Birches Health Online-Gambling Addiction Program’s Improvement Rate Booms

For decades, many people who had admitted having a gambling addiction to themselves and began searching for help sometimes confronted obstacles they found unmanageable.

In an age of ubiquitous technology, which is too often a facilitator of a problem, a generation groping for recovery finds itself more comfortable in front of a screen than in a circle of folding chairs.

There had long been the question of whether this digital interaction was good enough. It seems to be improving. An external study of Birches Health’s online-gambling addiction program asserts that 85% of patients report improved gambling-disorder symptoms after nine video interventions. The study was conducted via interviews of patients from July 2023 to October 2025.

“The predominant form of treatment and support for individuals who are struggling from gambling in the U.S. is a 12-step program and those programs over the past 50 years have truly saved lives,” Birches CEO Elliott Rapaport told InGame. “However, today you’re seeing a bunch of 18- to 40-year-olds who refuse to enter the local community center basement, because they’re not comfortable there. So there’s space for all modalities of treatment.”

Gambling disorder still a new treatment area

Gambling disorder was not included in the Diagnostic and Statistical Manual of Mental Disorders until an update in 2013 and it’s still considered one of the field’s least-recognized and least-treated conditions. The rise of mobile and online gambling, particularly sports betting with the repeal of the Professional and Amateur Sports Protection Act in 2018, as a coinciding event continues to concern clinicians.

Birches’ success rate, therefore, represents progress.

“Especially when you think about the past 10, 20 years of gambling-disorder treatment in the U.S., you could not have built this business a decade ago,” Rapaport said. “It would have been impossible.

“We’ve been very fortunate over the past three years, since the company was founded in 2023, to partner with clinical leaders who have helped us compile a best-in-class clinical program. We live and die by our clinical outcomes, and we’re very happy to be quite transparent and vocal about them, because we believe that’s the best thing for a patient population.”

And that patient population is swelling, according to academic research, in the post-PASPA era. A March poll released by the American Psychiatric Association (APA) claimed that 28% of American adults “have a daily habit of gambling online.”

That still may not capture the true problem, Rapaport said, noting that studies that pegged the problem-gambling population at around 1% in the United States are at least a decade old.

“You also have gambling in the under-25 cohort, which is actually growing at about a 15% [compound annual growth rate] over the next five years,” Rapaport said. “So gambling is very much here to stay, and that’s merely the entry point for many Americans.

“[The 15% figure] doesn’t include the gamblification of financial trading apps, of cryptocurrency platforms, even slot machine mechanics like loot boxes, and video games for children five-plus.”

Rapaport described the Birches patient population as slightly younger than traditional counseling cohorts, which was to be expected, given the group has never known a tech-free society.

A July U.S. News & World Report survey found that 30% carry debt they attribute to gambling.

“When you think about the clinical outcomes we’re measuring, our [goal] here is combating gambling addiction — the related behavioral health disorders, but also the significant social and financial harms that can result from that, using, of course, more and proven specialized methods of care,” Rapaport said. “Individuals and their families should no longer have to suffer in silence.”

“The 18- to 35-year-old cohort lives their life online, and perhaps they might be exhibiting at-risk behaviors online,” he said. “You need a clinical program meeting them where they are, which is predominantly online and is through virtual means through telehealth.”

Inside Birches’ online counseling

Though Birches touts progress in the first nine sessions of counseling, the program is not designed as a quick fix, Bobbe McGinley, Birches Health clinical director in Arizona, told InGame. After an initial “acute intervention” phase that mitigates immediate crisis, builds coping skills, and addresses urgent financial problems, patients and their families undertake a customized program that could include individual, family, couples, and group therapy.

“The next big focus is month four to year 40,” McGinley said. “We are not trying to get someone through a 12-week program and send them on their way. Birches Health is helping them build a life where they can maintain recovery without clinical intervention.”

McGinley said some patients “step down” to less intensive counseling after six months, but individual treatment varies. Tone, pacing, and verbalizing empathy are crucial in a virtual session, she added.

“Therapists can use clearer structure and frequent check-ins to build rapport and alignment, which is especially important when addressing shame and avoidance in digital addiction — gambling, sports betting, and financial trading in particular,” she explained. “While telehealth may limit full body language, it often helps clients feel more comfortable and willing to open up by meeting them in their own environment, which is so crucial for this patient population.”

Insurance, referral partnerships impactful

The program is covered by numerous insurance plans, such as UnitedHealthcare, Cigna, Aetna, and Blue Cross/Blue Shield. Birches has outreach programs with various sportsbooks and professional sports leagues and relationships with state-level departments of health.

Patients can gain access to the program either by inquiring themselves through the company website portal or by medical referral.

“The business really began in many ways with higher-acuity patients who are actively referring themselves,” Rapaport said, “someone who on a Sunday night had the crisis moment after they lost this month’s rent on a football game. And in many ways, that’s a patient who’s in crisis and is actively looking for care and would find us.”

Expansion to 50 states and amassing a broader clinical panel of providers, Rapaport said, has increased the percentage of referrals. In September, the United Kingdom-based Gordon Moody charity dedicated to supporting gambling-addiction charities announced a partnership with Birches, the same month that Birches announced a $20 million funding round.

“Historically, individuals often struggled to find a gambling-specialized therapist. If they managed to navigate what was often a web of referrals and hotlines and actually find a therapist, insurance usually didn’t cover care and costs were truly prohibitive. Or they explored sub-clinical options,” McGinley said. “Twelve-step programs have saved countless American lives, but in this day and age, younger patients often don’t want to go somewhere in person for support or prefer the private nature of specialized counseling with gambling-addiction specialists.”

Awareness is improving within industry

Rapaport said the legal sports betting industry has taken responsible gambling more seriously in the last decade. But the system hasn’t been perfected.

“Limits, self-exclusion, responsible gaming tools, they can help some people in the earlier stages by slowing behavior or by creating pauses, I think, in their at-risk behaviors,” he said. “But those aren’t clinical treatment. Once gambling becomes a clinical disorder, people need professional care from specialists that actually addresses the underlying behavioral health conditions.

“So we often work with those patients after those tools have stopped being enough. My call always to the gaming industry is around access and thinking about when someone needs to be escalated into care, when they’re in the crisis moment, how do we recognize that? Then how do we successfully get them into affordable, geographically accessible, and, of course, confidential treatment?”