Reel Lives: Elliott Rapaport of Birches Health On Virtual Therapy, The Fastest-Growing Patient Segment, And The Boss

Brett Smiley

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Every gambler has a story to tell. And so does every person who chooses to make a living in this unique industry.

In our “Reel Lives” seriesCasino Reports shines a spotlight on people working in the gaming business, from executives, to analysts, to media members and communications pros, and all points in between.

The subject in this interview: Elliott Rapaport, founder of Birches Health, a New York-based gambling addiction teletherapy provider that’s partnered with sports betting exchange Sporttrade and is on a mission to make counseling for gambling addiction more accessible.

Casino Reports (CR): So what prompted you to start the company?

Elliott Rapaport (ER): A friend struggling with their gambling made me realize that there was not a high-quality clinical provider for virtual gambling addiction treatment covered by insurance. Given my experience in healthcare operations, I had a vision of building a company that offers best-in-class problem gambling teletherapy treatment. We have since expanded the digital platform to provide resources, educational materials, and responsible gaming learning modules and tools in hopes that they can help counter the growing amount of individuals who end up needing treatment for their gambling addiction.

CR: What does your day-to-day look like?

ER: My day-to-day is focused on making sure we meet individuals where they are in terms of access to care that they need. This means working with individuals in our program nationally who are struggling with their gambling to deeply understand how Birches can provide the wraparound clinical support they need. It also means spending time supporting our national team of licensed, specialized clinicians. We often say that our company is only as strong as our clinical program — a program consisting of best-in-class providers specializing in gambling and gaming disorder.

CR: To what extent do you think persons deemed “VIP” clients are at greater risk (or not) for developing a gambling disorder? 

ER: Some of these clients may be statistically likely to be long-term losers to a significant degree. In terms of the potential for developing a gambling disorder, it likely varies widely depending on the mental and financial health of the client. For some, losing hundreds of thousands or millions of dollars could be the equivalent of the average American losing $20. However, incentives given to these players may prompt them to engage in at-risk behaviors. Irresponsible betting behaviors are dangerous and could certainly lead to serious problems such as a gambling disorder. 

CR:  What percentage of the Birches clientele present with each of these as the primary issue/possible addiction: gambling (unspecified), sports betting, day trading, crypto, video gaming, pornography, substance abuse, other?

ER: Our clinical team has decades of experience building gambling disorder treatment and training programs nationally. As a result, our program is laser focused on working with individuals struggling with gambling and gaming disorder nationally. While gambling disorder may be the majority of our patient population, due to the significant incidence of co-occurring disorders, our clinical specialties extend across the gambling, gaming, compulsive sexual behaviors, substance use disorder, and more. The fastest growing segment of our patient population is without a doubt sports betting. And indeed, a strong clinical concentration has been on the 21-to-40-year-old sports betting demographic.

CR: How often do gambling addiction treatment plans call for complete cessation? Is that a universal requirement for successful treatment? Are there people who are able to walk back from problem gambling to usage that might be considered fine and healthy?  

ER: Our clinical team often recommends a combined program entailing abstinence, self-exclusion, and a customized treatment plan complete with individual, family, couples, group counseling, and peer support. Virtual therapy is supported by a specialized, comprehensive digital platform ensuring clinical outcomes are maintained outside of session.

CR: What are you hearing from Birches clients/patients about what is particularly triggering — with respect to problem gambling — within regulated platforms in the post-PASPA era? Put another way, what do you think sports betting operators or iGaming operators can be doing better? 

ER: Increasing awareness of specialized resources and treatment like Birches Health is crucial to making sure that regulated platforms are a central component of a healthy ecosystem. With the now widespread access to iGaming and sports betting, we all play a part in ensuring gambling harms are reduced.

CR:  Is there any in-person counseling option at Birches for someone who doesn’t want to meet virtually

ER: Yes. While the vast majority of individuals in our patient population receive virtual care, we operate and partner with in-person treatment options nationally to make sure that patients feel supported for the correct acuity level of care as best they need.

Reel Fast

What’s your favorite national restaurant chain? 


Most expensive item you encountered in person at Sotheby’s?

Leonardo Da Vinci’s Salvator Mundi

Favorite airport?


Most played artist on your streaming platform of choice this year? 

Bruce Springsteen

How many hours a night do you usually sleep?

Not enough

Best live concert/performance you’ve ever seen? 

Bruce Springsteen

Favorite Summer Olympics sport to watch besides water polo?

200m races

You can find Elliott on LinkedIn here and also somewhere in the swamps of Jersey, probably.

Previous installments of Reel Lives:

Las Vegas Advisor’s Anthony Curtis On Counting Cards, Loving His Job, And Finding The Quintessential Vegas Deal

Sporttrade COO David Huffman On An Operator’s Challenges, A CEO Who Leads By Example, And Betting On Birth Weights

Invariant Communications Pro Caroline Ponseti On Owning The Issue, Mental Health Awareness, And DC’s Food Scene

The AGA’s Bill Miller On Helping The Industry Through COVID, The Sports Betting Explosion, And Coaching His Kids