Acceptance and commitment group therapy as an intervention for adolescent with internet gaming disorder: A randomized clinical trial

Background: Internet Gaming Disorder (IGD) is increasingly prevalent among adolescents. Acceptance and Commitment Group Therapy (ACGT), a transdiagnostic psychotherapeutic approach that focuses on enhancing psychological flexibility. This study evaluates the effectiveness of ACGT in reducing symptoms of IGD, depression, anxiety, and stress among high school students.

Methods: A randomized experimental design was used with 40 participants assigned to an intervention group (n = 20) or a control group (n = 20). The intervention consisted of eight weekly ACGT sessions (90 minutes each). Assessments were conducted using the Indonesian versions of the Game Addiction Scale (GAS) and the Depression Anxiety Stress Scale–Youth (DASS-Youth) at baseline (week 0), post-intervention (week 9), and follow-up (week 21).

Results: ACGT significantly reduced IGD scores in the intervention group (p < 0.000), with effects remaining stable through week 21. Significant improvements were observed in the domains of salience, mood modification, relapse, withdrawal, conflict, and problems, while tolerance showed inconsistent results. Depression, anxiety, and stress scores also decreased significantly (p < 0.05), although the reduction in depression was less pronounced compared to anxiety and stress. In contrast, the control group exhibited a progressive increase in IGD scores from baseline to follow-up. A weak positive correlation was found between IGD and anxiety at week 9 (p = 0.025).

Conclusion: ACGT was found to be effective in reducing IGD symptoms and improving anxiety and stress among adolescents.

Zahra Ibadina Silmi, MD, is a psychiatry resident at the Medical Faculty of Airlangga University and Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. She has strong interests in psychotherapy and addiction, and has undergone training in Acceptance and Commitment Therapy, Cognitive Behavioral Therapy, Psychodynamic Psychotherapy, and Dialectical Behavior Therapy both nationally and internationally. She serves as a counsellor with Peduli Remaja Indonesia and supports schizophrenia, bipolar, and mood disorder communities in Surabaya. Dr. Zahra is also the President of the Indonesian Psychiatric Trainees Association (IPTA) 2024–2025. Her current research focuses on psychotherapeutic interventions for youth and behavioral addiction.