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Page 8 of 10
Reminder Cards
Often patients feel overwhelmed because, through errors in their thinking, they exaggerate their difficulties and minimize the possibility of corrective action. To help the patient stay focused on the goal of either reduced use or abstinence from a particular application, have the patient make a list of the, (a) five major problems caused by addiction to the Internet, and (b) five major benefits for cutting down Internet use or abstaining from a particular application. Some problems might be listed such as lost time with one’s spouse, arguments at home, problems at work, or poor grades. Some benefits might be, spending more time with one’s spouse, more time to see real life friends, no more arguments at home, improved productivity at work, or improved grades.
Next, have the patient transfer the two lists onto a 3x5 index card and have the patient keep it in a pants or coat pocket, purse, or wallet. Instruct patients to take out the index card as a reminder of what they want to avoid and what they want to do for themselves when they hit a choice point when they would be tempted to use the Internet instead of doing something more productive or healthy. Have patients take the index card out several times a week to reflect on the problems caused by their Internet overuse and the benefits obtained by controlling their use as a means to increase their motivation at moments of decision compelling on-line use. Reassure patients that it is well worth it to make their decision list as broad and all-encompassing as possible, and to be as honest as possible. This kind of clear-minded assessment of consequences is a valuable skill to learn, one that patients will need later, after they have cut down or quite the Internet, for relapse prevention.
Personal Inventory
Whether the patient is trying to cut down or abstain from a particular application, it is a good time to help the patient cultivate an alternative activity. The clinician should have the patient take a personal inventory of what he or she has cut down on, or cut out, because of the time spent on the Internet. Perhaps the patient is spending less time hiking, golfing, fishing, camping, or dating. Maybe they have stopped going to ball games or visiting the zoo, or volunteering at church. Perhaps it is an activity that the patient has always put off trying, like joining a fitness center or put off calling an old friend to arrange to have lunch. The clinician should instruct the patient to make a list of every activity or practice that has been neglected or curtailed since the on-line habit emerged. Now have the patient rank each one on the following scale: 1 - Very Important, 2 - Important, or 3 - Not Very Important. In rating this lost activity, have the patient genuinely reflect how life was before the Internet. In particular, examine the "Very Important" ranked activities. Ask the patient how these activities improved the quality of his or her life. This exercise will help the patient become more aware of the choices he or she has made regarding the Internet and rekindle lost activities once enjoyed. This will be particularly helpful for patients who feel euphoric when engaged in on-line activity by cultivating pleasant feelings about real life activities and reduce their need to find emotional fulfillment on-line.
Support Groups
Some patients may be driven towards addictive use of the Internet due to a lack of real life social support. Young (1997c) found that on-line social support greatly contributed to addictive behaviors among those who lived lonely lifestyles such as homemakers, singles, the disabled, or the retired. This study found that these individuals spent long periods of time home alone turning to interactive on-line applications such as chat rooms as a substitute for the lack of real life social support. Furthermore, patients who recently experienced situations such as a death of a loved one, a divorce, or a job loss may respond to the Internet as a mental distraction from their real life problems (Young, 1997c). Their absorption in the on-line world temporarily makes such problems fade into the background. If the life events assessment uncovers the presence of such maladaptive or unpleasant situations, treatment should focus on improving the patient’s real life social support network.
The clinician should help the client find an appropriate support group that best addresses his or her situation. Support groups tailored to the patient’s particular life situation will enhance the patient’s ability to make friends who are in a similar situation and decrease their dependence upon on-line cohorts. If a patient leads one of the above mentioned "lonely lifestyles" then perhaps the patient may join a local interpersonal growth group, a singles group, ceramics class, a bowling league, or church group to help meet new people. If another patient is recently widowed, then a bereavement support group may be best. If another patient is recently divorced, then a divorcees support group may be best. Once these individuals have found real life relationships they will rely less upon the Internet for the comfort and understanding missing in their real lives.
I am routinely asked about the availability of Internet addiction support groups. To date, McLean Hospital in Belmont, Massachusetts and Proctor Hospital in Peoria, Illinois are two of the few treatment centers which offer Computer/Internet Addiction Recovery services. However, I suggest that clinicians attempt to find local drug and alcohol rehabilitation centers, 12 Step recovery programs, or clinicians in private practice who offer recovery support groups that will include those addicted to the Internet. This outlet will be especially useful for the Internet addict who has turned to the Internet in order to overcome feelings of inadequacy and low self-esteem. Addiction recovery groups will address the maladaptive cognitions leading to such feelings and provide an opportunity to build real life relationships that will release their social inhibitions and need for Internet companionship. Lastly, these groups may help the Internet addict to find real life support to cope with difficult transitions during recovery akin to AA sponsors.
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