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Spouses of problem gamblers suffer from a wide range of symptoms that are consistent with traumatic stress that are scarcely identified and rarely treated. A mixed methods study evaluated spousal symptoms, current spousal interventions, and clinical barriers to spousal symptom treatment. The emotional impact of gambling addiction on spouses was evaluated by National Certified Gambling Counselors through survey and questionnaire. Spousal symptoms were investigated via a quantitative survey, while clinician attitudes, experience, comfort, and interventions were conducted via both a qualitative telephone interview and a quantitative survey. Data obtained from 44 surveys and 6 questionnaires revealed a significant proportion of counselors largely without adequate tools for interventions with spouses, despite results also noting a significantly high prevalence of problematic emotional spousal symptoms including: betrayal, emotional withdrawal, numbing, intense anger, depressed mood, and anxiety, and feeling victimized.