Treatment options for people with gambling problems vary across regions. Treatments may be offered individually or in group format, and in-person or by telephone or online. In some regions, gambling treatments may be offered as part of mental health treatment systems. In others, they are offered as part of addiction treatment or as free-standing services. This has an impact on who can access treatment and how they can access it. In general, in-person treatment is more helpful and people who participate more fully (e.g., attend more sessions) report more benefits.
Psychotherapy
There is strong support for cognitive behavioural therapy (CBT) in the treatment of gambling problems. In CBT, gamblers identify their thoughts and beliefs about gambling, and learn how to cope with their gambling urges and situations that can lead to excessive gambling. Motivational interviewing and mindfulness-based approaches have also gained some support. Motivational interviewing helps gamblers explore what they think and feel about gambling in order to make changes.
There is evidence that even a single session can be helpful to reduce gambling. Given that few people seek treatment for gambling problems, brief interventions can be beneficial. Research is still needed to understand the long-term effects of most psychotherapies. Also, people with gambling problems may have other mental illnesses, such as depression and substance use. Thus, there is a need to understand how co-occurring mental illness may affect response to gambling treatment.
Pharmacotherapy
Currently, no medication has been approved for gambling treatment. Opioid antagonists, such as naltrexone, seem to have the greatest support. Opioid antagonists target dopamine pathways in the brain, which are involved in processing information about reward. The presence of co-occurring mental illness needs to be considered when making treatment decisions. Opioid antagonists could be more suited for people who also have substance use disorders; antidepressant medications or mood stabilizers could be more appropriate for people who also have depression or bipolar disorders.
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