Gambling addiction treatment: what works and where it is free

Cognitive behavioural therapy has the strongest evidence behind it of any gambling addiction treatment. England’s NICE guideline on gambling-related harms, published on 28 January 2025, tells services to offer group CBT first, usually a course of 8 to 10 sessions, and individual CBT, usually 6 to 8 sessions, when a group is unavailable or unsuitable. Peer support runs alongside therapy rather than replacing it. Medication comes later: naltrexone is considered only after a full course of therapy has not worked, or when relapses keep repeating.

Nearly all of this is outpatient. You keep living at home, attend sessions weekly in person or by video, and carry on with work and family. Residential rehab is not the standard route, and the NICE recommendations do not include it. In Great Britain, Australia, Ontario and much of the United States, gambling treatment costs the person nothing.

There is no cure, and no medicine approved for gambling disorder

A gambling addiction cure, meaning a treatment that removes the pull permanently or a pill that ends it, does not exist. A 2026 review in Frontiers in Pharmacology states plainly that no medication has been officially approved for the treatment of gambling disorder, and the American Psychiatric Association says the same for the United States: there are no FDA-approved medications for gambling disorders.

Treatment does something narrower than a cure. It reduces how severely and how often someone gambles, teaches skills for handling triggers and cravings, and gives the person a plan for the day a relapse happens. NICE tells clinicians to agree the goal of treatment with the person, and that goal is typically abstinence. The guideline also says relapse is not shameful and does not indicate individual failure, and that services should provide rapid re-entry to therapy after a course of treatment ends. Our page on recovery and relapse covers that part.

Some people do stop without formal help. The American Psychiatric Association notes that some people stop gambling on their own, while also reporting that only about one in ten people with gambling disorder seek treatment.

How strong the evidence is for each treatment

CBT works well in the short term and has barely been tested in the long term. The 2022 Cochrane review of psychological therapies for problem gambling pooled 14 randomised trials with 1,245 participants and found very large reductions in gambling symptom severity in the three months after CBT ended. Only one trial, with 147 participants, followed people out to 9 to 12 months, and there the advantage was smaller and no longer statistically significant. The reviewers rated the evidence very low to low quality and wrote that the durability of therapeutic gain is unknown.

CBT for gambling is not generic talking therapy. It targets the specific cognitive errors that keep the behaviour going, including the belief that losses can be recovered by continuing, and it should be delivered by a psychologist or an accredited CBT therapist with gambling-specific training. The detail of what happens in those sessions is in our guide to CBT for gambling addiction. Gamblers Anonymous is a fellowship rather than treatment: its only requirement for membership is a desire to stop gambling. See how GA meetings work.

Medication: what naltrexone is actually for

Naltrexone is used off-label. NICE’s protocol is specific: start at 25 mg once a day for three days, then 50 mg once a day for four to six months, after checking that kidney and liver function are normal and that the person is not taking opioids. It should be started by or under the supervision of an appropriately qualified specialist, with follow-up monitoring including liver function tests. NICE also advises continuing psychological therapy alongside it.

Antidepressants are a different question. They are not a treatment for the gambling itself, but they may treat co-occurring depression or anxiety. More on the evidence and the trade-offs in medication for gambling addiction.

Residential rehab: when it fits and what it costs

Residential treatment means living at a centre for a block of weeks with structured group and individual therapy. It suits a narrow group: people whose gambling is severe, whose home environment makes stopping impossible, or who have been through outpatient treatment without it holding. It is not a stronger version of CBT, and it does not remove the need for weekly work afterwards.

Prices for private programmes are not standardised, and free options exist. In the UK, the charity Gordon Moody runs residential programmes for men and women and states that it now offers all services at no cost; its male residential programme is a six-week stay inside an 18-week plan, with six weeks of preparation calls beforehand and weekly phone support afterwards, and the average wait for a place is four to six weeks. The charity also runs a separate private arm, Retreat by Gordon Moody, which is paid. In the United States, residential and inpatient facilities are listed in the NCPG treatment facilities directory, and many states fund treatment so that the person pays nothing.

What happens at the first appointment

The first session is an assessment, not therapy. NICE tells services to use a validated tool such as the Problem Gambling Severity Index or the South Oaks Gambling Screen, and to go through your gambling history: when it started and when it intensified, what you play and where, current frequency, and the money involved as a proportion of your income, including any borrowing. You will also be asked about physical and mental health, alcohol and drug use, risk of suicide including past attempts, the effect on relationships, work and study, your triggers and cravings, and what you want treatment to achieve.

The output of that session is a case formulation, a care plan and, where needed, a safety plan. Bringing three months of bank statements and a rough figure for total debt makes the money part faster and more accurate. If you want a sense of where you stand before you book, our self-test uses the same screening questions clinicians do.

Where to find a therapist, and what is free

General directories rarely say who is gambling-trained, so searching for a therapist near you is the slow route. The national services above screen for it. Everywhere else, start from the helplines by country list.

Depression, anxiety, ADHD, and the medicines that can trigger gambling

NICE describes three patterns for conditions that appear alongside gambling. Some are a consequence of the gambling and improve once it stops. Some existed first and need treating at the same time. Some, such as severe PTSD or alcohol or drug dependence, are severe enough that they need treating first, because otherwise the person cannot engage with gambling treatment at all. The conditions NICE names when it tells services to build links with specialists include PTSD, severe ADHD, alcohol and drug dependence, learning disabilities and Parkinson’s disease.

One check is easy to miss and worth raising yourself. NICE tells clinicians to assess whether a person’s current medication may be contributing to the gambling, naming aripiprazole and the dopamine agonists used in Parkinson’s disease, and to consider reducing or adjusting those medicines in consultation with the prescribing specialist. If you are on either and your gambling started or escalated after the prescription, say so at the assessment. Do not stop a prescribed medicine on your own.

If the person will not go to treatment

You cannot refer an adult into treatment against their will, and pressure usually delays the decision. Two things are within reach. The first is motivational interviewing, which NICE recommends specifically for people who are unsure or have reservations about starting treatment, so it is worth asking a service whether they offer a session aimed at ambivalence rather than an immediate treatment course.

The second is support for you. The NICE guideline treats family members and affected others as people who need help in their own right, and says services should offer them help both alone and jointly with the person who gambles, techniques to manage their own distress, and support for non-judgemental conversation. Helplines in every country listed above take calls from family. Protecting your own money is a separate task and does not require the other person’s agreement; the steps are in helping someone with a gambling problem. Putting blocking software on shared devices is a reasonable step meanwhile.