If individual or group therapy do not work (and they can take 6 to 12 months to show significant benefit), and if there is associated deterioration in day-to-day functioning such as disturbed sleeping or eating, school attendance issues, or family conflict, it may be appropriate to consider an in-patient stay. At the time of writing this article, there are no dedicated in-patient units, for either teenagers or adults, specifically treating PIU in this country. In the past decade a small number of private facilities have opened in the USA, in London, and in continental Europe.
“The key to a successful in-patient stay is optimum willingness and engagement in the client”
A few of the private facilities and hospitals in Australia, which have an important role in treating behavioural addictions such as gambling, sexual and pornography addictions and so on, may accept a client with PIU as their main problem, so it may be worth discussing this possibility with your health provider if you are concerned about a family member, or friend. The key to a successful in-patient stay is optimum willingness and engagement in the client (ie they are not admitted against their will), and a dedicated, empathic and professional team.
“Therapists in this country do not recommend that ‘internet boot camps’ are used, even in the most advanced cases”
It must also be noted here that many Asian countries also have well-established in-patient units dedicated to treating young clients with severe PIU, most notably South Korea (which also had the world’s first internet-addiction clinic for children), Japan, and China. Many of these are unregulated and privately-run, and include the now-infamous ‘internet boot camps’ where often desperate parents send their (usually unwilling) teenage children. These ‘camps’ are often located in army or police-training facilities and use robust, often abusive methods on the participants. In recent years, there have been two reported deaths in China of teenagers, due to essentially physical abuse at the hands of the ‘therapists’ in such camps, and I understand that the government in China is now moving to regulate the whole enterprise. Therapists in this country do not recommend that ‘internet boot camps’ are used, even in the most advanced cases.
On the use of medication
Use of medication is an area of great interest, but one that is still in infancy. As I noted above, a large proportion of PIU clients will also have depression, anxiety, distress, or less commonly bipolar disorder; all of these conditions can be effectively treated with medication, alongside psychotherapy. There have also been a few recent and intriguing ‘case reports’ of medication being used to treat severe, pathological PIU (though, to my knowledge, no large scale trials as yet). These include usage of Ritalin (commonly used to treat the impulsivity and overactivity in ADHD), and of Naltrexone, which reduces the intense cravings and agitation associated with heroin and other drug addictions.
“Major breakthroughs and developments are sure to emerge within the next decade”
At this stage, these treatments should best be regarded as experimental, but it is clear that the whole field of treatment options in PIU, from individual therapy through to the targeted use of medications, is at an exciting point in its evolution; major breakthroughs and developments are sure to emerge within the next decade.
About the author
Dr Philip Tam BA, MBBS, MA, FRANZCP, Cert Child Psych. is a Sydney-based child psychiatrist, researcher and lecturer in Public practice. He is the President and Co-Founder of NiIRA, the Network for Internet Investigation and Research in Australia.
Dr Tam has also written Internet addiction and how to treat it for The Kids Are All Right.
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