Common practice elements of cognitive behavioral therapy for gaming disorder: A systematic review and expert panel evaluation

Abstract

Gaming disorder (GD) is an addictive disorder with health and social impacts recognized by the World Health Organization. Although the GD treatment evidence base appear to favor cognitive behavioral therapy (CBT), knowledge of its common practice elements is limited. This systematic review critically evaluates CBT interventions for GD, encompassing individual, group, and mixed approaches, to identify and synthesize common practice elements. Employing a systematic review protocol following PRISMA guidelines and guided by an international expert panel, this review identified CBT studies and then critically reviewed their associated treatment manuals, guidelines, handouts, and related resources. A database search yielding 8479 results identified 28 studies from 12 countries reporting on 22 CBT interventions (n = 7 individual; n = 7 group; n = 8 mixed). Study authors were invited to share intervention materials, which were then independently coded and synthesized. Overall, 14 common practice elements were identified. The most frequent element was emotion regulation skills training (n = 21; 95.5%), followed by psychoeducation (n = 20; 90.9%) and cognitive restructuring (n = 19; 86.4%). Exposure techniques, and strength identification and self-compassion were the least frequent (n = 6; 27.3%). All individual CBT interventions used behavioral activation, psychoeducation, and relapse prevention, whereas emotion regulation skills training was the most frequently used element in group CBT. These findings reveal commonly reported CBT practice elements in the GD evidence base and provide expert summaries of established and less utilized therapeutic techniques. Improving the field's shared understanding of CBT is foundational to advancing GD clinical research and a model of best practice.