Inclusion Criteria:

1. Outpatient men and women age 18 to 75
2. Presence of current DSM-IV pathological gambling for at least 6 months duration
3. PG is the most problematic psychiatric disorder (in the patient's and clinician's opinion) and the primary reason for seeking treatment
4. Minimum score of >5 on the South Oaks Gambling Screen which reflects gambling severity consistent with pathological gambling

Exclusion Criteria:

1. Current clinically significant suicidality, severe depression (a score of ≥ 19 on the Hamilton Rating Scale for Depression, 17-item version)(30) or any other disorder requiring immediate intervention
2. Presence of any clinical features requiring a higher level of care than outpatient treatment
3. Cognitive impairment that interferes with the capacity to engage in CBT or to provide informed consent
4. DSM-IV substance abuse or dependence within the past 3 months (see Screening Visit)
5. Current Axis I diagnosis of bipolar disorder or psychotic disorder
6. Previous treatment of CBT for PG (duration of at least 6 sessions); because CBT is not widely used for PG, a minimum of 6 treatments will be rare.
7. Current use of psychotropic medications or within 2 months prior to study entry.
8. Current participation in Gambler's Anonymous (GA).