Substance · Treatment guide

Behavioral Addictions

Compulsive engagement in non-substance behaviors (gambling, gaming, pornography, shopping) despite harm.

In this guide

Overview

Gambling disorder is the only DSM-5 behavioral addiction, but treatment principles generalize. Combine motivational engagement, stimulus control, cognitive work on distortions (gambler's fallacy, escape coping), and relapse prevention.

First-line treatments

CBT — Cognitive Behavioral Therapy
Strongest evidence for gambling disorder; relapse-prevention framework applies broadly.
MI — Motivational Interviewing
Foundational for ambivalence; often the entry point to treatment.

Also consider

ACT
Defusion from urge thoughts; values-based action.
IFS
Working with the using part as a protector.
DBT
When emotion dysregulation drives the behavior.

Cautions

Screen for co-occurring substance use and mood/anxiety disorders — comorbidity is the rule.
Financial consequences in gambling may require coordinated case management.

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