Academic journal article Journal of Cognitive Psychotherapy

CBT-IA: The First Treatment Model for Internet Addiction

Academic journal article Journal of Cognitive Psychotherapy

CBT-IA: The First Treatment Model for Internet Addiction

Article excerpt

Research has identified Internet addiction as a new clinical disorder that causes relational, occupational, and social problems. Cognitive behavioral therapy (CBT) has been suggested as the treatment of choice for Internet addiction, and addiction recovery in general has used CBT as part of treatment planning. This article outlines cognitive behavioral therapy-Internet addiction (CBT-IA), a uniquely designed model for treating Internet addiction applying CBT with harm reduction therapy (HRT). CBT-IA uses a three-phase approach. In the first phase, behavior modification is used to gradually decrease the amount of time the addict spends online. In the second phase, cognitive therapy is used to address denial that is often present among Internet addicts and to combat the rationalizations that justify excessive online use. The third phase applies HRT to identify and treat coexisting issues involved in the development of compulsive Internet use. As the first model of its kind, it can be used both on an outpatient and inpatient basis to deal with this emergent client population.

Keywords: cognitive behavioral therapy; Internet addiction; recovery; treatment; harm reduction therapy

Studies on Internet addiction originated in the United States. More recently, studies have documented Internet addiction in a growing number of countries such as Italy (Ferraro, Caci, D'Amico, & Di Blasi, 2007), Pakistan (Suhail & Bargees, 2006), and the Czech Republic (Simkova & Cincera, 2004). Reports also indicate that Internet addiction has become a serious public health concern in China (BBC News, 2005), Korea (Hur, 2006), and Taiwan (Lee, 2007). About 10% of China's more than 30 million Internet gamers were said to be addicted. To battle what has been called an epidemic by some reports, Chinese authorities regularly shut down Internet cafes, many illegally operated, in crackdowns that also include huge fines for their operators. The Chinese government has also instituted laws to shut down the number of hours adolescents can play online games and opened the first inpatient treatment center for Internet addiction in Beijing. In the United States, Internet addiction has also been considered for classification in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-V; Block, 2008), and it is expected to be included in the appendix for the upcoming edition.

It is difficult to estimate how widespread the problem is. Given the popularity of the Internet, detecting and diagnosing Internet addiction is often difficult as its legitimate business and personal use mask addictive behavior (Young, 2010). However, in a nationwide study conducted by a team from Stanford University's School of Medicine, it was estimated that nearly one in eight Americans exhibit at least one possible sign of problematic Internet use (Aboujaoude, Koran, Gamel, Large, & Serpe, 2006).

Researchers have likened Internet addiction to impulse-control disorders on Axis I in DSM-IV (e.g., Aboujaoude et al., 2006; Beard & Wolf, 2001; Block, 2008; Shapira et al., 2003; Young, 1998) and have used various forms of DSM-IV based criteria to define Internet addiction. Cognitive behavioral therapy (CBT) has been shown to be an effective treatment for impulse control disorders such as intermittent explosive disorder, pathological gambling, and trichotillomania (Hucker, 2004). CBT has also been effective in treating substance abuse, emotional disorders, and eating disorders (Beck, 1979; Beck, Wright, Newman, & Liese, 1993). Researchers have suggested using CBT to treat Internet addiction (e.g., Greenfield, 1999; Hansen, 2002; Orzack, 1999), given the compulsive nature and similarity to other disorders successfully treated with CBT. However, Internet addiction has been noted to be different from other compulsive syndromes given the daily and necessary use of the Internet and technology in general. Therefore, this article outlines cognitive behavioral therapy-Internet addiction (CBT-IA), a uniquely designed model for treating Internet addiction, applying CBT with harm reduction therapy (HRT). …

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