Evaluation of an Internet Addiction Treatment Program for Chinese Adolescents in Hong Kong
Shek, Daniel T. L., Tang, Vera M. Y., Lo, C. Y., Adolescence
Despite the high speed of information flow and potential educational value of the Internet, several of its attributes may foster addictive behavior. These include easy access 24 hours a day, anonymity, provision for free, diversified, and an unlimited number of social networks without geographical boundaries, greater control over one's self-presentation, and provision of numerous opportunities to fulfill the need for belongingness as well as escape from emotional difficulties, problematic situations, and personal hardships (Bayraktar & Grin, 2007; Young, 1999a). Young (1999b) pointed out that Internet addiction adversely affected physical health, family life, and academic performance. Research studies in the Western (e.g., Kaltiala-Heino, Lintonen & Rimpela, 2004; Johansson & Gotestam, 2004) and Asian contexts (e.g., Kim et al., 2006; Ko et al., 2007; Shek, Tang, & Lo, in press) suggest that the risk of Internet addiction among young people is increasing.
In response to the increasing risk of Internet addiction and its negative consequences, there is a need to explore intervention models. Unfortunately, a survey of the literature shows that there are only a few treatment programs for Internet addiction, such as group therapy with a combination of Readiness to Change (RtC), Cognitive Behavioral Therapy (CBT), and Motivational Interviewing (MI) interventions (Orzack et al., 2006), as well as Reality therapy group counseling programs (Kim, 2007). Some of the programs were developed to help clients with specific addictions, such as Internet-addicted sexual behavior, but the protocols of those programs were not presented in detail. In addition, the effectiveness of those programs is not altogether clear.
Since the effective intervention models for Internet addiction problems in Chinese culture are almost non-existent, an indigenous multilevel counseling program was designed to provide services for young people who displayed Internet addictive behavior in Hong Kong. This program was part of a project entitled "Youngster Internet Addiction Prevention and Counseling Service" funded by the Community Chest of Hong Kong, which was launched by the Jockey Club Wah Ming Lutheran Integrated Service Centre, Hong Kong Lutheran Social Service, Lutheran Church-Hong Kong Synod (LC-HKS).
Based on a thorough review of the literature on intervention strategies and techniques used in the fields of substance abuse, family counseling, and peer support groups (e.g., Gross, 1996; Kurtz, 2001; Miller & Rollnick, 1991; Otto, 1999; Washton, 2001), a multi-level intervention model with the following features was developed:
1. Emphasis on controlled and healthy use of the Internet: Instead of proposing complete abstinence of Internet use, it is argued that Internet use is intrinsically neutral. As such, controlled and healthy use was regarded as the desired outcome.
2. Understanding the change process in adolescents with Internet addiction behavior: In the change model (Prochaska & DiClemente, 1984, 1986), there are several stages in the process of change, including pre-contemplation, contemplation, determination, action, maintenance, and relapse. This model was used in the present context in order to understand the needs of adolescents with Internet addiction problems and of their family members. In the intervention model, counseling tasks in relation to these different stages of change were devised.
3. Utilization of motivational interviewing model: Motivational interviewing is a directive, client-centered counseling style for eliciting behavior change by helping clients explore and resolve ambivalence (Rollnich & Miller, 1995). It assumes that the responsibility and capability for change are within the client.
4. Adoption of a family perspective: Internet addiction often occurs in the family context which results in serious conflicts between the adolescents and their parents. …