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A peer-reviewed study of 1,305 patients found nearly three-quarters saw clinically meaningful improvement in gambling symptoms, with results showing up in a median of just 14 days. Gambling disorder research just got its biggest real-world dataset yet.
As operators, regulators and advocacy groups place greater emphasis on responsible gambling, new research is shedding light on what happens after a player seeks help.
Birches Health, a national provider of virtual behavioral health treatment for gambling and other digital addictions, published a peer-reviewed study in the Journal of Medical Internet Research (JMIR) this week showing that patients in its specialized virtual care program saw fast, measurable improvement in gambling symptoms.
The study tracked 1,305 adults who received treatment through Birches Health between June 2024 and April 2026, making it the largest known real-world clinical dataset on virtual gambling disorder treatment in the US.
Most existing gambling treatment research comes from small, tightly controlled trials that tend to exclude patients with other psychiatric conditions — a narrower picture than what clinicians see in day-to-day practice.
Most patients improved fast, even with other diagnoses
Over 12 weeks of treatment, gambling symptom severity dropped by an estimated 8.3 points on the Gambling Symptom Assessment Scale (G-SAS), a standard clinical measure. Among clients with follow-up assessments, 71.7% achieved clinically meaningful improvement, with a median time to improvement of just 14 days.
The patient population was not a cherry-picked subset. More than half of participants (56%) presented with at least one co-occurring psychiatric diagnosis:
- Anxiety disorders (26.9%)
- Depressive disorders (21.2%)
- Trauma-related disorders (9.6%)
- Substance use disorders (6.5%)
- ADHD (5.1%)
Even accounting for that complexity, treatment produced meaningful improvement across the group, according to the study.
Treatment designed specifically for gambling disorder
Birches Health’s care model combines:
- Individual psychotherapy
- Group therapy
- Peer support with lived experience
- Financial wellness counseling
- Cognitive behavioral therapy
- Motivational interviewing
These services are delivered by licensed clinicians trained specifically in gambling disorder. The company operates in all 50 states and is covered by major insurers, including UnitedHealthcare, Cigna, Aetna, TRICARE and Blue Cross Blue Shield plans, with additional access through state health department partnerships.
Elliott Rapaport, founder and CEO of Birches Health, framed the findings as evidence that the standard approach has failed patients for years.
“Gambling disorder has been treated as an afterthought in the US healthcare system for decades,” Rapaport said. “People lose their savings, their families, their jobs, sometimes their lives, and the most common clinical response is still a referral to a generalist therapist who has never treated the condition. This study is peer-reviewed evidence that a different model exists and that it works. That should matter to every payer, employer and state health system still treating gambling addiction as someone else’s problem.”
Part of the problem has been the research itself. Small, tightly controlled trials are useful for isolating variables, but they do not tell providers, payers or employers much about whether treatment actually works for the messier, more clinically complex patients who show up in real life.
The JMIR study is a step toward closing that gap, and Birches Health says it is only the first entry in a planned series. Additional research on gambling disorder and other behavioral and process addictions is already underway.
Gambling disorder carries high risk, low treatment rates
More than 20 million US adults meet the criteria for problem gambling or gambling disorder, and that number keeps climbing as digital wagering becomes as normalized as checking a group chat. The condition carries one of the highest suicide risks of any behavioral health diagnosis and is highly comorbid with depression, anxiety and substance use disorders.
Despite the toll, fewer than 10% of people with gambling disorder ever seek treatment.
Dr. Cynthia Grant, Birches Health’s vice president of clinical care and a co-author of the study, said the data confirms what her clinicians see in practice every day.
“The thing I hear most from people in our care is that they wish they had come sooner,” Grant said. “They spent months or years trying to stop on their own, or seeing therapists who weren’t equipped for this condition, before they ever reached a provider trained in the treatment of gambling disorder. This study now gives us peer-reviewed evidence for what our clinicians see every day: people with gambling disorder, including those dealing with depression, anxiety and other conditions alongside it, respond to treatment when the care is built for them.”
For now, the takeaway is straightforward: specialized, gambling-specific virtual care produced fast, meaningful results across a genuinely difficult patient population. In an industry where legal betting access has outpaced treatment infrastructure, the findings offer evidence that effective support can be delivered at scale.
As responsible gambling continues to evolve from awareness campaigns and player tools toward a broader public health framework, expanding access to specialized treatment may prove just as important as preventing harm in the first place.
