ACT-Based Intervention for Problem Gambling (jugACT)

Efficacy of a Group Intervention Grounded in Acceptance and Commitment Therapy (ACT) to Address Problem Gambling in Youth: A Randomized Clinical Trial

The goal of this randomized clinical trial is to study if Acceptance and Commitment Therapy (ACT) is effective to treat Problem Gambling in young adults.The main questions it aims to answer are:

• Does ACT therapy improve health and gambling behavior?
• Are the clinical improvements of youth with gambling disorder receiving ACT-based intervention significantly greater than the clinical improvements of youth with gambling disorder on the waiting list?

Researchers will assess whether changes in health, gambling behavior, and other psychological variables are observed after eight weeks of therapy.

Participants will:

• Attend weekly online group sessions for 8 weeks
• Learn new tools that they will put into practice after the sessions
• Be required to complete evaluation questionnaires before and after the intervention and at the 3- and 6-month follow-up

Study Overview

• Status: Not yet recruiting
• Conditions: Problem Gambling
• Intervention / Treatment: Behavioral: Acceptance and Commitment Therapy (ACT)

Detailed Description

After being informed about the study, all patients giving written informed consent will be assessed to determine eligibility for study entry.

Patients who meet eligibility requirements will receive psychological intervention consisting in an 8-session group on line-delivered ACT-based treatment.

The participants will be assessed through self-report instruments before and after treatment and at 3 and 6 months follow-up.

The clinical trial will include a control group.

• Study Type: Interventional
• Enrollment (Estimated): 72
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Francisco Montesinos, Ph.D.; Phone Number: 647143773; Email: francisco.montesinos@universidadeuropea.es
• Study Contact Backup: Name: Ruben Perez; Phone Number: +34686822991; Email: ruben.perez@universidadeuropea.es

Study Locations

• Spain
  • Madrid
    • Villaviciosa de Odón, Madrid, Spain, 28670
      • Universidad Europea de Madrid
      • Contact: Sara Vilas, Ph.D.; Email: sarapaloma.vilas@universidadeuropea.es

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age between 18 and 25 years
• Score ≥ 3 on the Problem Gambling Severity Index (PGSI)
• Comprehension of Spanish, online connection, and signed consent

Exclusion Criteria:

• In active psychological or pharmacological treatment for gambling disorder
• Having received ACT-based psychological treatment in the last 6 months
• Problematic substance use: CAGE Adapted to Include Drugs Questionnaire (CAGE-AID) score ≥ 3
• Difficulty consistently attending online sessions

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: ACT group; 8 individual weekly sessions which included ACT methods	Behavioral: Acceptance and Commitment Therapy (ACT); Acceptance and Commitment Therapy methods were focused on promoting Values clarification, Acceptance, Cognitive defusion, Committed action and Flexible attention to the present moment, and included methods such as the Garden Metaphor or defusion training.
No Intervention: Waiting list; Participants assigned to Waiting List arm waited for 2 months before receiving treatment

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Problem Gambling Severity Index (PGSI)	The PGSI is a 9-item, 4-point Likert-format self-report scale (0 = never, 3 = almost always) that assesses the severity of problem gambling. Scores range from 0 to 27. A score of 8 or higher is considered indicative of problem gambling. Higher scores indicate greater severity of the disorder.	Change from Baseline severity of problem gambling at 8 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Difficulties in Emotion Regulation Scale (DERS-28)	he DERS-28 is a 28-item questionnaire with a 5-point Likert format (1 = almost never, 5 = almost always) that assesses difficulties in emotion regulation. It consists of six subscales: emotional nonacceptance, difficulty achieving goals, impulsivity, emotional awareness, limited strategies, and emotional clarity. Higher scores indicate greater difficulties in emotional regulation and worse clinical outcomes.	Change from Baseline emotion regulation at 8 months
Change in General Health Questionnaire (GHQ-12)	The GHQ-12 is a 12-item self-report questionnaire designed to detect general psychological symptoms. It is answered on a 4-point Likert-type scale. Higher scores reflect greater psychological distress and poorer perceived general health.	Change from Baseline psychological distress and perceived general health at 8 months
Change in the Comprehensive ACT Process Assessment Questionnaire (CompACT)	The CompACT is a 23-item, 7-point Likert-format scale (0 = not at all true, 6 = completely true) that assesses psychological flexibility, a core process of Acceptance and Commitment Therapy. It includes three subscales: openness to experience, awareness, and committed action. Higher scores reflect greater psychological flexibility.	Change from Baseline psychological flexibility at 8 months
Change in Values Living Questionnaire (VLQ)	The Valued Living Questionnaire assesses the degree of perceived importance and consistency of action directed toward personal values in 10 life domains (family, work, health, leisure, etc.). Each item is scored from 1 to 10. A composite index of discrepancy between importance and action is calculated. Higher scores indicate less value-behavior alignment.	Change from Baseline value-behavior alignment at 8 months
Change in Gambling-Related Emotional Distress Scale	A weekly subjective scale assessing the frequency and intensity of emotional distress associated with gambling behavior using Likert scales ranging from 0 to 5. Higher scores reflect greater gambling-related distress.	Change from Baseline gambling-related distress at 8 months
Change in Gambling-Related Experiential Avoidance scale	A weekly subjective scale assessing the extent to which the participant has attempted to avoid gambling-related emotions, thoughts, or internal situations. Higher scores indicate greater experiential avoidance and less flexibility.	Change from Baseline Experiential Avoidance at 8 months
Change in the frequency of self-reported gambling behaviors	Daily self-monitoring in which the participant indicates whether they gambled, the duration, type of gambling, emotions before, during, and after, and perceived function of the behavior. Weekly frequency of gambling episodes will be analyzed. Higher frequency is interpreted as worse clinical outcome.	Change from Baseline gambling behaviors at 8 months
Change in the frequency of committed actions	Self-monitoring of the frequency with which the participant has acted in accordance with their personal values during moments of desire to gamble. This is considered a positive behavioral indicator of change.	Change from Baseline committed actions at 8 months

Collaborators and Investigators

• Sponsor: Universidad Europea de Madrid
• Investigators: Principal Investigator: Francisco Montesinos, Ph.D., Universidad Europea de Madrid; Principal Investigator: David Lobato, Ph.D., Universidad Europea de Madrid

Study record dates

Study Major Dates

• Study Start (Estimated): March 1, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): July 1, 2027

Study Registration Dates

• First Submitted: July 4, 2025
• First Submitted That Met QC Criteria: July 4, 2025
• First Posted (Actual): July 15, 2025

Study Record Updates

• Last Update Posted (Actual): July 18, 2025
• Last Update Submitted That Met QC Criteria: July 15, 2025
• Last Verified: July 1, 2025

More Information

Terms related to this study

• Keywords: Problem Gambling; Gaming Disorder; Psychological Inflexibility
• Additional Relevant MeSH Terms: Mental Disorders; Disruptive, Impulse Control, and Conduct Disorders; Gambling
• Other Study ID Numbers: CEIm25/04

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No