POWAY -- People addicted to gambling have a new place to get help: cyberspace.

A Poway-based counselor who specializes in problem gambling recently started an online treatment program for people who live too far from a mental health professional or are too ashamed to seek help in the more traditional face-to-face setting.

"They are very ambivalent about treatment," said Suzanne Graupner Pike, a licensed psychologist who recently started the online service. "It's the stigma."

Graupner Pike is a state-certified gambling counselor. She runs the San Diego Center for Pathological Gambling, a program that she founded in 2003.

Despite the booming, multibillion-dollar gambling industry in California, there are relatively few places people can turn to for help with gambling addictions. The California Council on Problem Gambling, a nonprofit group that promotes problem gambling awareness, lists only 19 state-certified counselors, including Graupner Pike.

The online treatment program she runs is one of only a handful of ways to get problem gambling help through the Internet. The council on problem gambling offers a hot line and educational materials on its Web site. Gamblers Anonymous offers a free 12-step program similar to Alcoholics Anonymous.

Graupner Pike said she started the service in part to make it easier for people to seek treatment.

She counsels her patients through an online chat room on her Web site, www.sandiego-rx4gambling.com. People who are in another part of the county or the state don't have to drive to her office. And people who find it difficult to talk about their problem in person feel more at ease talking about it via a computer, she said.

One of her patients said it was the only way she could find to treat her problem.

"There is no local help," said Cheryl Weissbart, a gambling addict from Morgan Hill, a city near San Jose.

Weissbart said she used to gamble thousands of dollars at card clubs, going deep into credit card debt. But she said she has not gambled since she started treatment in April. She said she attended Gamblers Anonymous meetings in her area, but said she felt uncomfortable in that setting.

"It's worked out very well for me," she said about the online treatment.

Graupner Pike said the unconventional counseling sessions are not ideal. She can't see her patients' facial expressions and body language. It's not easy to tell a patient's mood online. So she has to ask more questions to gauge a person's emotional state, she said.

However, there are some studies that suggest online help is effective to treat problem gambling, said Richard Rosenthal, co-director of the Gambling Studies Program at UC Los Angeles. He was not familiar with Graupner Pike's program.

"I was skeptical about online treatments that are not face to face, but there is a fair amount of work that indicates it was effective," Rosenthal said.

Last year, the state released a study that estimated there were as many as 1.2 million compulsive gamblers in California. A 2006 report by the California Research Bureau estimated that pathological gambling costs the state $1 billion, largely in costs related to crime, bankruptcy and public health services.

In California, gambling is a $13-billion-a-year industry. Most of the casinos are operated by American Indians.

The state's tribal gambling industry nearly tripled in size in the last decade, from about 20 small casinos and bingo parlors in the late 1990s to 60 casinos last year, including some that rival Las Vegas gambling resorts in size, amenities and games.

San Diego County has 10 tribal casinos, five of them in North County. Ten more casinos are in Riverside County, including one at the Pechanga Indian Reservation near Temecula.

Proximity to gambling establishments often means larger numbers of problem gamblers in the area. However, Graupner Pike's online patient group is relatively small in number, fewer than a dozen. The treatment chat room officially launched in July, she said.

Lack of advertising may be one reason why so few patients have found their way to her service, Graupner Pike said. She said she relies on fliers and business cards to spread the word.

Some insurance companies will not pay for treatment. She charges $60 for a one-hour, online session. There are other small benefits that go with online treatment. People can save their session and print it. They also can save on gas because they don't have to drive to her office, Graupner Pike said.

For Weissbart, $60 is a small price to pay, she said. Her insurance doesn't cover the sessions.

"I could lose much more than that sitting at a poker table," she said.

Contact staff writer Edward Sifuentes at (760) 740-3511 or esifuentes@nctimes.com.