A Guide to Understanding Gambling Addiction and How Addiction Counselors Can Specialize

online poker player Online poker… sports betting… lottery and scratch cards… day trading. It’s all the kind of gambling that gets its hooks in people these days, no different from the horse racing, bingo, and slot machines of previous generations. And for a significant portion of the population, it’s a real problem.

It’s estimated that up to 2 percent of the population may have a gambling addiction.

It’s never been more accessible and more convenient to gamble, thanks to the proliferation of online gambling in recent years. During COVID, a perfect cocktail of social isolation and easy access to gambling at their fingertips sent many Americans into a tailspin of problematic gambling behaviors. According to the National Council on Problem Gambling, online gambling has increased between 30-40 percent since the pandemic.

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How to Spot When Casual Gambling Becomes a Compulsion

According to the American Psychiatric Association, gambling addiction, which they refer to as “gambling disorder,” is defined as a “pattern of repeated and ongoing betting and wagering” that continues even in the face of serious problems in a person’s life.

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines it clinically as a “persistent, recurrent pattern of gambling that is associated with substantial distress or impairment.”

Like many other types of addictions, compulsive gambling can affect adults at any stage of their lives. Children and young adults are also emerging as a growing demographic of gamblers. A Canadian study found that nearly two-thirds of adolescents ages 12-18 said they had gambled or played gambling-like games in the last year.

Individuals with a gambling addiction often:

Have persistent thoughts about gambling
Are unsuccessful at controlling, cutting back, or stopping their gambling habits
Experience restlessness, irritability, or anxiety when they attempt to cut back or stop gambling
Use gambling to escape from their personal or professional problems
Downplay or lie to others about their gambling habits
Engage in reckless spending habits, including stealing, asking others for money, and incurring debts they cannot pay
Sacrifice/lose important professional and personal relationships and opportunities because of gambling

Gambling addiction may be consistent for some individuals, while for others, it may come in periods or waves. Some of the factors that contribute to gambling disorder include:

Trauma
Social inequality
Low income/poverty
Unemployment

Many times, an addiction to gambling goes hand in hand with other untreated mental health conditions such as ADHD, depression, and anxiety.

Vulnerable groups include men, who outnumber women 2 to 1 when it comes to gambling addictions, and young adults (particularly males), about 5 percent of whom go on to develop a gambling disorder.

From Impulsivity to Addiction: Inside the Brain of a Compulsive Gambler

Gambling is now recognized as an addiction, but it hasn’t always been that way. In fact, up until 2013, when the American Psychiatric Association classified it as an addictive disorder (in the DSM-5), problem gambling was largely seen as an impulsive disorder.

To fully understand the compulsion of gambling, it’s important to understand how and why this occurs. Compulsive gambling habits may be what we see, but there’s a whole lot going on inside the brain that’s feeding them.

Both the brain’s prefrontal cortex and the ventral striatum play a role in addiction. In those with a gambling addiction, scientists have found a decrease in activity the prefrontal cortex (the problem-solving and planning part of the brain) and an increase in activity in the ventral striatum (the brain’s reward center), both of which are thought to create a need to make instant, reward-based decisions that have poor long-term consequences instead of sound decisions that have positive long-term consequences.

A surge of dopamine—the neurotransmitter responsible for pleasure and motivation—to the ventral striatum when gamblers win creates that “high” and further reinforces their urge to gamble. A deficiency in the brain’s dopamine system leads to what scientists refer to as the “reward deficiency model,” where individuals seek out reward-stimulating activities to account for an underactive brain reward system. Some studies have also shown genetic factors at play.

Other studies have shown that compulsive gamblers are more likely to have a smaller amygdala and hippocampus, both of which are directly related to emotions and stress. This explains why many adolescents and young adults whose regions of the brain haven’t fully developed are more susceptible to engaging in risky behaviors like gambling and drugs.

The Connection Between Gambling Addiction and Substance Use Disorder

Substance use disorder and gambling disorder are both classified as behavioral addictions, and for good reason. There’s a number of common threads that run through both disorders.

According to UCLA’s Gambling Studies Program (within the Department of Psychiatry and Biobehavioral Sciences), some of the similarities people experience with both gambling addiction and drug addiction include:

They have difficulty controlling their choices and feel powerless to stop them.
They are preoccupied with their behavior and spend a lot of time thinking about how to get money to engage in the behavior.
They try to minimize or deny their addictive behaviors.
They experience an escalation in their addiction because the brain feels desensitized or numb to the excitement or thrill of the high.
They develop a careless attitude toward their well-being.
They develop withdrawal when they don’t have access to the substance or gambling.
They experience similar withdrawal symptoms like irritability, anger, and sleeping difficulties.
They use their addiction to escape reality – difficult emotions or painful experiences.
They engage in risk-taking behavior and show poor judgement and decision-making.
They continue to engage in the addictive behavior regardless of negative consequences.
They develop cravings for the addictive behavior.
They report feelings of shame, impulsivity, distrust, loneliness, and boredom.
They may engage in criminal activities to support their addiction.
They report feeling a “high” when engaging in their addictive behavior.

Modern Treatments for Today’s Gambling Addictions

Gambling addiction is treated with therapy and support groups, although there is some evidence to show that medications, largely mood stabilizers and antidepressants, are also effective when used in combination with therapy.

Individual and group counseling, family therapy, peer support, and financial counseling are used to treat gambling addiction. Cognitive-behavior therapy (CBT), motivational interviewing, and 12-step principles have all been shown to be effective at identifying and changing the problem behaviors associated with gambling.

According to the National Council on Problem Gambling, therapeutic avenues often include:

Peer support groups, which provide individuals with a sense of community
Outpatient treatment programs, which offer treatment for individuals while they continue to live at home
Residential treatment programs, which provide more intensive therapy in a controlled and supportive environment
Inpatient treatment programs, which provide around-the-clock care in a hospital setting for individuals requiring additional support, such as medical stabilization, treatment for other mental health conditions, and close supervision

Earning State Credentials and National Certification in Gambling Addiction Counseling

Because of the close connection between substance use disorder and gambling addiction, many substance abuse counselors choose to specialize in gambling addiction.

And fortunately, there are many educational programs to develop your skills, professional organizations to support your growth, and certifications to attest to your competence.

Earning a State-Issued Credential

In most cases, it will take little more than your current substance abuse counselor state certification/license and a course of education in addiction counseling to specialize in gambling addiction. In some states, you can even earn a state-issued credential in gambling addiction counseling.

For example:

In Louisiana, credentialed Addiction Counselors can become a Certified Compulsive Gambling Counselor through the Addictive Disorder Regulatory Authority by completing 20 clock hours of gambling addiction courses from an ADRA-approved education program.
In Pennsylvania, certified addiction counselors (CAAC, CADC, CAADC, CCDP, CCDPD, CCS) can earn a Certificate of Competency in Problem Gambling through the Pennsylvania Certification Board (PCB) by completing at least 30 hours of problem gambling-specific education. Depending on your current credential, you may also need to take and pass the International Gambling Counselor Certification Board (IGCCB) exam.
In Washington State, you can earn the Washington State Certified Gambling Counselor (WSCGC – I/II) credential through the Washington State Gambling Counselor Committee by holding a current Washington State certificate or license in mental health or substance use treatment services; earning a bachelor’s degree (or an associate’s degree and two sears of post-SUDP licensure clinical experience); completing at least 30 hours of gambling-specific training; earning at least 1,500 hours of post-certification supervised experience working with those affected by problem gambling/gambling disorder; and passing the International Gambling Counselor Certification Board (IGCCB) exam.

Many colleges, universities, and nonprofits offer CE courses and training programs in gambling addiction counseling. For example, Lewis & Clark College’s Graduate School offers a free series of training modules that’s hosted by the Oregon Health Authority Problem Gambling Services and the Oregon Council on Problem Gambling,

And the Council on Compulsive Gambling of New Jersey (CCGNJ) offers a free 30-hour Counselor Training for Disordered Gambling program.

Earning Certification Through the International Gambling Counselor Certification Board

You can also add gambling addiction counselor to your substance abuse counselor credentials by earning the International Certified Gambling Counselor (ICGC – I/II) credential through the International Problem Gambling and Gaming Certification Board (IPGGC).

To become an ICGC-I, you must:

Earn a bachelor’s degree in a behavioral health field
Complete at least 30 hours of IPGGC-approved gambling-specific training and education
Complete a 100-hour clinical experience treating individuals with a gambling disorder or their family members
Pass the International Gambling Counselor Certification Board (IGCCB) exam

To become an ICGC-II, you must:

Earn a bachelor’s degree in a behavioral health field
Complete at least 60 hours of IPGGC-approved gambling-specific training and education
Complete at least 2,000 hours of clinical experience treating individuals with a gambling disorder or their family members
Pass the International Gambling Counselor Certification Board (IGCCB) exam

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