Birches Health spotlighted in Fast Company story
Birches Health and founder Elliott Rapaport were featured in a new Fast Company article that explores the gambling addiction treatment landscape in the United States. Here are some excerpts and highlights from the story:
Rapaport watched a close friend spend months navigating the search for gambling addiction treatment—calling hotlines that led nowhere, finding therapists untrained in the disorder, discovering his insurance covered almost nothing. In 2023, Rapaport founded Birches Health to try to close the gap.
The model is telehealth: therapy delivered remotely, covered by insurance, available nationwide. Birches now works with more than 100 insurance plans across all 50 states. According to Rapaport, 94 percent of patients pay less than $25 per session out of pocket—a number that looks very affordable next to Algamus’s $26,000 residential price tag.
The question Rapaport raises, without prompting, is whether it actually works.
The honest answer is that the evidence is real, but still building. A 2024 randomized trial published in JAMA Network Open and a large Swedish cohort study in the Journal of Medical Internet Research both found meaningful reductions in gambling behavior through internet-delivered cognitive behavioral therapy, especially when paired with a trained therapist rather than fully self-guided. Birches’ own data shows 85 percent of patients reporting improved symptoms after nine sessions.
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The patient population that needs Rapaport’s version is growing fast. Young men between 18 and 35 are the most vulnerable. For them, sports betting arrived already gamified and social.
“Their friends think it’s hilarious when they lose money,” Rapaport says, “until it’s obviously not funny anymore.”
More than one in three boys between 11 and 17 has gambled in the past year, according to one survey. On college campuses, students have been found logging into accounts under a parent’s name or funneling bets through older classmates. In Massachusetts—where online gambling is legal—school counselors have identified gambling as the fastest-growing behavioral concern among middle schoolers.
Both Benson and Rapaport agree that the current system is nowhere near adequate to handle a generation that grew up with a casino in their pocket.
