Sex and Gambling Assessment (SAGA)

What is The Sex and Gambling Assessment (SAGA)

The SAGA is a 30-item self-report screening instrument designed to assess the co-occurrence of compulsive sexual behavior disorder (CSBD) and gambling disorder in adult clients. It uses a 5-point Likert scale across seven clinical subscales, producing a composite score that flags elevated risk and supports clinical case conceptualization.

What the SAGA Measures

The seven subscales assess clinically relevant dimensions including:

  • Behavioral preoccupation and urge frequency
  • Loss of control across sexual and gambling contexts
  • Emotional dysregulation and mood-driven behavior
  • Consequence tolerance and minimization
  • Relational and financial impact
  • Shame and secrecy patterns
  • Help-seeking avoidance

A composite score of 75 or above indicates elevated clinical concern warranting further assessment.

Who This Instrument Is For

The SAGA was developed for use by individuals who struggle with compulsive sexual behavior and co-occurring problematic gambling behaviors. The SAGA is a supportive assessment tool for licensed mental health clinicians, addiction counselors, and behavioral health professionals who work with clients presenting with:

  • Compulsive sexual behavior or sex addiction
  • Problem gambling or gambling disorder
  • Co-occurring behavioral addictions
  • Betrayal trauma and relational consequences of addiction
  • Financial infidelity tied to hidden gambling or sexual behavior

It is appropriate for use in outpatient, intensive outpatient, and residential treatment settings.

Research Bases

The instrument was developed by Debra Kaplan, MA, LPC, CSAT-S with the assistance of AI for style and assessment structure in response to emerging empirical literature on behavioral addiction co-occurrence. Research included Way, B. M., Jennings, T. L., Grubbs, J. B., Chapman, H., & Kraus, S. W. (2025). Double trouble – Examining the co-occurrence of compulsive sexual behavior disorder and gambling disorder among two American samples. The American Journal on Addictions, 35(1), 36–45. Other sources include information from behavioral addiction research consistent with DSM-5 Gambling Disorder and ICD-11 Compulsive Sexual Behavior Disorder criteria.

Clinical Disclaimer

The SAGA is a self-report screening instrument. It has not undergone formal psychometric validation, peer review, or normative standardization. Its use is intended to support — not replace — a formal evaluation by a mental health professional.

Sex and Gambling Assessment (SAGA)
S G SAGA Sex and Gambling Assessment A CLINICAL SCREENING INSTRUMENT Debra Kaplan, MA, LPC, CSAT-S debrakaplancounseling.com
SAGA  ·  Version 3.0  ·  30 Items  ·  7 Subscales  ·  Likert 1–5  ·  Clinical Threshold: 75+

About This Tool

The Sex and Gambling Assessment (SAGA) is a clinician-administered or clinician-supervised screening instrument designed to assess patterns of gambling behavior, compulsive sexual behavior, and pornography use — and their co-occurrence — across seven clinical domains. It is appropriate for adults and is grounded in current behavioral addiction research, including empirical analysis of the co-occurrence of compulsive sexual behavior disorder and gambling disorder (Way, Jennings, Grubbs, Chapman & Kraus, 2025).

This instrument is intended as a clinical starting point, not a diagnostic tool. Scores should be interpreted within the full clinical picture, including client history, co-occurring conditions, and the therapeutic relationship. Elevated scores warrant deeper clinical exploration, not categorical diagnosis.

This tool was developed for use by Debra Kaplan, MA, LPC, CSAT-S. For licensing or training inquiries, contact debrakaplancounseling.com.
Directions for the Client: Please read each statement carefully and select the number that best describes how often the statement applies to you. There are no right or wrong answers. Answer based on the past 12 months unless otherwise noted.
1 = Never  ·  2 = Rarely  ·  3 = Sometimes  ·  4 = Often  ·  5 = Always
Item
Never
1
Rarely
2
Sometimes
3
Often
4
Always
5
A — Exposure & Access Items 1–5  ·  Frequency, variety, and accessibility of gambling and sexual behavior.
Never
1
Rarely
2
Sometimes
3
Often
4
Always
5
1.I gamble on sports, in-game betting, tokenized equities, perpetual futures, or prediction markets at least once per week.
2.I notice that the more I gamble the more I seek out pornography or access sexually explicit content online through a mobile device.
3.I engage in sexual behavior online — such as live cam sites, hookup apps, sexting platforms, or paid subscription content.
4.I participate in multiple forms of gambling at the same time (e.g., sports betting, in-game betting, tokenized equities, perpetual futures, or prediction markets).
5.I access gambling or gamblified financial platforms through a mobile phone, tablet, or app on a daily basis.
B — Emotional Reliance Items 6–10  ·  Using gambling or sexual behavior to regulate emotion, manage stress, or escape distress.
Never
1
Rarely
2
Sometimes
3
Often
4
Always
5
6.I turn to gambling, masturbation, or other sexual behavior to cope with stress, anxiety, loneliness, or emotional pain.
7.I feel restless, irritable, or emotionally unsettled when I am unable to gamble or access sexual content.
8.Gambling or sexual stimulus is the fastest way I know to feel better when I am distressed.
9.I use these behaviors to avoid thinking about difficult emotions or uncomfortable situations.
10.After a gambling loss or win, I seek out online sexual partners even when I know I will experience guilt or shame.
C — Social Displacement Items 11–15  ·  Impact on relationships, social functioning, and concealment of behavior.
Never
1
Rarely
2
Sometimes
3
Often
4
Always
5
11.My gambling has created conflict, emotional distance, or a loss of trust with someone close to me.
12.I have missed work, family obligations, or important commitments because of time spent gambling.
13.I have hidden or minimized the extent of my gambling activity from a partner, family member, or therapist.
14.I spend significantly less time with friends or family because of how much time these behaviors now occupy.
15.My intimate relationship has been damaged by my gambling or online sexual behavior.
D — Escalation & Tolerance Items 16–20  ·  Increasing frequency, intensity, financial stakes, or novelty-seeking over time.
Never
1
Rarely
2
Sometimes
3
Often
4
Always
5
16.I need to bet larger amounts or take higher financial risks to feel the same level of excitement I used to get from smaller wagers.
17.I have shifted gambling from online sports betting platforms to higher-risk trading in prediction markets, perpetual futures, or tokenized stocks.
18.The sexual content I seek has become more explicit, more extreme, or more unusual over time to produce the same level of arousal.
19.I pursue new sexual partners, platforms, or experiences more frequently because familiar ones no longer provide the same level of stimulation.
20.I consistently spend more money or time on gambling or sexual behavior than I planned when I started.
E — Loss of Control Items 21–25  ·  Failed attempts to stop, compulsive continuation, and harm-driven return to behavior.
Never
1
Rarely
2
Sometimes
3
Often
4
Always
5
21.I have made sincere attempts to cut back or stop gambling but have been unable to follow through.
22.I continue gambling even after these activities have caused clear financial, relational, or emotional harm.
23.I feel a compulsive pull toward gambling even when I consciously want to stop.
24.I use sexual behavior (e.g., porn, masturbation) to numb a gambling loss or to celebrate a gambling win.
25.I lie to myself — or significantly minimize — how much I gamble, how much I lose, or how often I engage in micro betting.
F — Vulnerability Factors Items 26–28  ·  Structural risk amplifiers: history, comorbidity, and concurrent stressors.
Never
1
Rarely
2
Sometimes
3
Often
4
Always
5
These items assess pre-existing risk factors associated with elevated susceptibility to co-occurring gambling and sexual behavior disorders, based on research linking these presentations to trauma history, mental health comorbidity, and behavioral addiction history.
26.I have a personal history of depression, anxiety, trauma, PTSD, or another mental health condition.
27.I have a family history of addiction, problem gambling, compulsive sexual behavior, or other behavioral disorders.
28.I use alcohol, cannabis, or view pornography as part of a gambling ritual.
G — Insight & Awareness Items 29–30  ·  Client recognition of problematic patterns and readiness to engage with change.
Never
1
Rarely
2
Sometimes
3
Often
4
Always
5
Note to Clinician: Items 29 and 30 assess the client’s level of reality-testing and insight. These items are scored as answered (no reversal applied to the total; they are interpreted contextually). Higher scores indicate greater insight, which is clinically protective. However, a high score here does not override elevated risk in other domains.
29.I believe my gambling or sexual behavior has become a problem that affects my daily functioning, relationships, or finances.
30.I have considered or thought about seeking professional help for my gambling but I have not taken action.

Co-Occurring Conditions to Explore

Based on elevated subscale scores, consider screening or clinical inquiry in the following areas:

Elevated Section B or C:Attachment disruption, betrayal trauma, social anxiety, avoidant attachment style
Elevated Section D or E:Behavioral addiction, compulsivity, impulse control disorder, co-occurring substance use
Elevated Section F:Trauma history, relational betrayal, complex PTSD, sex addiction, financial infidelity
Low Section G (1–2 on items 29–30):Poor insight or pre-contemplative stage. Motivational interviewing indicated as primary intervention before structured treatment planning.
A + D + E all elevated:CRITICAL FLAG: Triple co-elevation. Immediate comprehensive assessment and care coordination required.
B + C both elevated:Affect and concealment cluster. High probability of co-occurring relationship trauma and partner betrayal.

Scoring Guide

Step 1 — Score Each Item

Record the number selected by the client on each item (1–5). For items 29 and 30, note the score as marked — these are scored as answered (no reversal is applied to the total; they are interpreted contextually).

Step 2 — Calculate Subscale Scores

Add the scores for each subscale as indicated below. Enter totals in the Client Score column.

Subscale Items Score Range Concern Threshold Client Score
A — Exposure & Access #1–5 5–25 ≥ 12 ________
B — Emotional Reliance #6–10 5–25 ≥ 15 ________
C — Social Displacement #11–15 5–25 ≥ 12 ________
D — Escalation & Tolerance #16–20 5–25 ≥ 12 ________
E — Loss of Control #21–25 5–25 ≥ 15 ________
F — Vulnerability Factors #26–28 3–15 ≥ 9 ________
G — Insight & Awareness #29–30 2–10 ≥ 7 ________
TOTAL SCORE #1–30 30–150 ≥ 75 ________
Step 3 — Interpret Total Score

Sum all 30 item scores. The total score ranges from 30 to 150. Use the table below to identify the risk level and recommended clinical response. The clinical significance threshold is 75.

Total Score Risk Level Clinical Interpretation & Recommended Action
30 – 54 Minimal / Baseline No significant concern at this time. Psychoeducation on behavioral addiction risk recommended. Monitor over time.
55 – 74 Low Concern Some patterns of engagement warrant monitoring. Brief psychoeducation and normalization discussion recommended. Re-administer in 3 months.
75 – 99 Moderate Concern Emerging risk indicators present. Integrated clinical discussion recommended. Consider behavioral tracking, motivational interviewing, and co-occurring condition screening.
100 – 124 Elevated Risk ⚠ Clinically significant concern. Formal behavioral addiction assessment recommended. Address co-occurring issues (attachment, trauma, mood disorders). Treatment planning indicated.
125 – 150 High Risk ★
CLINICAL THRESHOLD		 Meets threshold for clinically significant compulsive/addictive use. Comprehensive assessment, treatment plan, and consideration of intensive outpatient or specialist referral strongly recommended.
★ Clinical Significance Threshold: A total score of 75 or above warrants formal behavioral addiction assessment.
Important Disclaimer — Empirical Validity: The Sex and Gambling Assessment (SAGA) is a clinician-developed screening instrument and has not undergone formal psychometric validation, including reliability testing, factor analysis, or normative standardization. It has not been subjected to peer review, published in a clinical or scientific journal, or independently validated by external researchers. The item content, subscale structure, and scoring thresholds were derived from the clinician’s professional judgment informed by published empirical literature on the co-occurrence of compulsive sexual behavior disorder and gambling disorder — they do not constitute a validated psychometric scale in the formal sense.

This instrument is intended solely as a clinical conversation starter and structured observation aid. It should not be used to render diagnoses, make treatment determinations, or support legal or forensic conclusions as a standalone instrument. Scores must be interpreted within the full clinical context, including the client’s history, presenting concerns, cultural background, and the therapeutic relationship. Clinicians are responsible for the appropriate and ethical use of this tool within the scope of their licensure and professional standards.
Research Basis: This instrument was developed in response to empirical literature on the co-occurrence of compulsive sexual behavior disorder and gambling disorder. Primary research basis includes:

Way, B. M., Jennings, T. L., Grubbs, J. B., Chapman, H., & Kraus, S. W. (2025). Double trouble – Examining the co-occurrence of compulsive sexual behavior disorder and gambling disorder among two American samples. The American Journal on Addictions, 35(1), 36–45. https://doi.org/10.1111/ajad.70090

Additional theoretical grounding and resourcing draws from behavioral addiction frameworks consistent with DSM-5 Gambling Disorder and ICD-11 Compulsive Sexual Behavior Disorder criteria.
© 2026 Debra Kaplan, MA, LPC, CSAT-S. All rights reserved. The Sex and Gambling Assessment (SAGA), including all item content, subscale structure, scoring methodology, and clinical frameworks, is the proprietary intellectual property of Debra Kaplan, MA, LPC, CSAT-S. Unauthorized reproduction, distribution, adaptation, or publication of this instrument in whole or in part — in any format, including print, digital, or electronic — is strictly prohibited without prior written permission from the author. For licensing, training, or permission inquiries, contact debrakaplancounseling.com/contact.

Assessment Submitted

Thank you for completing the Sex and Gambling Assessment (SAGA). Your responses have been submitted securely.

Results and clinical interpretation are provided exclusively by Debra Kaplan, MA, LPC, CSAT-S. To discuss your results and next steps, please contact Debra directly at debrakaplancounseling.com/contact or call 520.203.1943.

Assessment Complete

SAGA Results Summary

SAGA  ·  Version 3.0  ·  Clinical Threshold: 75+
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Subscale Scores

© 2026 Debra Kaplan, MA, LPC, CSAT-S  ·  debrakaplancounseling.com  ·  For clinical use only

***Results and clinical interpretation are provided exclusively by Debra Kaplan, MA, LPC, CSAT-S. Results remain the property of Debra Kaplan. Individuals taking the assessment should first consider individual history and pre-existing conditions. It is recommended to seek support if elevated scores warrant deeper clinical exploration.