ClinicalTrials.gg
RecruitingNCT04467502VIRET-GADUpdated May 14, 2026

Virtual Reality Exposure Therapy for Gambling Disorder

An interventional study of cognitive-behavioral therapy for gambling disorder and imaginal exposure therapy focus on gambling cues in Gambling Disorder, sponsored by University Hospital, Lille. Recruiting at 10 sites in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-05-14.

Sponsored by University Hospital, Lille · Not applicable, Interventional, and Other

From the registry’s dates

  • Started Jul 2023; still recruiting 3 years 3 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
124
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study 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. 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:

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. Compare the quality of the two therapeutic strategies at the end of treatment.
02

Conditions studied

  • Gambling Disorder

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Keywords

  • Exposure therapy
  • virtual reality
  • cognitive behavioral therapy
  • pathological gambling
  • CBT
03

In context

Gambling

158 studies on the registry are indexed under Gambling; 42 are open to participants now.

This study's planned enrollment of 124 is above the median of 66 across 128 interventional studies indexed under Gambling.

Browse Gambling studies →

Lead sponsor

University Hospital, Lille is the lead sponsor of 631 studies on the registry; 142 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • 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 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 to participate
  • Willing to comply with all study procedures and duration

Exclusion criteria

Exclusion Criteria:

  • 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
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

DSM diagnostic criteria

The American Psychiatric Association’s manual of mental health diagnoses. DSM-5 (2013, revised as DSM-5-TR in 2022) replaced DSM-IV, and some studies still name the older edition. “Meets DSM criteria for …” means diagnosed by that edition’s diagnostic criteria, usually by a clinician in an interview.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Other
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
124 participants (estimated)

Study arms

  • Experimental
    CBT with VRET

    Other: cognitive-behavioral therapy for gambling disorder · Other: virtual reality exposure therapy focus on gambling cues

  • Active comparator
    CBT with imaginal ET

    Other: cognitive-behavioral therapy for gambling disorder · Other: imaginal exposure therapy focus on gambling cues

Interventions

  • Othercognitive-behavioral therapy for gambling disorder

    6 sessions of cognitive-behavioral therapy for gambling disorder

  • Otherimaginal exposure therapy focus on gambling cues

    6 sessions of imaginal exposure therapy focus on gambling cues

  • Othervirtual reality exposure therapy focus on gambling cues

    6 sessions of virtual reality exposure therapy focus on gambling cues

06

What researchers measure

Primary outcomes

  1. 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.

    Time frame: at the end of treatment (an average of 6 months)

Secondary outcomes

  1. 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.

    Time frame: at baseline, and through study completion, an average of 18 months

  2. 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.

    Time frame: at baseline, and through study completion, an average of 18 months

  3. 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.

    Time frame: at baseline, and through study completion, an average of 18 months

  4. 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

  5. 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

  6. 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

  7. 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.

    Time frame: at baseline, and through study completion, an average of 18 months

  8. Change in craving reactivity to gambling cues

    Time frame: at baseline, and through study completion, an average of 18 months

  9. Number of craving episodes using daily craving assessed by participants

    Time frame: up to 6 months during the treatment

  10. Cumulative duration of craving episodes using daily craving assessed by participants

    Time frame: up to 6 months during the treatment

  11. 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.

    Time frame: at baseline, and through study completion, an average of 18 months

  12. 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.

    Time frame: at baseline, and through study completion, an average of 18 months

  13. 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.

    Time frame: at baseline, and through study completion, an average of 18 months

  14. Rate of patients who attended the 12 sessions (6 months)

    Quality of the two therapeutic strategies

    Time frame: up to 6 months during the treatment

07

Study locations

1 of 10 sites recruiting
  • CHU Amiens-Picardie
    Amiens, France
    Not yet recruiting
    • Alain DERVAUX, MD,PhD · Principal investigator
  • CH Boulogne sur mer CSAPA
    Boulogne-sur-Mer, France
    Not yet recruiting
    • Fréderic TEISSIERE, MD · Principal investigator
  • CHU de Caen
    Caen, France
    Not yet recruiting
    • Nicolas CABE, MD · Principal investigator
  • Hôpital Fontan, CHU lille
    Lille, 59000, France
    Not yet recruiting
    • Olivier COTTENCIN, MD,PhD · Principal investigator
  • Assoriation Cédragir Lomme CSAPA
    Lomme, France
    Not yet recruiting
    • Stéphanie Lienard · Sub investigator
  • CH de l'arrondissement de Montreuil / CSAPA
    Montreuil-sur-Mer, France
    Not yet recruiting
    • Mathieu LAWNICZAK · Sub investigator
  • CHU Rouen
    Rouen, France
    Not yet recruiting
    • Olivier GUILLIN, MD, PhD · Principal investigator
  • CH de Saint Amand les Eaux
    Saint-Amand-les-Eaux, France
    Not yet recruiting
    • Charles LESCUT, MD · Principal investigator
  • CH Seclin Carvin CSAPA
    Seclin, France
    Recruiting
    • Pierre TAQUET, PhD · Principal investigator
  • Association GREID ValenciennesCSAPA
    Valenciennes, France
    Not yet recruiting
    • Ines Roux · Sub investigator
08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Jul 2023 (actual). Primary completion is estimated for Jul 2027, 48 months after the start.

Of 47 non-industry interventional studies with no phase under Gambling, half reached primary completion within 16 months of starting (the median), counting those still running; a quarter within 10 and three quarters within 51. This study's planned 48 months is above that.

Counting every sponsor, half of 47 studies reached it within 16 months; a quarter within 10 and three quarters within 51.

How these figures are worked out, and which studies are left out of them.

Registered
Jun 29, 2020
First posted
Jul 13, 2020
StartActual
Jul 12, 2023
Primary completionEst.
Jul 2027
CompletionEst.
Jul 2027
Last update
May 14, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on May 14, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT04467502
Collaborators
Ministry of Health, France
Responsible party
Sponsor
First posted
Jul 13, 2020
Start date
Jul 12, 2023
Primary completion
Jul 2027 (estimated)
Completion
Jul 2027 (estimated)
Last update
May 14, 2026

Study contacts

Pierre TAQUET, PhD
Contact
pierre.taquet@chru-lille.fr
0320445838 ext. +33
Pierre TAQUET, PhD
principal investigator · University Hospital, Lille

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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