Internet addiction is the broad and more common term for what Dr Philip Tam has termed Problematic Internet Use, or PIU. In his first article for The Kids Are All Right, Is your teen addicted to the Internet?, Dr Tam explained what is Internet addiction.
In this follow-up article, Dr Tam discusses the treatment options for Internet addiction.
A question that is commonly asked when assessing a child or adolescent with Problematic Internet Use (PIU) is: what sorts of treatments are available for this often challenging condition? In brief, PIU has been with us for too short a time for a generally-accepted, ‘gold standard’ treatment type to be available. It is also clear that it is a complex behavioural problem, with a strong association with mental health disorders such as childhood depression, anxiety, or even ADHD, as well as issues such as family conflict, bullying and low self-esteem. PIU also occurs along a spectrum of severity, from milder and less problematic forms (which may not need specialist intervention), through to severe, pervasive forms (which may require the input of a suitably skilled psychologist or psychiatrist).
“PIU is a complex behavioural problem, strongly associated with mental health disorders such as childhood depression, anxiety, or even ADHD”
Despite these considerations, in the past decade or so there has been a large increase in the amount of research into PIU, or ‘Internet Addiction’ as it is commonly termed, mainly aimed at establishing the prevalence of the disorder internationally, but also beginning to look at suitable treatment options. We are, however, still quite far off establishing what researchers term ‘evidence-based practice’.
The primary task whenever deciding on a treatment plan is, of course, a thorough and holistic clinical assessment and formulation, and treating any underlying mental illness or difficulty.
Looking in a bit more detail at what treatment forms are emerging around the world, and to a smaller extent in Australia where research is less well-established, it is notable that a wide range of therapies have been proposed as helpful in PIU.
By far the commonest therapy is individual psychotherapy with a trained psychologist. This usually utilises the well-established principles of CBT (cognitive-behavioural therapy), and may also incorporate aspects of narrative therapy (where the client and therapist sensitively explores one’s history and ‘life story’), and insight-oriented therapy, where the work focuses on assisting the client ‘gain insight’ (ie deep understanding) into his problem and the effect it may have on him and the people around him.
“It is clearly an emerging and complex problem that the community is very concerned about”
These are the methods that I most commonly use in daily practice with such clients, but I regularly include the family in sessions given that I work mainly with teenagers still living at home and attending school. Currently, PIU is not a reimbursable item on Medicare, but I have publicly called for this to be considered by policymakers in Australia, given that it is clearly an emerging and complex problem that the community is very concerned about.
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There have also been a few studies looking at ‘group therapy’, generally using CBT principles as well as ‘group dynamics’ similarly to what is used in Alcoholics Anonymous group therapy. Again, there is now good evidence that this approach can work well, though of course careful selection of the clients to be included in the group is important.
Next: In-patient stays and medication
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