Effectiveness of an integrated motivational cognitive–behavioral group intervention for adolescents with gaming disorder: a randomized controlled trial

Yinan Ji, Daniel Fu Keung Wong*

*Corresponding author for this work

Research output: Contribution to journalJournal articlepeer-review


Aims, Design and Setting: The aim of this study was to test the efficacy of the integrated cognitive–behavioral therapy with a strength-based motivational approach [integrated cognitive–behavioral therapy (ICBT)] intervention to change gaming disorder (GD) symptoms and other outcomes and to study the therapeutic mechanism. A two-arm parallel randomized waiting-list controlled trial with 3- and 6-month follow-ups were conducted in a secondary vocational school in mainland China. Participants: Participants comprised 77 Chinese adolescents with GD symptoms with a mean age of 16.36 years [standard deviation (SD) = 0.93]; 88.3% were male. Interventions: Participants were randomized into an ICBT group (n = 38) and a waiting-list control (WLC, n = 39) group. ICBT intervention comprised eight weekly sessions to encourage participants to identify their interests and strengths and set goals for developing personally meaningful real-life activities. Measurements and Findings: The outcomes were measured at pre-treatment (t0), post-treatment (t1), 3-month (t2) and 6-month (t3) follow-ups. The primary outcome was GD symptoms at t3. Secondary outcomes included GD symptoms at t1 and t2, and gaming motivation, maladaptive gaming cognition, depression and anxiety symptoms at t1, t2 and t3. With the intention-to-treat principle, the GD scores at t3 were significantly different between the CBT and WLC groups [mean difference 62.08 (SD = 10.48) versus 73.64 (SD = 11.70); Hedges’ g = 1.15, 95% confidence interval = 0.67–1.62]. Linear mixed-effects modeling showed significant group × time interaction for the secondary outcomes (P < 0.01), with a moderate to strong between-group effect size in the reduction in depression symptoms (g = 0.67–0.84) and anxiety symptoms (g = 0.6–0.64). Path analysis shows ICBT leads to GD reduction through reducing gaming motivation and maladaptive gaming cognition. Conclusions: An integrated cognitive–behavioral therapy with strength-based motivational approach intervention reduced gaming disorder symptoms and time spent gaming over a 6-month period by decreasing maladaptive gaming motivation and cognition.

Original languageEnglish
Pages (from-to)2093-2104
Number of pages12
Issue number11
Early online date12 Jul 2023
Publication statusPublished - Nov 2023

Scopus Subject Areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health

User-Defined Keywords

  • China
  • cognitive–behavioral therapy
  • gaming disorder
  • gaming motivation
  • integrated method
  • maladaptive gaming cognition
  • strength-based approach


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