Columbia Gambling Disorders Clinic

Columbia Gambling Disorders Clinic

Gambling addiction ruins the lives of millions of people every year. In many cases, the lives of others are affected as well. Individuals with gambling addiction are more likely to lose their jobs and have increased emotional, medical and legal problems, which often result in significant cost to the individual, his or her family and/or friends and to society.

Call 646-774-8096 for help or email us at

We offer free, intensive outpatient treatment for gambling addiction to problem gamblers and their concerned significant others (CSOs). Gambling addiction—sometimes also referred to as gambling disorder, compulsive gambling, problem gambling or pathological gambling—is not limited to casino gambling. Frequent playing of lotteries, sports betting including “fantasy” sports, dice games, “scratch” games, slot machines, poker and other card games, or roulette, whether online or in person, may signal a gambling problem. Gambling addiction affects people of all ages and from all walks of life and life experiences. Individuals with a gambling addiction are more likely to struggle with substance abuse and are more likely to experience mental health issues such as depression.

Help for Concerned Significant Others

Individuals who live with, love, or look after problem gamblers may also experience financial and emotional distress, as well as other negative consequences. Our program for concerned significant others is based on the evidence-based Community Reinforcement and Family Training (CRAFT) model developed by Drs. Robert J. Meyers and Jane Ellen Smith of the University of New Mexico.

Our approach to supporting concerned significant others is that an actively involved partner, friend or family member will be able to get his or her own needs met and be better equipped to provide positive, measurable support to their loved one’s recovery. Our therapists will work one-on-one with a problem gambler’s concerned significant others to provide:

  1. education about the nature of gambling disorder and its treatment
  2. problem solving skills to manage the impact of problem gambling
  3. communication and assertiveness coaching to improve personal confidence and foster mutual respect
  4. coping and self-care skills to handle one’s own personal stress

Our clinicians provide treatments that have been shown to work in clinical trials with individuals who have gambling problems and with those who are concerned for them. Our clinic is funded by the New York State Office of Alcoholism and Substance Abuse Services (OASAS).

If you think you or someone you care about may have a gambling problem or addiction, please take a moment to complete this brief assessment.

Our team is available now to set up an appointment for consultation:
Columbia Gambling Disorders Clinic
Call for an appointment: (646) 774-8096
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The Treatment Team

Mayumi Okuda, MD, is a psychiatrist and the Director of the Gambling Disorders Clinic. Dr. Okuda has published several manuscripts examining the epidemiology of a wide range of addictions in the United States. She has extensive experience providing Cognitive Behavioral Therapy (CBT), the most efficacious treatment for gambling addiction. Dr. Okuda has published several manuscripts on gambling addiction, including an article on how cognitive behavioral therapy is delivered and how it can be adapted for the specific needs and beliefs of patients with gambling addiction. Dr. Okuda has written several book chapters on the epidemiology of gambling addiction and on practical and successful strategies for diagnosing and treating patients with the condition. Dr. Okuda is also member of the board of directors of the New York Council on Problem Gambling (NYCPG); a non-for-profit organization dedicated to increasing public awareness about gambling problems and gambling addiction in New York State.

Frank Grazioli, LMSW, is a therapist and research associate at the Columbia Gambling Disorders clinic. He holds a Master of Social Work (MSW) degree from New York University. He specializes in clinical social work with addictive and co-occurring disorders. He held a SARET (Substance Abuse Research, Education, and Training) fellowship in collaboration with NYU programs in social work, dentistry, nursing and medicine and has been published for his work in addiction treatment studies He previously held an internship with NY State HOPEline, a substance treatment referral service of OASAS, the NY State Office of Alcoholism and Substance Abuse Services.

Michael McKee, PhD is a Research Scientist in the Gambling Disorders Clinic at the New York State Psychiatric Institute, and Assistant Clinical Professor of Medical Psychology (in Psychiatry) at Columbia University College of Physicians & Surgeons. Trained in the use of Cognitive Behavioral Therapy (CBT) by leaders in the field such as Dr. Gail Steketee, Dr. Richard Heimberg, and Dr. Marsha Linehan, among others, Dr. McKee currently specializes in CBT for problem gambling. Dr. McKee has also been a cognitive-behavioral research therapist for National Institute of Mental Health-funded projects studying the effectiveness of CBT in the treatment of social anxiety, obsessive-compulsive disorder and hypochondria. In addition, he supervises the work of pre-doctoral trainees and postdoctoral fellows at the Anxiety Disorders Clinic. Dr. McKee has extensive experience with the treatment of a range of behavior problems, and maintains a private practice in Scarsdale and Cold Spring, New York.

Cindy Varona, BA, is the Gambling Disorders Clinic Administrator. She holds a degree in Industrial Engineering from Universidad Dominicana O & M (Dominican Republic). Ms. Varona has been the program administrator for the Gambling Disorders Clinic since 2012.

Questions? Click Here to Send Your Questions or Comments to Our Staff.

Get Help

The Columbia Gambling Disorders Clinic at the New York State Psychiatric Institute, funded by the New York State Office of Alcohol and Substance Abuse Services (OASAS), provides treatment free of charge to people with a problem gambling and to their concerned significant others.

Visitors can take an online Self-Assessment that helps determine the severity of their gambling problem. The site also provides information for teens with gambling problems. To make an appointment call 646-774-8096. Or send us an e-mail to to find out more about the program.

Why Treat a Gambling Problem?

Some people gamble to escape from problems or to relieve depression. Others gamble for the excitement. Whatever the reasons for gambling, problem gamblers frequently end up having to lie to people they care for about how much they gamble or about the consequences of their gambling. It is not unusual for them to engage in riskier activities to obtain the money they need to maintain their gambling addiction.

What are the consequences of problem gambling?

Gambling addiction is associated with sizeable money losses and with a progressive disruption of the gambler's life. In many cases, the lives of the people close to him/her are affected as well. Many problem gamblers lose their jobs and experience increased emotional and medical problems. These serious personal and social problems, including financial, legal, occupational, medical, and psychological difficulties, result in significant costs to the individual, the family/friends, and society.

What are the treatment options for problem gambling?

Numerous studies point to the effectiveness of cognitive behavioral therapy (CBT) and Motivational Interviewing (MI) for gambling disorder, demonstrating favorable short- and long-term outcomes. In certain circumstances medications can help.

Problem Gamblers: Clinical Services That Recognize the Diversity of the Disorder

Alfred, 62, recently retired from a long career in public service administration, was losing his retirement savings gambling through the night in a casino. He was at the same time receiving medication for a chronic neurologic condition. While working with Alfred to help him develop and practice coping skills and expand his connection to social supports that helped him to reduce the time and money he was spending gambling, our team also consulted with his medical care provider to adjust his other medications, so that he was able to take his gambling from a reduced level to abstinence.

Caroline, 29, had been gambling in casinos for more than 10 years, often losing whole paychecks in each visit. Desperate for money to evade eviction from her home, she resorted to trafficking narcotics to finance her gambling. Our team worked with Caroline to help her identify and avoid the “triggers” that caused her to gamble and to begin to cope with and manage stressful situations and thoughts that might lead her to gamble again. We also worked with her to explore new skills in managing her money.

Hector, 72, has been working with his therapist on developing and practicing his own coping skills, rediscovering neglected friendships and hobbies, after focusing most of his attention and effort to control the financial problems brought about by 40 years of problem gambling by his spouse. He hopes that his work with his therapist will better assist him in eventually persuading his spouse to seek treatment for problem gambling.

Ryan, 19, was so involved with fantasy sports that he eventually found himself in thousands of dollars of credit card debt, and needing to withdraw from college. Working with his therapist he is learning how to respond effectively to invitations from peers to avoid gambling. He is also learning basic money management skills so that he can protect his income from two part-time jobs he is taking until he can return to school. Our clinical team also worked with Ryan to assist him in finding support while he is away at school and to work with his school’s office of student affairs to accommodate his treatment in his academic schedule.

Get Help

Our staff is available to set up an appointment.
The Gambling Disorders Clinic
(646) 774-8096
Questions? Click Here to Send Your Questions or Comments to Our Staff.


The Columbia Gambling Disorders Clinic is located at the New York State Psychiatric Institute and is easily reached from New York City, New Jersey, and Westchester and Rockland Counties.

By public transportation within New York City:

Take the A, C, or #1 subway to 168th Street, or take the M2, M3, M4, M5, or M100 bus to 168th Street and Broadway. Proceed west on 168th Street and cross Fort Washington Avenue. The Visitor entrance to the New York State Psychiatric Institute and the Columbia Gambling Disorders Clinic is located at 40 Haven Avenue, immediately beyond the Neurological Institute of New York, on the left side of the street after crossing Fort Washington Avenue. Visitors can follow signs to cross the interior bridge to the Herbert Pardes Building (1051 Riverside Drive). Use the elevators to proceed to the third floor and Suite 3500.

By Car:

Use the entrance located at 1051 Riverside Drive. The most direct route is to follow directions leading to the George Washington Bridge. Exit at the Henry Hudson Parkway, and proceed toward Riverside Drive (southbound). The Institute is on the right as you proceed south on Riverside Drive. Public parking is located at the corner of 165th Street and Fort Washington Avenue.

Links to Resources

OASAS: The New York State Office of Alcoholism and Substance Abuse Services (
The OASAS goal is to improve the lives of New Yorkers by ensuring quality prevention and treatment services for chemical dependence and compulsive gambling, and promoting recovery from addiction.

New York State HOPEline (1-877-8HOPENY)
HOPEline (1-877-846-7369) is a service of NY State OASAS and offers free, confidential phone and text-chat based help and crisis intervention 24 hours a day, 365 days a year for crisis intervention, problem gambling, alcoholism, and drug abuse.

New York Council on Problem Gambling (
The New York Council on Problem Gambling is a not-for-profit independent corporation dedicated to increasing public awareness about problem and compulsive gambling and advocating for support services and treatment for persons adversely affected by gambling. The Council is governed by a Board of Directors.

National Council on Problem Gambling (
The Mission of the National Council on Problem Gambling is to increase public awareness of problem gambling, ensure the widespread availability of treatment for problem gamblers and their families and concerned significant others, and to encourage research and programs for prevention and education.

The Council on Compulsive Gambling of New Jersey, Inc. (1-800-GAMBLER)
NJCPG is a private non-profit organization that provides information, education and referral services for people affected by a gambling problem. The 1-800-GAMBLER helpline is free and confidential, and it is available 24 hours a day throughout much of the U.S. for problem gamblers as well as their friends and families.

New York Responsible Gambling Hub (
The New York Responsible Gambling Hub presents educational online material for persons employed by gaming facilities such as casinos for prevention of problem gambling.

Know the odds (
This webpage explains some of the myths about the odds of winning at gambling and provides practical tips for staying in control. Additionally, it presents informative educational videos and other material, including infographics and ebooks.

Don’t Bet Yet (
This website uses videos and educational materials to inform youth on the dangers of problem gambling so they can avoid the pitfalls of gambling as they get older.

Gambler's Anonymous (
Gambler’s Anonymous is a fellowship of men and women who meet to discuss their gambling addiction and support each other toward recovery.

Gam-Anon (
Gam-Anon provides information for the general public about problem gambling and its financial and emotional effects on the gamblers’ families and loved ones.

GAMTALK provides online support for gambling issues. The site offers live chat for real-time peer support and information; stories of hope and inspiration; and a community forum.

NYC WELL ( or text “WELL” to 65173)
NYC WELL provides 24/7 support through talk, text, and chat for individuals struggling with problems like stress, depression, anxiety, or drug and alcohol misuse, or for those who care about them.

CRAFT: Community Reinforcement Approach and Family Training (CRAFT) (
The Community Reinforcement Approach and Family Training (CRAFT) intervention is an evidence- based program developed to help concerned significant others (CSOs) to engage treatment-refusing substance abusers into treatment. This intervention was developed to capitalize on the concerned significant others’ ability to contribute to many areas of addiction treatment. Results from randomized controlled trials have shown that CSOs who receive the CRAFT intervention benefit from the program by becoming more independent and reducing their depressive and anxiety symptoms even when the substance abuser does not enter treatment.

National Suicide Prevention Lifeline: 1-800-273-8255 (
This website and help line serves individuals in a suicidal crisis within the United States. They facilitate the contact of the nearest available suicide prevention and mental health service.