NHS and Gambling Harm Reduction

Explore the NHS's strategy for reducing gambling-related harm. A guide on new treatment centres, clinical pathways, and support resources for patients

02:47 01 August 2025

As a mental health or addiction professional, you are on the front line of one of the UK's most pressing public health issues: gambling-related harm. The psychological toll of problem gambling—including anxiety, depression, and suicidal ideation—is profound, and clients often present in a state of crisis, feeling isolated and overwhelmed.

In recent years, the NHS has formally recognised the severity of this issue and is significantly scaling up its response. For therapists, counsellors, and support workers, understanding this evolving landscape is crucial for guiding clients towards the most effective and appropriate care. This article provides a professional overview of the NHS's strategy, the clinical pathways available, and your vital role within this national framework.

The Shifting Landscape: Recognising Gambling as a Public Health Issue

The conversation around gambling has fundamentally changed. It is no longer viewed as a fringe issue or a moral failing, but as a behavioural addiction with serious health and social consequences. This shift has been driven by the sheer accessibility of modern gambling. The digital age means access is no longer confined to high street bookmakers; it's now instant, pervasive, and available 24/7 through thousands of online platforms, from major international brands to smaller operators like casino fortunica, making it incredibly difficult for those at risk to find respite or escape their triggers. In response, the NHS has made tackling gambling harm a key priority.

The NHS Long Term Plan: A New Era for Treatment

The NHS Long Term Plan marked a turning point, committing to a significant expansion of services for those affected by gambling addiction. This national strategy is moving treatment away from a postcode lottery and towards a more standardised, accessible system.

Key commitments from the plan include:

• The establishment of up to 15 specialist NHS gambling harm clinics across the country.
• The launch of the UK's first specialist clinic for children and young people affected by gaming and gambling addiction.
• Closer collaboration with third-sector organisations like GamCare to create a 'no wrong door' approach to seeking help.
• Increased investment in research to better understand gambling harms and develop evidence-based interventions.

Navigating the Clinical Pathway: From Referral to Recovery

For many clients, you are the first point of contact. Knowing how to navigate the system is essential for instilling hope and initiating the recovery process. Whilst pathways can vary by region, the general process follows a clear structure.

Stage	Action by Clinician	Key Considerations
1. Identification & Assessment	Use screening tools (e.g., GAD-7, PHQ-9, PGSI) to assess for problem gambling and co-occurring conditions.	Create a non-judgmental space. Many clients feel deep shame and may not disclose gambling issues unless asked directly.
2. Referral	Make a formal referral to a specialist NHS Gambling Harm Service or a partner organisation.	Ensure the client understands the process and consents to the referral. Provide them with helpline numbers for immediate support.
3. Treatment Phase	Liaise with the specialist service (with client consent) to support integrated care, especially for co-occurring conditions.	Focus on your core therapeutic work (e.g., anxiety, trauma), which supports their specialist addiction treatment.
4. Aftercare & Relapse Prevention	Help the client build a strong relapse prevention plan as part of their long-term recovery.	Connect them with local peer support groups and resources for ongoing community-based support.

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Evidence-Based Therapeutic Interventions

The NHS and its partners utilise a range of evidence-based therapies tailored to gambling disorder. Understanding these can help you align your own work with the client's broader treatment plan.

Common therapeutic models:

• Cognitive behavioural therapy (CBT): The cornerstone of treatment, helping clients identify and challenge the cognitive distortions that fuel gambling (e.g., the gambler's fallacy) and develop new coping strategies.
• Motivational interviewing: A client-centred approach used to explore and resolve ambivalence about change, strengthening motivation to stop gambling.
• Group therapy: Provides a supportive environment where clients can share experiences, reduce feelings of isolation, and learn from the recovery journeys of others.
• Family and couples therapy: Addresses the wide-ranging impact of gambling harm on relationships, helping to rebuild trust and establish a supportive home environment.

Addressing Co-Occurring Conditions

Problem gambling rarely exists in a vacuum. It is critical to screen for and address co-occurring conditions, as their interplay can create significant barriers to recovery.

Co-occurring Condition	Common Link to Gambling	Integrated Approach Consideration
Depression & Anxiety	Gambling may be used as a psychological escape from low mood or anxiety, which is then exacerbated by financial losses.	Treatment must address both mood regulation and gambling triggers simultaneously.
Substance Use Disorder	Alcohol or drug use can lower inhibitions, leading to impaired decision-making and increased gambling.	A dual-diagnosis approach is essential, tackling both addictions in parallel.
Trauma (PTSD)	The dissociation and risk-taking associated with gambling can be a way of coping with unresolved trauma.	A trauma-informed care model is vital to avoid re-traumatisation and address root causes.

Your Vital Role in the National Strategy

The expansion of NHS services offers a historic opportunity to make a real difference in the lives of those harmed by gambling. These new clinics and clearer pathways provide the specialist infrastructure, but it is frontline professionals like you who build the bridge between a person in need and the help they deserve.

Your expertise in creating therapeutic alliances, assessing complex needs, and supporting long-term change is the bedrock upon which this national strategy is built.

We encourage you to familiarise yourself with the NHS Gambling Harm Service in your region and share this information with your professional network. By working together, we can ensure that every person affected by gambling harm has a clear path to recovery.