by Andrew John Tucker, LCSW
Researched by Corina Evi Tucker y de la Huerta
www.addictiontherapynyc.com
One of the most common things I hear from people struggling (and their families) with gambling is this: “I don’t even know what treatment is supposed to look like.”
That uncertainty feeds shame. And shame keeps people quiet.
That’s why I was encouraged to see the Massachusetts Office of Problem Gambling Services publish its evidence-informed guidance, “Treatment Recommendations for Gambling Disorders.” Rather than vague advice or moral messaging, the document lays out what research and clinical practice actually support.
The central message is clear: gambling disorder is treatable, and effective treatment is structured, intentional, and grounded in evidence.
The recommendations highlight cognitive behavioral therapy (CBT) as a first-line approach. That makes sense. Gambling often involves predictable cognitive distortions…chasing losses, overestimating control, selective memory of wins, and minimizing harm. CBT helps clients slow these loops down and replace them with clearer, more reality-based thinking.
Motivational Interviewing is also emphasized. This is critical, (and I love that we continue to turn to M.I.) Many individuals seeking help feel ambivalent. They may not be sure they want to stop completely. Evidence shows that collaborative, non-confrontational approaches increase engagement and reduce dropout. In other words, we don’t shame people into recovery…we invite them into it.
The guidance also recognizes co-occurring conditions. Anxiety, depression, substance use, trauma histories…these are not side notes. They are often central drivers of gambling behavior. Effective treatment addresses the whole person, not just the bet.
Importantly, the recommendations acknowledge that recovery may include financial counseling, peer support, and coordination of care. Gambling disorder is not just psychological. It is behavioral, relational, and sometimes legal or financial. Treatment works best when it reflects that complexity.
For clinicians, this document reinforces something many of us have experienced firsthand: gambling disorder deserves the same seriousness, structure, and evidence-based attention as substance use disorders.
For individuals struggling, the takeaway is powerful. This is not a niche issue. It is not a moral failing. It is a recognized condition with clear treatment pathways.
Here are three practical ways this guidance can support recovery work:
- Normalize treatment expectations. Clients benefit from knowing there is a roadmap. Therapy is not improvisation…it is grounded in research.
- Address co-occurring conditions early. Screening for anxiety, depression, and substance use increases long-term stability.
- Strengthen collaborative care. Financial planning, family work, and peer support are not optional add-ons. They are part of comprehensive recovery.
When public health agencies publish structured treatment recommendations, it signals something important: this issue matters. And help is real.
The more we talk about gambling disorder as treatable, the less space shame has to grow. If you need help or have questions about treatment, I am happy to discuss it.
Original resource:
Massachusetts Office of Problem Gambling Services. (2025). Treatment Recommendations for Gambling Disorders.
https://www.mass.gov/info-details/treatment-recommendations-for-gambling-disorders
If you or anyone you know might benefit from a free consultation with a Clinical Addiction Specialist, fill out the confidential form on my website www.addictiontherapynyc.com, and I will reach out to you within 12 hours.
