Mental health · Sep 2, 2026
My son is gambling, how do I help?
In that appointment I asked about alcohol, about cannabis and about sleep, and I did not ask about betting. He was 19. The debt surfaced four months later, through his mother rather than through him. I went looking for what the research said and found a review that only accepts studies following the same people over years, with 13 individual risk factors measured and just two protective factors in the domain of relationships, one of them parental supervision.
Medical school taught me to ask about everything you drink, smoke, snort or inject. I had a ready script for substances and none at all for behaviour. In six years of medical school and the years of residency, nobody told me I needed to ask how much that young man had bet over the weekend. He had not lied to me. I had simply never asked.
So I went to find out the size of the thing. The broadest review available today, published in 2024 in the Lancet Public Health by a team led by Lucy Tran at the University of New South Wales, pooled 380 representative samples from 68 countries and territories. Among adults, 46.2% had gambled in the previous 12 months. Among adolescents, 17.9%. Problematic gambling, measured only among adults, came to 1.41% overall and to 15.8% among those playing online casino or slots.
The authors note that there is almost no data on any-risk and problematic gambling in adolescent samples. We know how many young people gamble and we do not know how many of them are already in trouble. I would rather say that up front, because a family arriving with this worry deserves to know where the science stops.
An online betting operator, the kind anyone finds on a phone and that Brazilians simply call a bet, works with a number the family does not have, which is the real chance of any given wager coming off. The operator knows and the family does not, and the whole business rests on that gap.
Thirteen things that raise the risk, two that hold
Nicki Dowling and colleagues at Deakin University in Australia pooled 15 studies published across 23 articles, all of them following the same people over years, which makes them more reliable about causes than a snapshot.
On the risk side the review measured 13 individual factors, among them impulsivity, frequency of alcohol use, antisocial behaviour, depression, cannabis use and sensation seeking. At the community level, what was left standing was poor academic performance. In the domain of relationships, two protective factors, and one of them is parental supervision. Effect sizes run from small to medium.
The authors close by saying that protective factors have been investigated too little to guide prevention. It is a polite way of saying the literature measured everything that goes wrong with great care and barely looked at what holds. The short list is the one a mother actually needs.
What the house teaches without saying it
In Florence, Maria Anna Donati surveyed 680 pairs made up of a secondary school student and one of their parents, and measured how much each side gambled. The more the parents gambled, the more the children gambled, and how much the child gambled was in turn tied to the severity of the child’s problem. In the United States, a study of 1,517 Connecticut high school students by Zu Wei Zhai and colleagues found that adolescents who bought lottery tickets reported more permissive attitudes towards gambling and greater parental approval of it.
On the other side of the ledger, a German estimate published in 2025 calculated that about 1 in 25 children in the country has a parent living with gambling disorder. The office pool and the Sunday scratch card teach something too, and nobody has to say a word for that to happen.
Where feeling turns into a number
On impulse there is a recent portrait. A team led by Samuel Chamberlain in Southampton assessed 543 young people aged 18 to 29 who had gambled at least five times in the previous year, ran diagnostic interviews and measured difficulty with emotion regulation in each condition. The greatest difficulty showed up in those who screened positive for ADHD, and after them in those who screened positive for intermittent explosive disorder, social phobia and generalised anxiety disorder.
It is a portrait of a single moment, drawn from a community sample rather than a treatment service, and it says nothing about what came first or what caused what. It still moves the conversation somewhere I can use. What shows up in these young people is not a lack of shame, it is difficulty cutting what they feel down to a size they can carry. Betting offers exactly that, a place where feeling turns into a number, and a number looks like something under control.
Treatment moves three things, and confidence most of all
Rory Pfund and colleagues at the University of Memphis published an umbrella review in 2023 on cognitive behavioural treatment for gambling harm, covering 56 studies and 5,389 participants. Counting only the moderate to high quality meta-analyses, the treatment reduced gambling disorder severity with a large effect, gambling frequency with a medium effect and gambling intensity with a small one. Between 65% and 82% of the people who received it improved more than those left with minimal or no treatment.
What was missing was where the improvement passes through, and a 2024 analysis of 15 randomised trials with 1,536 participants went after that. Beliefs about gambling shifted, coping shifted, and the largest of the three effects was on the person’s confidence that they could do it. That matches what I see in the room, where the turn does not come from more information.
Both reviews look at adults aged 18 and over. For adolescents there is no comparable body of trials, and anyone promising a parent that treatment for a 15-year-old carries the same weight is selling something.
The night the debt surfaces
What I see working best is to separate two conversations that arrive stuck together. One is about money, with an amount, a deadline and who pays what. The other is about care. When both happen on the same night in the same tone, the second one loses, and it is the second one that decides what comes next.
Paying the debt quietly, without the rest of the family knowing and without any request for professional help, buys a calmer week and teaches that there is a net underneath. Paying may well be the right call, and it goes further alongside a booked appointment.
Then there is the boring question, asked with a number and without a note of judgement. Ask how much he bet this weekend, how much is still outstanding and who he owes. That is easier to answer than asking whether he is “an addict”, because the second question demands a confession and the first one asks for an amount.
What time he went to bed on Tuesday
Back to that gap from the beginning. The betting operator has the number for the odds and the family does not. What the family has is a number the operator will never get. A mother knows what time her son went to bed on Tuesday, the week he stopped going out with his friends, the name of the friend who disappeared, and she knows when the phone started sitting face down on the table. No algorithm buys that. It is what the review calls parental supervision.
Supervision here does not mean surveillance. Going through a phone earns you a fight and a new app installed the next day. What the research measures is duller than that, because it is knowing where your son is, who he is with, how much money he has and when he is coming home, and having asked in a way that lets him answer without bracing.
As for the 19-year-old, what I changed was my own script. The betting question now goes in beside the one about alcohol and the one about sleep, in every appointment with an adolescent or a young adult, asked with the same face I use for height. It was a repair to a script. And if someone who trained alongside me never learned to ask either, the hole is in the curriculum we both sat through.
If this worry is sitting sideways in you, the gesture that fits today or tomorrow is a single question. Ask the boring one with a number, once, without an ambush and without an audience, then stay quiet for as long as the answer needs. If it comes, you have a start. If it does not, the silence is information too, and it is not a reason to shout. That first number is a thread, not a verdict. Take whatever turns up to an individual appointment, which is where this conversation really pays off.
Frequently asked questions
How do I know if my child is gambling?
Look at what changes in the routine before you go looking for proof. Sleep turned upside down, money disappearing without explanation, small repeated requests to borrow, the phone face down on the table, plans with friends dropped, and irritation whenever anyone asks about money. No single one of these signs means gambling disorder, and several of them piling up within a few weeks is reason enough to ask directly and to book an appointment.
My son is in debt from betting, should I pay it?
There is no single answer, and there is a way to get it less wrong. Separate the money conversation from the care conversation, because when the two happen on the same night the second one is lost. If you decide to help with the debt, do not do it in silence or with nothing asked in return, and agree on a booked appointment as part of it. Clearing a debt behind the rest of the family buys a calmer week and teaches that there is a net underneath.
What do I say to my child about betting?
Ask with a number instead of asking for a confession. Ask how much he bet this weekend, how much is still outstanding and who he owes. Asking whether he is addicted invites denial, because it requires him to accept a label before he can say anything at all. The question with a number is easier to answer and already gives you the information you need.
How do I know if it has become gambling disorder?
What separates a pastime from a disorder is not the amount staked, it is the loss of control over the behaviour and the harm that behaviour causes in a life. Betting more than planned, trying to stop and failing, betting to win back what was lost, lying about how much is being played, and school, work or relationships taking the hit are the points that make a doctor or a psychologist think about a diagnosis. That judgement is clinical and does not get settled by an online questionnaire.
Does the way I gamble influence my child?
The research shows an association, and it is a consistent one. In an Italian study of 680 parent and adolescent pairs, the more the parents gambled, the more the children gambled. In a United States study of 1,517 students, adolescents who bought lottery tickets reported greater parental approval of gambling. Both designs are cross-sectional and do not prove cause, and the office pool and the Sunday scratch card teach something even when nobody comments on them.
Can gambling disorder be treated?
It can, and cognitive behavioural treatment is the approach with the most evidence behind it. In a review pooling the meta-analyses in the field, covering 56 studies and 5,389 participants, it reduced gambling disorder severity with a large effect, and between 65% and 82% of those who received it improved more than people left without treatment. Worth knowing that these reviews look at adults aged 18 and over, and that for adolescents this body of trials does not yet exist.
References
- TRAN, L. T. et al. The prevalence of gambling and problematic gambling: a systematic review and meta-analysis. The Lancet Public Health, v. 9, n. 8, p. e594-e613, 2024. PMID: 39025095.
- DOWLING, N. A. et al. Early risk and protective factors for problem gambling: a systematic review and meta-analysis of longitudinal studies. Clinical Psychology Review, v. 51, p. 109-124, 2017. PMID: 27855334.
- DONATI, M. A. et al. Parental gambling frequency and adolescent gambling: a cross-sectional path model involving adolescents and parents. PLoS One, v. 18, n. 2, e0280996, 2023. PMID: 36780466.
- ZHAI, Z. W. et al. Lottery-purchasing adolescents: gambling perceptions, problems, and characteristics. Journal of Gambling Studies, v. 37, n. 4, p. 1177-1195, 2021. PMID: 33528742.
- STEFAN, N. et al. How many children have parents with gambling disorder, a Germany-based estimate. BMC Public Health, v. 25, n. 1, 2166, 2025. PMID: 40537747.
- ASLAN, I. H. et al. Emotion regulation across psychiatric disorders. CNS Spectrums, v. 29, n. 3, p. 215-220, 2024. PMID: 38695189.
- PFUND, R. A. et al. Cognitive-behavioral treatment for gambling harm: umbrella review and meta-analysis. Clinical Psychology Review, v. 105, 102336, 2023. PMID: 37717456.
- FREE, B. L. et al. Does cognitive-behavioral treatment affect putative mechanisms of change among individuals with problem gambling? A systematic review and exploratory meta-analysis. Addictive Behaviors, v. 158, 108110, 2024. PMID: 39089195.
Dr. Marcelo Gobbo Jr.
Family and Community Physician (CRM-MG 74.511 · RQE 69038), with a master’s degree in Psychology from the Federal University of Uberlândia and a Laboratory Associate appointment in the Department of Psychiatry at Yale School of Medicine, based at the Program for Recovery and Community Health. He cares for neurodiverse families and people living with severe mental illness, in person and remotely.