Behind the Bet: An Assessment-Informed Counseling Model for Predicting and Addressing Problematic Betting Behavior Among Adolescents in Ghana

Adolescent gambling is an emerging public health concern in sub-Saharan Africa, yet culturally appropriate tools for assessing betting behaviors remain scarce. The study evaluated the psychometric properties of the Adolescent Betting Behavior Assessment Scale (ABBAS) and investigate its applicability in measuring problematic betting behavior and associated psychological distress among adolescents in Ghana. Using a cross-sectional design, a total of 500 adolescents, aged 12 to 19 years, participated in the study. The findings highlight the scale’s utility in counseling settings and its role in identifying adolescents at risk of developing gambling-related issues. Results indicated strong internal consistency for the subscales (Cronbach’s α = 0.75 to 0.82) and total scale (α = 0.85), with significant correlations with related behavioral constructs such as risk-taking (r = 0.65 to 0.72, p < .01), gambling beliefs (r = 0.60 to 0.80, p < .01), impulsivity (r = 0.48 to 0.63, p < .01), social anxiety (r = 0.39 to 0.62, p < .01), and academic performance (r = − 0.21, p < .05). The scale demonstrated robust criterion validity, evidenced by strong positive correlations with the Gambling Belief Scale and Risk-Taking Scale, and negative correlations with Grade Point Average, confirming its effectiveness in capturing adolescent betting behaviors within this cultural context. Pre- and post-intervention analyses revealed significant reductions in betting frequency by 34.29% (t(58) = 6.14, p < .001) and emotional distress by 35.48% (t(58) = 6.55, p < .001) among adolescents receiving Adolescent-Centred Cognitive Behavioral Therapy (A-CBT), as well as reductions in the Non-Guided Counseling (NGC) group by 28.57% (t(57) = 5.91, p < .001) for frequency and 30.89% (t(57) = 5.87, p < .001) for distress, both showing large effect sizes (Cohen’s d = 0.79 and 0.85). Additionally, impulsivity scores decreased by 27.59%, while anxiety and depression symptoms declined by 17.3% and 24.32%, respectively, indicating the scale’s sensitivity in tracking changes in both gambling behaviors and psychological distress. Hierarchical regression analyses revealed that gender and impulsivity significantly moderated intervention outcomes. Gender predicted ABBAS frequency in A-CBT (β = 0.18, ΔR² = 0.032, F = 4.88, p = .032), and impulsivity interacted with A-CBT to predict frequency (β = − 0.41, ΔR² = 0.054, F = 6.72, p = .011). For ABBAS distress in the NGC group, gender was a significant predictor (β = − 0.29, ΔR² = 0.061, F = 7.94, p = .007), indicating differential intervention effects by sex. These findings underscore the importance of tailoring evidence-based interventions to individual differences, integrating both behavioral and emotional aspects of gambling, and using group-based support strategies in school and community settings. Overall, the ABBAS is a culturally relevant, reliable, and valid tool for identifying and monitoring problematic betting behavior in Ghanaian adolescents.