has borrowed money to continue gambling.

The cycle of gambling that Marcus, Linda, and Tyler are in closely resembles the general addiction cycle, seen below.

Open the Door: Gambling Assessment

In any area of clinical practice, thorough assessment is vital in order for a clinician to formulate an accurate case formulation. What assessment areas are most critical in assessing when problematic gambling is suspected or known? Consider the value of exploring the following areas with clients:

Areas to Assess in Problem Gambling

• Gambling patterns: Types of gambling, frequency, duration, money/time spent

• Loss of control: Difficulty limiting, cutting back, or stopping

• Preoccupation & urges: Cravings, planning, thinking about gambling

• Chasing losses: Returning to recover money previously lost

• Financial impact: Debt, borrowing, unpaid bills, depleted savings, financial instability

• Functional impact: Effects on work, school, relationships, health, and responsibilities

• Secrecy & deception: Hiding gambling, losses, debts, or extent of involvement

• Emotional function: Gambling to escape distress, loneliness, anxiety, depression, or boredom

• Consequences: Relationship conflict, legal problems, employment difficulties, housing instability

• Co-occurring concerns: Substance use, depression, anxiety, trauma, impulsivity

• Suicide risk: Suicidal ideation, hopelessness, acute financial/relationship crises

• Motivation & protective factors: Readiness for change, supports, coping resources, previous attempts to stop

Supporting People with Problematic Gambling

Alcoholics Anonymous, or AA, was founded almost 100 years ago by two men who met in Akron, Ohio. One of the men was in recovery from alcohol, and the other was a hopeless alcoholic at the time of their meeting. The significance of this first meeting between these two men was the formation of what would become AA, built on a belief that mutual aid and shared recovery is valuable.  Over the last century, AA has helped a significant number of people enter recovery from alcohol and helped them find a place for community with others in their recovery journey. The premise of AA led to the formation of Gamblers Anonymous (GA) in 1957. Ironically, the formation of GA replicated how AA was founded; two men with compulsive gambling habits gathering to support each other. Gamblers Anonymous follows the traditional AA twelve-step model, which focuses on personal accountability, spirituality, and mutual aid. 

GA can be an appropriate resource to share with clients who are problem gamblers, because it provides a non-clinical and community-based space for problem gamblers to receive support and mentors while learning how other gamblers have experienced recovery. Shame and stigma can be prevalent in any addiction, and gambling is no exception. 

Behavioral therapy or cognitive behavioral therapy may be helpful. Behavioral therapy uses a process of exposure to the behavior that a gambler wants to unlearn and teaches skills to reduce urges to gamble. For example, the skill of urge surfing is useful to address and mitigate any problematic behaviors that a person finds difficult to resist. Cognitive behavioral therapy focuses on identifying unhealthy, irrational and negative beliefs and replacing them with healthy, positive ones. The goal of CBT for intemperate gambling is to identify and change “cognitive distortions and errors” that are associated with excessive gambling and its adverse sequelae. For gambling, CBT can include at least four components: (a) correcting cognitive distortions about gambling; (b) developing problem solving skills; (c) teaching social skills; and (d) teaching relapse prevention. There are several CBT trials that suggest that it is an effective form of treatment for gambling.

Consider the following treatment plan as an example of how a clinician might support a client struggling with problematic gambling.

NICE recommends group CBT, offers individual CBT when group treatment is unsuitable, and includes relapse prevention in CBT. It also recommends considering MI for confidence and engagement and offering peer support to people who want it. Practical financial and access safeguards support treatment; they are not stand-alone psychotherapies. 

Ask directly about suicidal thoughts and intent, particularly after major losses or other gambling-related crises; assess depression, substance use, and other co-occurring concerns. 

Help and hope is available for people who struggle with gambling. Providing person-centered care, engaging in thorough assessment, and connecting clients with treatment options are key best practice steps. Sue Acton, writing about her own recovery from severe gambling problems, described recovery as coming through a combination of Gamblers Anonymous, counseling from a clinician trained in gambling harms, peer support, and support from family and friends. She concludes: “And I have perhaps the most important thing: hope.” ◼

104783 Gambling Disorder: Assessment, Diagnosis, and Evidence-Informed Interventions

Live Event

Tue, Nov 17th, 2026

8:00am – 11:15am US Pacific Time

3 CE Hours Evidence Based Interventions, MI

This training provides mental health professionals with a practical, clinically focused overview of Gambling Disorder and its impact on individuals, families, relationships, and overall functioning. Participants will examine the diagnostic features and common clinical presentations of Gambling Disorder, including patterns of gambling behavior, associated consequences, and factors that may complicate assessment and treatment. The course will explore strategies for conducting...

  Register Now

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