Maryland Has More Treatment Options Than Most People Realize

If you or someone you love is struggling with gambling, Maryland offers a meaningful network of treatment resources — from outpatient counseling and residential programs to peer support and crisis intervention. The challenge is usually not a shortage of options. It’s knowing where to start, what to ask for, and how to take that first step without fear of judgment.

This page walks through what treatment actually looks like in Maryland, what the research says about effective approaches, and how to connect with support — whether you’re ready to make a call today or just beginning to ask questions.

Recognizing the Problem: What Problem Gambling Looks Like in Practice

Gambling disorder is not simply a matter of spending too much money. It’s a recognized behavioral condition in which a person continues gambling despite significant consequences — financial, relational, emotional, or legal. For many people in Maryland, the problem develops gradually, often starting with lottery tickets, casino visits to National Harbor, or online sports betting after Maryland legalized mobile wagering in 2022.

Some signs that gambling has become a problem include:

• Needing to gamble with larger amounts of money to feel the same excitement
• Repeated unsuccessful attempts to cut back or stop
• Lying to family members or employers about gambling activity
• Borrowing money, selling possessions, or taking out loans to fund gambling

These patterns are not character flaws. Research from the National Institute of Mental Health consistently shows that behavioral addictions share neurological pathways with substance use disorders — the brain’s reward system is genuinely altered over time. Understanding this is important for both the person struggling and the family members trying to make sense of behavior that can otherwise seem baffling or hurtful.

The Most Effective Treatments for Gambling Disorder

Treatment for gambling disorder has evolved considerably over the past two decades. No single approach works for everyone, but the evidence base is strong for several specific modalities.

Cognitive Behavioral Therapy (CBT)

CBT is widely considered the gold standard for gambling disorder treatment. It works by helping individuals identify the distorted thinking patterns that fuel gambling — beliefs like “I’m due for a win” or “I can control the outcome if I stay focused.” A therapist trained in CBT will work with you to replace those patterns with more accurate thinking and develop concrete coping strategies for urges and high-risk situations.

Clinical studies published in peer-reviewed literature have demonstrated that CBT produces meaningful reductions in gambling frequency, financial harm, and psychological distress. Sessions are typically structured and goal-oriented, often running 12 to 20 weeks in an outpatient setting. Many Maryland providers offer CBT through both in-person and telehealth formats.

Motivational Interviewing

Not everyone enters treatment fully committed to stopping. Motivational interviewing (MI) is a counseling approach designed for exactly that situation. Rather than confronting or lecturing, an MI-trained therapist helps you explore your own ambivalence — the part of you that wants to stop and the part that isn’t sure yet. This technique is often used in early stages of treatment or during intake assessments.

Medication-Assisted Support

There are no FDA-approved medications specifically for gambling disorder, but psychiatrists and addiction medicine specialists sometimes use medications off-label to address co-occurring conditions or reduce gambling urges. Naltrexone, for example, has shown promise in clinical treatment literature for reducing the intensity of gambling cravings in some individuals. A psychiatric evaluation can help determine whether medication is appropriate as part of a broader treatment plan.

Peer Support and Group Programs

Many people in recovery find that structured peer support — meeting regularly with others who understand the experience firsthand — is as important as formal therapy. Maryland has active peer support communities, and some treatment programs integrate group sessions directly into their clinical model. Peer support does not replace professional treatment but can significantly strengthen long-term recovery outcomes.

Maryland’s Treatment Infrastructure: What’s Available Statewide

Maryland has invested in problem gambling services through the Maryland Center of Excellence on Problem Gambling, which coordinates training for clinicians, maintains a directory of certified treatment providers, and funds public education efforts. This infrastructure means that licensed therapists across the state — from Baltimore City to the Eastern Shore — are increasingly equipped to treat gambling disorder specifically, not just general behavioral health concerns.

Treatment settings vary widely depending on the severity of the problem and individual circumstances:

• Outpatient counseling: Individual therapy sessions, typically once or twice a week, conducted through private practices, community mental health centers, or hospital-based programs
• Intensive outpatient programs (IOP): Structured treatment several days per week, often three hours per session, for people who need more support than weekly counseling but do not require residential care
• Residential treatment: Inpatient or residential programs that provide a structured, immersive environment — typically recommended when gambling has caused severe life disruption or when co-occurring disorders require close monitoring
• Telehealth services: Remote therapy sessions that can be particularly useful for Marylanders in rural counties or those with transportation or scheduling barriers

Financial access is a real concern for many families. Maryland’s Medicaid program covers behavioral health services, and many certified problem gambling providers work with insurance plans or offer sliding-scale fees. If cost is a barrier, asking about financial assistance options during your first call is entirely appropriate — providers are accustomed to that conversation.

Co-Occurring Mental Health Conditions

Gambling disorder rarely travels alone. Depression, anxiety, ADHD, and substance use disorders frequently co-occur with problem gambling, and each condition can reinforce the others. Someone gambling to escape feelings of hopelessness may also be managing untreated depression. A person using alcohol to cope with gambling losses may find that both problems escalate together.

Effective treatment addresses these connections directly. A provider who only focuses on gambling behavior without assessing for co-occurring mental health conditions may miss a significant driver of the problem. When you contact a treatment program or therapist, asking whether they conduct a full mental health assessment — not just a gambling-specific one — is a reasonable and important question.

The relationship between behavioral health and gambling is well-documented. Mental health research from the CDC highlights that untreated mental health conditions significantly affect quality of life and recovery outcomes across behavioral health conditions, including gambling disorder. Integrated care — treatment that addresses gambling and mental health simultaneously — tends to produce better long-term results than treating each condition separately.

Support for Family Members and Loved Ones

Gambling addiction affects the entire household. Spouses, parents, adult children, and close friends often carry enormous stress — financial pressure, broken trust, emotional exhaustion, and uncertainty about how to help without enabling. These experiences are real, and they deserve attention in their own right.

Family members in Maryland have several options for support:

• Family therapy: A licensed therapist can work with family members — together or separately — to process the impact of gambling, rebuild communication, and establish healthy boundaries
• Educational resources: Understanding gambling disorder as a clinical condition, rather than a moral failing, often helps family members respond more effectively and with less resentment
• Peer support for families: Groups specifically for family members provide a space to share experiences with others who understand the particular dynamics of loving someone with a gambling problem

If you’re a family member trying to figure out how to approach a conversation about treatment, or simply trying to protect yourself financially and emotionally, reaching out for guidance is a reasonable first step — even before the person who is gambling is ready to seek help themselves.

Online and Mobile Gambling: A Growing Concern in Maryland

Since Maryland launched legal mobile sports betting in late 2022, access to gambling has expanded dramatically. A person can now place a bet from their phone at 2 a.m. without leaving home. This 24/7 availability removes many of the natural friction points that once limited gambling frequency — the drive to the casino, the need for cash, the social visibility of the act.

For people already vulnerable to gambling disorder, this accessibility can accelerate the development of a serious problem. It also makes the problem easier to hide. A spouse may not notice that their partner has placed hundreds of bets over the past month — there’s no casino receipt, no visible absence, no obvious behavioral cue.

If online or mobile gambling is part of the picture for you or someone you love, treatment providers in Maryland are familiar with this pattern. Platform-specific considerations — including self-exclusion tools available through Maryland’s gaming regulators — can be part of a broader recovery plan. For more information on platform-specific gambling help, visit our platform-specific gambling addiction resources.

Self-Exclusion Programs in Maryland

Maryland offers a voluntary self-exclusion program through the Maryland Lottery and Gaming Control Agency. Enrolling in self-exclusion means requesting that licensed Maryland casinos — including MGM National Harbor, Live! Casino, and others — ban you from their premises. If you are found gambling after enrolling, any winnings can be forfeited.

Self-exclusion is not a treatment on its own, but it can serve as a meaningful barrier during early recovery when urges are strongest. Some people find that the formal commitment of self-exclusion helps reinforce their decision to stop. It works best when combined with counseling or other therapeutic support rather than used in isolation.

For online gambling platforms, self-exclusion options vary by operator. Some platforms allow users to set deposit limits, cooling-off periods, or full account suspensions. Asking your treatment provider to help you navigate these tools as part of your recovery plan is a practical and worthwhile step.

How to Find a Qualified Treatment Provider in Maryland

Not every therapist or counselor has specific training in gambling disorder. When searching for a provider, looking for credentials or experience specific to problem gambling — rather than general addiction counseling — can make a meaningful difference in the quality of care you receive.

Questions worth asking when contacting a potential provider:

• Do you have specific training or certification in gambling disorder treatment?
• What treatment approaches do you use, and what does a typical course of treatment look like?
• Do you assess for co-occurring mental health conditions as part of your intake process?
• Do you offer telehealth sessions, and do you accept my insurance or offer sliding-scale fees?

Maryland’s network of certified providers has grown in recent years, and many community mental health centers now have at least one clinician with problem gambling training. The Maryland Center of Excellence on Problem Gambling maintains referral resources that can help you identify qualified providers in your area.

What Happens When You Call for Help

Many people put off calling because they’re not sure what will happen — or they worry about being judged, pressured, or committed to something they’re not ready for. These concerns are understandable. Here’s what you can actually expect.

When you call the 24/7 Gambling Addiction Hotline, you’ll speak with a trained specialist who will listen without judgment. The call is confidential. You won’t be told what to do or pushed into a program you haven’t chosen. The goal of the call is to understand your situation — or your loved one’s situation — and help you identify next steps that make sense for your circumstances.

That might mean a referral to a Maryland-based therapist. It might mean information about a local intensive outpatient program. It might mean guidance for a family member trying to figure out how to have a difficult conversation. Whatever brought you to the phone, the conversation starts where you are — not where someone else thinks you should be.

You don’t have to be in crisis to call. Some people reach out because they’re curious about whether their gambling has become a problem. Others call in the middle of a financial emergency. Both are valid reasons to reach out, and both deserve a thoughtful, personalized response.

Recovery Is Possible — and It Starts With One Step

Gambling disorder is a serious condition, but it is also one that responds to treatment. People recover. Relationships are repaired. Financial stability is rebuilt. The path looks different for everyone, and it is rarely a straight line — but the evidence is clear that treatment works, and that reaching out for help is the most important thing you can do.

Maryland has the resources. You don’t have to navigate them alone. Whether you’re ready to start treatment today or just need someone to talk through the options, help is available right now. Visit our educational resources and recovery tools to learn more, explore state-specific gambling resources if you or a loved one needs support in another state, or take the most direct step and speak with a specialist at the 24/7 Gambling Addiction Hotline — confidentially, at no cost, any time of day or night.