The decision making process used in selecting the proper treatment modality can be complex in some cases. 

When considering the appropriate treatment for problem and pathological gambling I generally the following issues:

Is the person having strong suicidal thoughts.

Are they facing legal/criminal problems.

Have they tried to quit in the past, what has already been attempted.

Are there additional serious psychiatric problems other than the gambling.

Does the person have a good social support network or are they alone.

How stable is the person in general.

How likely is the person to be successful in outpatient treatment.

Inpatient treatment is often the life-changing event that is needed for severe gambling problems and most patients who COMPLETE an inpatient treatment gambling-specific program have improved outcomes, especially when followed-up with a strong aftercare program.

There are several questions that I consider when making a determination of the need for inpatient treatment.  In general, the vast majority of gamblers can be helped sufficiently by a combination of outpatient therapy and Gambler's Anonymous meetings, with adjunctive psychiatric medication if needed. 

At the present time there are only a few qualified inpatient treatment options for gambling addiction.     There are a number of programs that are trying to provide treatment for gamblers, and a list of these programs can be found at the California Council for Problem Gambling web page:  http://www.calproblemgambling.org/help_InpatientTreatment.html 

I suggest that any program be carefully evaluated.  Some questions to ask include:

How many gamblers are in the clinic right now, how many are expected during the time that the prospective gambler will be in treatment.

How many gamblers were treated last year.

What are the qualifications of the staff members to treat gamblers and to provide mental health treatment in general.

Is there a psychologist who will conduct a psychological assessment, if so how quickly is it done and in what format is the information presented to the patient

Is there a medication evaluation and board certified psychiatrist on the treatment team.

What is the average length of stay.

Is there an aftercare program and what does it consist of.

Is the facility licensed by the State in which it is located.

What is the facilities treatment approach, how strong of a GA connection does it have, how often will the patient be attending GA meetings, and will these meetings be onsite or off site.