Counseling Approaches to Gambling Addiction
Counseling Schools Search
When you click on a sponsoring school or program advertised on our site, or fill out a form to request information from a sponsoring school, we may earn a commission. View our advertising disclosure for more details.
For some clients, gambling is more than a bad habit. Gambling can turn into an addiction when it causes significant distress to one’s finances, close relationships, and social environment. Counseling can help.
Some signs of gambling addiction are a loss of control over gambling behavior, unsuccessful attempts to cut back on gambling, irritability during withdrawal, and an increased need to gamble more to gain the same sense of excitement.
Assessment for Gambling Disorder
When clients with gambling misuse enter the counseling office, they usually do not have any physical signs of a problem. Presenting problems range from depression, anxiety, financial concerns, relational conflicts, and legal issues. The counselor will need to ask about gambling directly because clients often do not talk about gambling without prompting. Getting a clear picture of the client’s current gambling behaviors and mental health symptoms helps guide the assessment and treatment planning process.
Counselors will conduct an initial evaluation and assessment to determine gambling behavior. Counselors can include questions about gambling behavior in the assessment. Examples include:
- Have you ever gambled?
- How much money do you spend when you gamble?
- Have you tried to cut down or stop gambling but been unsuccessful?
Counselors need to gather detailed information about a client’s gambling behavior history and any previous mental health treatment. This includes asking the client at what age they began gambling, what type of gambling they do, and the frequency of gambling. At times, problematic gambling and gambling addictions coincide with legal issues. Ask if the client has had any legal problems.
In addition, the counselor asks about any prior individual or group counseling for gambling, periods of abstinence, alcohol or substance abuse detoxification, alcohol or substance abuse treatment programs, or hospitalizations related to mental health. Many people with gambling disorder have comorbid disorders, including mental health diagnoses, alcohol misuse, or substance misuse.
Inquire about trauma history. Those who have a gambling disorder often come from traumatic backgrounds. Ask about any instances of neglect, emotional/verbal, physical, or sexual abuse. Moore and Grubbs (2021) state, “Post-Traumatic Stress Disorder (PTSD) symptoms result in increased severity of Gambling Disorder (GD), and pathological dissociation plays a particularly important role in exacerbating this relationship”.
Cultural beliefs and norms about gambling vary. Ask about your client’s culture and how that impacts their gambling behavior. Some cultures view gambling as a social pastime, while others view it as a shameful activity to be avoided.
Risk-Taking Behaviors
Treatment includes increasing the client’s awareness of their risk-taking behaviors. Ask the client, “Has anyone expressed concern about your gambling?”
Often, clients feel a sense of excitement when taking a risk, such as chasing a bet or winning. Through treatment, clients learn how to experience a healthy sense of excitement without gambling.
One risk-taking behavior counselors must watch for is suicidality. Clients may attempt suicide after a large loss, when facing bankruptcy, or when feeling hopeless or ashamed about their addiction. Ongoing assessment is important.
Financial Impacts
Those with a gambling disorder feel money is both the cause of and also the solution to their problems. They often face negative financial consequences. They may have credit card debt, be unable to pay their bills, have their utilities shut off, or file for bankruptcy. In some cases, people have their cars repossessed. They may lie to family or friends about their losses. Legal issues can include stealing money, forging checks, or using other people’s credit cards to fund gambling behaviors.
The counselor helps by assessing the client’s financial health and any feelings of shame surrounding money loss. Counselors make referrals to financial counselors or debt management services as needed.
Treating a Behavioral Addiction
Gambling is different from alcohol and substance misuse disorders because it is a behavioral addiction. This means there is a psychological dependence but no physical withdrawal symptoms. Gambling primarily affects the brain’s reward system. Treatment focuses on changing behaviors and reducing impulses.
Some clients will choose to become abstinent, while others work with a harm reduction model to decrease the harmful effects of gambling. Developing a relapse prevention plan is important. It is common for clients to feel restless or irritable when they attempt to cut down on gambling or feel guilty or anxious after they gamble. Gambling behavior can mask feelings of stress, anxiety, or depression.
A part of counseling is developing a relapse prevention plan. Counselors and clients work together to plan for high-risk situations, manage urges, and create positive coping strategies to prevent gambling behaviors.
Addressing Distorted Thinking
Cognitive- behavioral therapy is recommended for treatment. Many people who have a gambling disorder experience distorted thinking or beliefs. Some of these thoughts or behaviors can include:
- I am due for a win
- I wouldn’t continue to gamble if my life weren’t so stressful
The counselor brings awareness to this type of thinking and introduces healthy ways to cope.
Working through Gambling Ambivalence
A person with a gambling disorder often displays ambivalent motivation. They may experience negative consequences from their behavior but hold onto the belief that, with one more bet, they will win all their money back. Motivational interviewing is important for treatment.
Clients at the beginning of treatment often gamble and do not think about making a change in their behavior. Psychoeducation about gambling and the negative consequences can be helpful in this stage. The counselor can view this time as planting the seeds for change.
When clients recognize they need to change, they may feel unsure how to do it. For example, they could admit to having a gambling problem, but are unsure or are not ready to stop the behavior. This is an opportune time to provide the client with resources to consider, such as information on gambling recovery groups or financial counseling.
Counselors assist clients in identifying triggers for gambling. Gambling is often triggered by environmental cues, such as being near casinos, online platforms, or places where lottery, keno, or scratch tickets are sold. Finding ways to manage these urges and choosing healthy alternatives is important.
When clients are ready to change their behavior, they attend their first recovery meeting, go to their first appointment with a financial advisor, commit to counseling to work on their addictive behaviors, or avoid triggers.
As clients move through the recovery process and experience relapse, they move through the stages of change again. It is normal for clients to experience ambivalence as they make changes to their gambling behaviors. The counselor assesses the client’s readiness for change and supports motivation throughout treatment.
Family-Centered Care
Family therapy is recommended due to the damage that gambling addiction causes to relationships. Clients may lie or hide their gambling from their loved ones. In some instances, clients may take family objects to sell, steal money from family members, or forge a family member’s signature to obtain credit cards or loans. The preoccupation with gambling may cause them to avoid responsibilities or have problems at work or school.
Obtaining family input is an important component of individual counseling treatment. The counselor can speak with a family member by phone or virtually if they are unable to attend in person. When the client signs a release of information to talk with their family, the counselor can ask for their input about family dynamics, communications, and the effect gambling has had on the family.
Gambling affects the entire family system. Research demonstrates that there is an association between children who witness their family members gamble and a risk of developing a gambling problem later in life. “Witnessing and/or participating in gambling with family or household members in youth led to higher levels of gambling problem severity as an adult” (Nower et al., 2022).
Recovery Support Groups
Counselors who work with gambling disorders may find it useful to attend Gamblers Anonymous (GA) or other recovery meetings, including twelve-step meetings. This helps counselors understand how these programs work, what the twelve steps are, and how group members experience the recovery process. Some clients have already been in 12-Step and Non-12-Step Recovery for alcohol or substance abuse. For a non-12-step recovery group, there is SMART Recovery’s 4-Point Program, based on cognitive behavioral therapy (CBT).
Families of those affected by gambling often need their own support and healing. Groups such as Gam-Anon have been created to help families and friends with the financial and emotional effects of compulsive gambling. SMART Recovery Family & Friends is a non-12-step program focusing on developing effective coping and communication skills for families affected by addiction.
Modern Gambling
Gambling is no longer limited to playing the lottery, scratch tickets, casinos, or private bets made amongst friends. Now, gambling has expanded to online platforms and sports betting apps.
Prediction markets, which are regulated at the federal level by the Commodity Futures Trading Commission, feature gambling-type behaviors. They allow users to bet on a variety of real-world scenarios. Some of these are political elections, sports, and even war outcomes. Some differences are that platforms set the odds instead of markets, it is a peer-to-peer type of trading, and it is often unregulated. The nature of these bets is similar to gambling and can lead to gambling issues.
Online gambling and prediction market betting are available 24 hours a day, seven days a week. Today, placing a bet online is completed with a few quick clicks on one’s phone. This makes gambling faster and more convenient than ever. As a result of this easy access, more young adults are becoming addicted to gambling or developing problematic gambling habits than ever before. For those who want to block or limit their access to gambling online, there are certain gambling apps or sites that can help.
Lisa Hutchison, LMHC
Writer & Contributing ExpertLisa Hutchison, LMHC, is a licensed mental health counselor for the Commonwealth of Massachusetts. She works for professionals who want to treat and prevent compassion fatigue. With over 20 years of psychotherapy experience, she helps her clients assert themselves, set boundaries, and increase their coping skills. Her specialty is decreasing stress, anxiety, and depression while increasing realistic methods of self-care for those who help others. Ms. Hutchison’s psychological advice has been featured in Reader’s Digest and the Huffington Post. Her articles have been published in numerous magazines, including Grief Digest and Today’s Caregiver.
Lisa is the bestselling author of I Fill My Cup: A Journal for Compassionate Helpers and a faculty member writer for NetCE. Her latest continuing education unit publication is “Setting Ethical Limits for Caring and Competent Professionals.” She has taught creative writing in colleges and presented on boundaries for the compassionate helper; the use of expressive art to heal grief, anxiety, and depression; inspirational and motivational topics; and creative writing techniques.