Birches Publishes First Large-Scale Study Showing Specialized Virtual Treatment Produces Rapid Improvement in Gambling Addiction Symptoms
Birches Health, the leading national provider of specialized digital addiction treatment, today announced the publication of a peer-reviewed clinical outcomes study in the Journal of Medical Internet Research (JMIR) demonstrating that adults who received specialized virtual treatment for gambling addiction achieved rapid, clinically meaningful reductions in gambling symptom severity. The study of over 1,300 adults represents the largest known real-world clinical dataset on virtual gambling disorder treatment in the United States.
More than 20 million U.S. adults meet the criteria for problem gambling or gambling disorder, a number that continues to grow as online access to these products increases and becomes more normalized across American culture. The condition has among the highest risks of suicidality in behavioral health and is highly comorbid with depression, anxiety and substance use disorders. Despite the devastating impact on individuals and their families, fewer than 10% of people with gambling disorder have seek treatment causing significant social and financial system costs.
The clinical research has not kept pace with the scale of the problem. Most existing studies on gambling treatment are small, tightly controlled trials that exclude patients with psychiatric comorbidities, leaving providers, payers, and employers with limited real-world evidence that treatment works. This JMIR peer-reviewed study published by Birches Health provides that evidence at scale, demonstrating that specialized care produces rapid, clinically meaningful improvement for adults with gambling disorder, including those with complex clinical profiles.
The research analyzed outcomes for adults who received virtual behavioral health treatment through Birches Health between June 2024 and April 2026. Key findings include:
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)
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%)
Treatment produced meaningful improvement across the full spectrum of clinical complexity, including clients with co-occurring psychiatric conditions
"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. That should matter to every payer, employer, and state health system still treating gambling addiction as someone else's problem."
The study describes outcomes from Birches Health's multi-component virtual care model, which delivers specialized treatment through licensed clinicians with dedicated training in gambling disorder. Treatment combines individual psychotherapy, group therapy, peer support from individuals with lived experience and financial wellness counseling, with care grounded in cognitive behavioral therapy and motivational interviewing. Birches Health operates in all 50 states and is covered by major national insurance plans including United Healthcare, Cigna, Aetna, TRICARE and Blue Cross Blue Shield plans, with additional access supported through state department of health partnerships.
"The thing I hear most from people in our care is that they wish they had come sooner, Dr. Cynthia Grant, Vice President of Clinical at Birches Health and co-author of the study. "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."
Higher baseline depressive symptom severity was associated with faster improvement in gambling symptoms. “We were seeing some parallel improvements,” Grant added in an interview with Anastassia Gliadkovskaya of Fierce Healthcare.
The data is relevant to payers, employers and health systems, Rapaport noted to Fierce, who don’t realize the extent “of what we believe is a public health epidemic that is rapidly advancing across the U.S.” The goal of the study was, in part, to “show that despite the scale of the problem of gambling disorder in the U.S., specialized care does exist [and works].”
The JMIR publication is the first in a planned series of peer-reviewed research from Birches Health examining clinical outcomes in gambling disorder treatment. Additional research on gambling disorder and other behavioral and process addictions is currently in development.
While this study focused primarily on clients who only received individual psychotherapy, Birches has expanded its clinical model since. Treatment options now include one-on-one therapy, plus group therapy, peer support and financial wellness counseling. These are all voluntary. Expansion of the offerings is driven by internal analyses that show patients are more engaged in care when they participate in groups and work with a peer, per Grant.
