Gambling DisorderVIRET-GADNCT04467502
Virtual Reality Exposure Therapy for Gambling Disorder
A study testing cognitive-behavioral therapy for gambling disorder, imaginal exposure therapy focus on gambling cues and virtual reality exposure therapy focus on gambling cues in people with Gambling Disorder, run by University Hospital, Lille at 10 sites in France.
Trial summary
Gambling disorder (GD) is recognized as an addictive disorder in the DSM-5. Craving is a core phenomenon in addiction that can lead to relapse in problem gambling for pathological gamblers. Exposure Therapy (ET) focuses on craving in addiction treatment. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Gambling Disorder
- What is being tested?
- cognitive-behavioral therapy for gambling disorder, imaginal exposure therapy focus on gambling cues and virtual reality exposure therapy focus on gambling cues
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 124 participants
- Where
- 10 sitesFrance
- Study dates
- 12 Jul 2023to Jul 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Seek treatment for GD within one of health care facilities participating in the research (first request for treatment and not patients already receiving treatment for gambling disorder in the care center).
- Meet a current diagnosis of gambling disorder according to DSM-5 criteria and with a South Oaks Gambling Screen (SOGS) score ≥ 5
- Meet a casino gambling behavior with a casino gambling frequency ≥ 1 time every two months during the last 12 months
- Have a sufficient understanding of French for therapy
- Beneficiary of the French social security system
- Give an informed consent to participate
- Willing to comply with all study procedures and duration
Who cannot join
- Visual disturbance making impossible the use of virtual reality equipment (e.g. advanced retinal degeneration, central scotoma, age-related macular degeneration)
- Pregnant woman
- Minor or adult under guardianship, conservatorship, under judicial protection, persons deprived of their liberty
- Balance disorder (e.g. cerebellar disorder, inner ear disorder)
- Photosensitive epilepsy
- Refusal to participate
Trial locations and contacts
10 sites in 1 country. Contact the study team or a site near you to ask about taking part.
10 sites in 1 country
France10 sites, 10 recruiting
- Not yet recruiting
CHU Amiens-Picardie
Amiens
Alain DERVAUX, MD,PhD
- Not yet recruiting
CH Boulogne sur mer CSAPA
Boulogne-sur-Mer
Fréderic TEISSIERE, MD
- Not yet recruiting
CHU de Caen
Caen
Nicolas CABE, MD
- Not yet recruiting
Hôpital Fontan, CHU lille
Lille, 59000
Olivier COTTENCIN, MD,PhD
- Not yet recruiting
Assoriation Cédragir Lomme CSAPA
Lomme
Stéphanie Lienard
- Not yet recruiting
CH de l'arrondissement de Montreuil / CSAPA
Montreuil-sur-Mer
Mathieu LAWNICZAK
- Not yet recruiting
CHU Rouen
Rouen
Olivier GUILLIN, MD, PhD
- Not yet recruiting
CH de Saint Amand les Eaux
Saint-Amand-les-Eaux
Charles LESCUT, MD
- Recruiting
CH Seclin Carvin CSAPA
Seclin
Pierre TAQUET, PhD
- Not yet recruiting
Association GREID ValenciennesCSAPA
Valenciennes
Ines Roux
About this study
Official title: Virtual Reality Exposure Therapy for Gambling Disorder: Randomized Controlled Trial
Gambling disorder (GD) is recognized as an addictive disorder in the DSM-5. Craving is a core phenomenon in addiction that can lead to relapse in problem gambling for pathological gamblers. Exposure Therapy (ET) focuses on craving in addiction treatment. ET in Cognitive-Behavioral Therapy (CBT) is based on classical conditioning that addresses the association between contextual cues and the craving response. ET helps the patient to reduce craving when faced with cues triggering craving. ET includes in vivo exposure and imaginal exposure. The literature recommends being as close as possible to the context of addiction to facilitate the extinction of craving but in vivo ET is complicated to perform. For GD, in outpatient consultation, bringing a patient to a casino presents obstacles (e.g., time, human and financial cost, agreement with casino for therapy).
The study will be to assess the effectiveness of Virtual Reality Exposure Therapy (VRET) in a virtual gambling environment. Various trials show that VRET is no more or less effective than classical ET in CBT but has other advantages for motivation to treatment. This research aims to compare efficacy between CBT with VRET and CBT with imaginal exposure for treatment of GD in a multicenter, randomized, controlled, non-inferiority clinical trial.
Read the detailed description
Main aim:
Show, within patients seeking care for GD, that VRET integrated with CBT is non-inferior to imaginal ET integrated with CBT on GD symptom reduction at the end of 12 treatment sessions.
Secondary objectives:
- Show that VRET integrated with CBT is non-inferior to imaginal ET integrated with CBT on GD symptom reduction during the first 12 months post-treatment.
- Compare the effect of the two therapeutic strategies on GD symptoms (measured by complementary assessments to that used in the main aim), at the end of treatment and during the first 12 months post-treatment.
- Show the efficacy of VRET integrated with CBT compared to imaginal ET integrated with CBT on gambling behavior, craving, and gambling-related cognitions at the end of treatment and during the first 12 months post-treatment.
- Show the efficacy of VRET integrated with CBT compared to imaginal ET integrated with CBT on the evolution of anxiety and depressive symptoms at the end of treatment and during the first 12 months post-treatment.
- Compare the quality of the two therapeutic strategies at the end of treatment.
- Conditions
- Gambling Disorder
- Being tested
- cognitive-behavioral therapy for gambling disorder, imaginal exposure therapy focus on gambling cues, virtual reality exposure therapy focus on gambling cues
- Keywords
- Exposure therapy, virtual reality, cognitive behavioral therapy, pathological gambling, CBT
- Medical subject headings
- Gambling
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
cognitive-behavioral therapy for gambling disorderOther
6 sessions of cognitive-behavioral therapy for gambling disorder
imaginal exposure therapy focus on gambling cuesOther
6 sessions of imaginal exposure therapy focus on gambling cues
virtual reality exposure therapy focus on gambling cuesOther
6 sessions of virtual reality exposure therapy focus on gambling cues
| Study group | Role | What they receive |
|---|---|---|
| CBT with VRET | Experimental | Not described Receives: Other: cognitive-behavioral therapy for gambling disorder; Other: virtual reality exposure therapy focus on gambling cues |
| CBT with imaginal ET | Active comparator | Not described Receives: Other: cognitive-behavioral therapy for gambling disorder; Other: imaginal exposure therapy focus on gambling cues |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in South Oaks Gambling Screen (SOGS) between baseline and end of treatment (12 sessions, 6 months)
The SOGS is a 20-item instrument used to screen for pathological gambling. The SOGS is scored by summing the number of items endorsed out of 20 and a cut score of 5 or more indicates a probable pathological gambling. The score ranges from 0 to 20.
Measured: at the end of treatment (an average of 6 months)
Secondary outcomes (14)
Change in South Oaks Gambling Screen (SOGS) between baseline and follow-up at 3, 6 and 12 months after the end of treatment
The SOGS is a 20-item instrument used to screen for pathological gambling. The SOGS is scored by summing the number of items endorsed out of 20 and a cut score of 5 or more indicates a probable pathological gambling. The score ranges from 0 to 20.
Measured: at baseline, and through study completion, an average of 18 months
Change in gambling disorder symptoms between baseline, end of treatment and follow-up assessed by the following criteria: number of DSM-5 criteria for GD
Nine criteria for gambling disorder are described in DSM-5. The endorsement of 4-5 criteria means the presence of a mild gambling disorder, 6-7 criteria a moderate gambling disorder and 8-9 criteria a severe gambling disorder. The score ranges from 0 to 9 criteria.
Measured: at baseline, and through study completion, an average of 18 months
Change in gambling disorder symptoms between baseline, end of treatment and follow-up assessed by the following criteria: Problem Gambling Severity Index (PGSI)
The PGSI consists of nine items to assess level of risk for problem gambling. Cut-off scores are 1-2 for low-risk gamblers, 3-7 for moderate-risk gamblers and 8 or more for problem-gamblers. Non-problem gamblers correspond to 0. The score ranges from 0 to 27.
Measured: at baseline, and through study completion, an average of 18 months
Change in gambling behavior assessed by gambling frequency during the last month
Measured: at baseline, and through study completion, an average of 18 months
Change in gambling behavior assessed by amount of money spent in gambling during the last month
Measured: at baseline, and through study completion, an average of 18 months
Change in gambling behavior assessed by time spent gambling during the last month
Measured: at baseline, and through study completion, an average of 18 months
Change in frequency subscale of gambling Craving Experience Questionnaire (g-CEQ)
The frequency subscale of gambling Craving Experience Questionnaire assesses the frequency of craving for gambling during the last week. This questionnaire consists of nine items. A high score means a high frequency of craving during the last week. The score ranges from 0 to 90.
Measured: at baseline, and through study completion, an average of 18 months
Change in craving reactivity to gambling cues
Measured: at baseline, and through study completion, an average of 18 months
Number of craving episodes using daily craving assessed by participants
Measured: up to 6 months during the treatment
Cumulative duration of craving episodes using daily craving assessed by participants
Measured: up to 6 months during the treatment
Change in gambling-related cognitions assessed by Gambling-Related Cognitions Scale (GRCS)
The French version of the Gambling-Related Cognitions Scale consists of 23 items to assess various cognitions related to gambling. A high score means that gambling-related cognitions are typical cognitions of problem gamblers. The score ranges from 23 to 161.
Measured: at baseline, and through study completion, an average of 18 months
Change in depressive symptoms assessed by Beck Depression Inventory short-form (BDI-SF)
Beck Depression Inventory short-form consists of 13 items to assess depressive symptoms. A high score means a high level of depressive symptoms. The score ranges from 0 to 39.
Measured: at baseline, and through study completion, an average of 18 months
Change in anxiety symptoms assessed by State-Trait Anxiety Inventory (STAI)
State-Trait Anxiety Inventory consists of 20 items to assess state-anxiety and 20 items to assess trait-anxiety. A high score means a high level of anxiety symptoms. The score ranges from 20 to 80 both for state-anxiety and trait-anxiety.
Measured: at baseline, and through study completion, an average of 18 months
Rate of patients who attended the 12 sessions (6 months)
Quality of the two therapeutic strategies
Measured: up to 6 months during the treatment
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Jul 2020
- Study start12 Jul 2023
- Primary completionJul 2027 (estimated)
- Study completionJul 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Gambling DisorderStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 124 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University Hospital, Lille
- Sponsor type
- University, hospital or other
- Collaborators
- Ministry of Health, France
- Responsible party
- Sponsor
- Investigators
- Pierre TAQUET, PhD, Principal investigator, University Hospital, Lille
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04467502
- Sponsor's protocol ID
- 2020_02
- Other IDs
- 2020-A02710-39
- Acronym
- VIRET-GAD
- Status last verified
- May 2026
- First submitted
- 29 Jun 2020
- Last updated
- 14 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 14 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Virtual Reality Exposure Therapy for Gambling Disorder: Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT04467502
- Acronym / sponsor ID
- VIRET-GAD / 2020_02
- Conditions
- Gambling Disorder
- Keywords
- Exposure therapy, virtual reality, cognitive behavioral therapy, pathological gambling, CBT
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 124 participants (estimated)
- Lead sponsor
- University Hospital, LilleUniversity, hospital or other
- Collaborators
- Ministry of Health, France
- Study start
- 12 Jul 2023 (actual)
- Primary completion
- Jul 2027 (estimated)
- Study completion
- Jul 2027 (estimated)
- First posted
- 13 Jul 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Gambling disorder (GD) is recognized as an addictive disorder in the DSM-5. Craving is a core phenomenon in addiction that can lead to relapse in problem gambling for pathological gamblers. Exposure Therapy (ET) focuses on craving in addiction treatment. ET in Cognitive-Behavioral Therapy (CBT) is based on classical conditioning that addresses the association between contextual cues and the craving response. ET helps the patient to reduce craving when faced with cues triggering craving. ET includes in vivo exposure and imaginal exposure. The literature recommends being as close as possible to the context of addiction to facilitate the extinction of craving but in vivo ET is complicated to perform. For GD, in outpatient consultation, bringing a patient to a casino presents obstacles (e.g., time, human and financial cost, agreement with casino for therapy).
The study will be to assess the effectiveness of Virtual Reality Exposure Therapy (VRET) in a virtual gambling environment. Various trials show that VRET is no more or less effective than classical ET in CBT but has other advantages for motivation to treatment. This research aims to compare efficacy between CBT with VRET and CBT with imaginal exposure for treatment of GD in a multicenter, randomized, controlled, non-inferiority clinical trial.
Detailed description
Main aim:
Show, within patients seeking care for GD, that VRET integrated with CBT is non-inferior to imaginal ET integrated with CBT on GD symptom reduction at the end of 12 treatment sessions.
Secondary objectives:
- Show that VRET integrated with CBT is non-inferior to imaginal ET integrated with CBT on GD symptom reduction during the first 12 months post-treatment.
- Compare the effect of the two therapeutic strategies on GD symptoms (measured by complementary assessments to that used in the main aim), at the end of treatment and during the first 12 months post-treatment.
- Show the efficacy of VRET integrated with CBT compared to imaginal ET integrated with CBT on gambling behavior, craving, and gambling-related cognitions at the end of treatment and during the first 12 months post-treatment.
- Show the efficacy of VRET integrated with CBT compared to imaginal ET integrated with CBT on the evolution of anxiety and depressive symptoms at the end of treatment and during the first 12 months post-treatment.
- Compare the quality of the two therapeutic strategies at the end of treatment.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| CBT with VRET | Experimental | Other: cognitive-behavioral therapy for gambling disorder, Other: virtual reality exposure therapy focus on gambling cues |
| CBT with imaginal ET | Active comparator | Other: cognitive-behavioral therapy for gambling disorder, Other: imaginal exposure therapy focus on gambling cues |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Seek treatment for GD within one of health care facilities participating in the research (first request for treatment and not patients already receiving treatment for gambling disorder in the care center).
- Meet a current diagnosis of gambling disorder according to DSM-5 criteria and with a South Oaks Gambling Screen (SOGS) score ≥ 5
- Meet a casino gambling behavior with a casino gambling frequency ≥ 1 time every two months during the last 12 months
- Have a sufficient understanding of French for therapy
- Beneficiary of the French social security system
Key exclusion criteria (6 listed)
- Visual disturbance making impossible the use of virtual reality equipment (e.g. advanced retinal degeneration, central scotoma, age-related macular degeneration)
- Pregnant woman
- Minor or adult under guardianship, conservatorship, under judicial protection, persons deprived of their liberty
- Balance disorder (e.g. cerebellar disorder, inner ear disorder)
- Photosensitive epilepsy
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| cognitive-behavioral therapy for gambling disorder6 sessions of cognitive-behavioral therapy for gambling disorder | Other | CBT with VRET, CBT with imaginal ET |
| imaginal exposure therapy focus on gambling cues6 sessions of imaginal exposure therapy focus on gambling cues | Other | CBT with imaginal ET |
| virtual reality exposure therapy focus on gambling cues6 sessions of virtual reality exposure therapy focus on gambling cues | Other | CBT with VRET |
Primary outcome
Change in South Oaks Gambling Screen (SOGS) between baseline and end of treatment (12 sessions, 6 months)
Time frame: at the end of treatment (an average of 6 months)
The SOGS is a 20-item instrument used to screen for pathological gambling. The SOGS is scored by summing the number of items endorsed out of 20 and a cut score of 5 or more indicates a probable pathological gambling. The score ranges from 0 to 20.
14 secondary outcomes
Change in South Oaks Gambling Screen (SOGS) between baseline and follow-up at 3, 6 and 12 months after the end of treatment
Time frame: at baseline, and through study completion, an average of 18 months
Change in gambling disorder symptoms between baseline, end of treatment and follow-up assessed by the following criteria: number of DSM-5 criteria for GD
Time frame: at baseline, and through study completion, an average of 18 months
Change in gambling disorder symptoms between baseline, end of treatment and follow-up assessed by the following criteria: Problem Gambling Severity Index (PGSI)
Time frame: at baseline, and through study completion, an average of 18 months
Change in gambling behavior assessed by gambling frequency during the last month
Time frame: at baseline, and through study completion, an average of 18 months
Change in gambling behavior assessed by amount of money spent in gambling during the last month
Time frame: at baseline, and through study completion, an average of 18 months
Change in gambling behavior assessed by time spent gambling during the last month
Time frame: at baseline, and through study completion, an average of 18 months
Change in frequency subscale of gambling Craving Experience Questionnaire (g-CEQ)
Time frame: at baseline, and through study completion, an average of 18 months
Change in craving reactivity to gambling cues
Time frame: at baseline, and through study completion, an average of 18 months
Number of craving episodes using daily craving assessed by participants
Time frame: up to 6 months during the treatment
Cumulative duration of craving episodes using daily craving assessed by participants
Time frame: up to 6 months during the treatment
Change in gambling-related cognitions assessed by Gambling-Related Cognitions Scale (GRCS)
Time frame: at baseline, and through study completion, an average of 18 months
Change in depressive symptoms assessed by Beck Depression Inventory short-form (BDI-SF)
Time frame: at baseline, and through study completion, an average of 18 months
Change in anxiety symptoms assessed by State-Trait Anxiety Inventory (STAI)
Time frame: at baseline, and through study completion, an average of 18 months
Rate of patients who attended the 12 sessions (6 months)
Time frame: up to 6 months during the treatment
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 May 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Pierre TAQUET, PhD principal investigator
University Hospital, Lille
10 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing cognitive-behavioral therapy for gambling disorder, imaginal exposure therapy focus on gambling cues and virtual reality exposure therapy focus on gambling cues in people with Gambling Disorder, run by University Hospital, Lille at 10 sites in France.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 14 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 10 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Pierre TAQUET, PhD (0320445838 ext. +33, pierre.taquet@chru-lille.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in South Oaks Gambling Screen (SOGS) between baseline and end of treatment (12 sessions, 6 months) (time frame: at the end of treatment (an average of 6 months)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 May 2026.