An innovative pilot treatment program was developed for problem gamblers living in rural areas of Australia using cognitive behaviour therapy (CBT) modified from an established specialist therapy service. The standard 12 weekly group program was delivered on site by adapting it to two 1 week blocks with daily group sessions and 1 week of patient practice between the face to face group sessions. The median SOGS score (8) met the cut off for probable pathological gambling at assessment. All 7 who were assessed as suitable for the program completed the treatment with the median SOGS score of 0 at the end of treatment indicating these clients were no longer pathological gamblers. This was maintained at 12 months for 5 clients who provided follow up measures. Participants experienced a clinically significant change in the severity of their gambling and its impacts. This pilot program proved to be acceptable to rural participants and provides preliminary evidence that this intervention can reduce gambling and improved life functioning. Randomised controlled designs are needed to confirm the efficacy of this treatment approach. This program may provide a model for the treatment of gambling clients with complex co-morbidities in other rural settings.