Birches Health, a national provider of specialized digital addiction treatment, announced results from a retrospective cohort study showing that adults with gambling disorder who received specialized virtual behavioral health treatment achieved rapid, clinically meaningful reductions in gambling symptom severity.¹
Published in JMIR Mental Health, the study analyzed outcomes for 1305 adults treated through the company's platform between June 2024 and April 2026, and the company describes it as the largest known real-world clinical dataset on virtual gambling disorder treatment in the United States.
More than 20 million US adults meet criteria for problem gambling or gambling disorder, and the condition carries among the highest suicidality risk of any behavioral health diagnosis while remaining highly comorbid with depression, anxiety and substance use disorders. Fewer than 10% of people with gambling disorder seek treatment, and most existing clinical trials on gambling treatment are small and exclude patients with psychiatric comorbidities, leaving providers and payers with limited real-world evidence that treatment works outside controlled settings.¹
"Gambling disorder has been treated as an afterthought in the US healthcare system for decades," said Elliott Rapaport, founder and CEO of Birches Health. "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."
Frequently Asked Questions
What did the JMIR study find about virtual treatment for gambling disorder?
The retrospective cohort study of 1,305 adults found an estimated 8.3-point reduction on the Gambling Symptom Assessment Scale over 12 weeks of virtual behavioral health treatment, with 71.7% of clients with follow-up assessments achieving clinically meaningful improvement.
How quickly did clients improve, and did comorbid conditions affect outcomes?
Median time to clinically meaningful improvement was 14 days. More than half of participants (56%) had at least one co-occurring psychiatric diagnosis, most commonly anxiety or depressive disorders, and treatment produced meaningful improvement across this full range of clinical complexity.
Birches Health delivers care through licensed clinicians with dedicated training in gambling disorder, combining individual psychotherapy, group therapy, peer support from individuals with lived experience and financial wellness counseling, grounded in cognitive behavioral therapy and motivational interviewing.¹ Participants received care virtually, and the company operates in all 50 states, with coverage through major national insurance plans including United Healthcare, Cigna, Aetna, TRICARE and Blue Cross Blue Shield plans.
Gambling symptom severity declined significantly over 12 weeks of treatment, with an estimated 8.3-point reduction on the Gambling Symptom Assessment Scale (G-SAS).¹ Among clients with follow-up assessments, 71.7% achieved clinically meaningful improvement in gambling symptom severity, with a median time to improvement of 14 days.
More than half of participants (56%) presented with at least one co-occurring psychiatric diagnosis, most commonly anxiety disorders (26.9%), depressive disorders (21.2%), trauma-related disorders (9.6%), substance use disorders (6.5%) and ADHD (5.1%).¹ The study found treatment produced meaningful improvement across the full spectrum of clinical complexity, including participants with these co-occurring conditions, addressing a population typically excluded from smaller controlled trials.
"The thing I hear most from people in our care is that they wish they had come sooner," said Cynthia Grant, PhD, vice president of clinical at Birches Health and study co-author. "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."
The JMIR publication is the first in a planned series of peer-reviewed research from Birches Health examining clinical outcomes in gambling disorder treatment, with additional research on gambling disorder and other behavioral and process addictions currently in development.¹
References
1. Birches Health. Birches Health publishes first large-scale study showing specialized virtual treatment produces rapid improvement in gambling disorder symptoms. News release. July 30, 2026. Accessed July 30, 2026. https://www.prnewswire.com/news-releases/birches-health-publishes-first-large-scale-study-showing-specialized-virtual-treatment-produces-rapid-improvement-in-gambling-disorder-symptoms-302838549.html
2. Clinical outcomes and predictors of improvement with virtual behavioral health care for gambling disorder: retrospective cohort study. JMIR Mental Health. 2026;13:e101517.
