The toll that problem gambling can take is not debatable. What has been debated is if there is enough treatment and if treatment really works.

Finding help is the hard part. And, if you're lucky enough to find it, odds are the treatment will be effective. That's according to professor Bo Bernhard. His latest work includes interviews with more than 400 patients treated for problem gambling addiction in Nevada. His research shows that more than 92 percent of the patients either cut back or completely stopped gambling after treatment.

Patients also made improvements in dealing with life issues and avoided harmful behaviors typically associated with gambling excessively. The treatment's success was measured by how well patients functioned in areas such as housing, work, family, and everyday issues.

Bernhard, director of gaming research at UNLV's International Gaming Institute, discussed the project and the data that shows these programs are a solid investment.

What were the most unique findings of the Nevada Problem Gambling Project?
Historically, researchers in the field thought of it as a disorder that affects males, but we now see more females. And we see a variety of gambling activities. This affects a wide segment of the population -- from the young to senior citizens.

What helped patients the most?
In a revealing and very human finding, the bond between patient and counselor correlated strongly with positive outcomes. In a treatment world, where "the human touch" is often said to be lacking, these clinics seem to be excelling. The client-counselor bond was one of the most important predictors of success. It's about our relationships and human connectivity. These social safety nets can help us in times of trouble.

Out of the hundreds of interviews you've conducted, which of the patient's stories stuck out at the most?
The general public thinks of problem gamblers as derelicts and not worthy of tremendous sympathy. Very often people think of these folks as scum, as opposed to neighbors and friends.

This could affect your next-door neighbors, the bank president, or a teacher. Some of the most famous people I met through this study have moved here because of Nevada's income tax breaks, but it becomes very expensive when they develop a gambling problem.

I've heard the stories of Nellis Air Force Base leaders -- people who have risen through the ranks of the Armed Forces -- only to see that crumble down. It is inspiring watching them return to productive citizenship, with the patience of their superiors and the help of these clinics.

The recent data show that 92 percent of patients have reduced gambling since treatment and 94 percent spend less money per gambling outing. Are these improvements or set backs in addiction treatment?
Given the desperate status of many clients when they arrived for treatment, this study reveals dramatic improvements in self-confidence and the strength to avoid gambling.

It's not a failure. Health care is a lifelong process and this is a population that has slips -- what matters is how we respond to slips as clinics and as individuals.

Gambling addiction is an affliction that is invisible. Gambling addicts are able to hide their addictions much longer than other people who have addictions. They end up being in more severe situations. In part, this is a disorder that affects money, so problem gamblers could get caught trying to generate funds creatively (such as embezzlement) and the problem gambler could get caught in criminal problems. This leads to relationship problems with children, family members, and in the workplace.

What factors can trigger a gambling addiction?
Clearly, there is a biological disposition programmed as a factor for addiction. Other triggers include traumatic events such as problems at work, a death in the family, a divorce, or problematic relationships. With those vulnerabilities, problem gamblers self-medicate or numb the pain through gambling.

Background

Since 2007, Bernhard, has been tracking the post-treatment lives of Nevada's problem gamblers. Under the Nevada Problem Gambling Project, he conducted long-term studies on the development of gambling addiction and effectiveness of treatment programs.

Funded by the Nevada Department of Health and Human Services, the project examines six state-funded gambling treatment programs in Nevada.