Birches Health has published a study suggesting that telehealth can produce rapid improvement for people with gambling disorder. The Arizona-based clinic, which specialises in behavioural addictions, said the paper covers what it called the largest real-world clinical dataset on virtual gambling disorder treatment in the United States.
The peer-reviewed outcomes study appeared in the Journal of Medical Internet Research and was a retrospective analysis of 1,305 adults treated by Birches between mid-2024 and mid-2026. The sample was 65% male and had an average age of 41.5.
More than half of the patients had psychiatric comorbidities. Anxiety and depression were among them, and the study also reported trauma-related disorders, substance use disorders and ADHD in smaller shares of the sample. Higher baseline depressive symptom severity was associated with faster improvement in gambling symptoms, and Cynthia Grant, Birches’ vice-president of clinical, said the team was seeing “some parallel improvements.”
Researchers measured severity with the Gambling Symptom Assessment Scale, or G-SAS, which ranges from 0 to 48. They defined clinically meaningful improvement as a drop of four points or more, and 71.7% of the sample met that mark. The average improvement was 8.3 points, and the median time to reach meaningful improvement was 14 days. Nearly half the sample, 47.7%, sustained improvement on a consecutive assessment.
The findings arrive against a backdrop of low treatment uptake. A separate protocol paper on gambling-disorder treatment said only about 20% of affected people seek professional help, while Fierce Healthcare reported that some estimates put treatment below 10%. That broader literature also points to stigma, a shortage of treatment options and a high burden of comorbid mental-health conditions.
The Birches study has limits. GamingAmerica described it as backward-facing, since it looked at real-world patients who had already received virtual therapy rather than testing a new hypothesis against a control group. It also focused on one provider, which makes it harder to generalise the results to other treatment systems.
A GambleAware and Responsible Gambling Council evidence review found that all 16 studies it examined reported positive outcomes for remote interventions, but said the field still needs more work on direct comparisons with face-to-face care, follow-up assessments and independent evaluation. A later protocol paper likewise said evidence comparing asynchronous internet-based therapy with synchronous CBT remained limited.
Birches chief executive Elliott Rapaport said gambling disorder has been treated as “an afterthought” in the US healthcare system for decades. He said the study is peer-reviewed evidence that “a different model exists and that it works.” Fierce Healthcare also reported that Birches has treated more than 5,000 patients, operates in all 50 states and now offers individual therapy alongside group therapy, peer support and financial-wellness counselling. The company says reimbursement usually requires a gambling-disorder diagnosis, although it can treat some patients with problem-gambling symptoms if they have another diagnosis such as depression.
