Despite a recent proliferation of gambling treatment protocols and studies examining the success of these protocols, there exists an absence of attention to mechanisms of change and the individual characteristics that predict treatment outcome. A better understanding of the characteristics that place particular individuals at-risk for treatment failure will be vital for developing new treatments as well as modifying existing treatments. Furthermore, the development of tools to identify those at risk for treatment failure, prior to treatment initiation, will allow for the tailoring of protocols to suit individual needs and vulnerabilities. In the current paper, we review the state of gambling treatment and suggest a framework for better understanding and ultimately reducing gambling treatment failure.