The effects of cognitive-behavioral group therapy for reducing symptoms of internet addiction disorder and promoting quality of life and mental health

Alavi, Seyyed Salman; Ghanizadeh, Maryam; Mohammadi, Mohammad Reza; Jannatifard, Fereshteh; Esmaili Alamuti, Sudeh; Farahani, Malihe

doi:10.47626/2237-6089-2020-0010

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Original Article • Trends Psychiatry Psychother. 43 (1) • Jan-Mar 2021 • https://doi.org/10.47626/2237-6089-2020-0010 copy

The effects of cognitive-behavioral group therapy for reducing symptoms of internet addiction disorder and promoting quality of life and mental health

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

Internet addiction disorder has reportedly become an important cause of health and social problems. The aim of this study was to investigate the effectiveness of cognitive-behavioral group therapy for internet addiction symptoms, quality of life, and mental health of students with internet addiction.

Methods

This was a quasi-experimental study with pretest-posttest measures and a control group. The statistical population of the study consisted of all students at Tehran universities in the academic year of 2018-19. The target group was selected through an internet addiction test and a clinical interview using a targeted sampling method and was divided into experimental and control groups by randomization. The experimental group participated in fifteen 90-minute cognitive-behavioral group therapy sessions. Before, immediately after, and 3 months after the treatment, the internet addiction symptoms of both groups were evaluated to assess mental health with the IAT, quality of life (QOL), and SCL-90-R questionnaires. Data were analyzed with ANCOVA analysis using SPSS Statistics 20 software.

Results

After treatment, cognitive-behavioral therapy groups showed reductions in internet addiction scores (p < 0.05). Results showed that the cognitive-behavioral group therapy was effective for improving quality of life (p < 0.05) and mental illnesses (p < 0.05) in students with internet addiction.

Conclusions

Cognitive-behavioral group therapy can enhance awareness and mental health of students with internet addiction. Therefore, this intervention can be used as a beneficial treatment to reduce internet addiction symptoms and improve the condition of people with behavioral addictions such as internet dependency.

Cognitive-behavioral therapy; internet addiction; quality of life; group therapy; psychopathology

Sessions	Session titles	Goal(s)	Techniques	Practices
First session	Greeting and Introducing the Cognitive-behavioral Model	Description of the vicious cycle of thoughts, feelings and behaviors
Second session	Cognitive model and its relation to “Internet Addiction”	Introducing stimulants or factors that lead a person to excessive use of Internet	Self-directed self-knowledge	The ways to promote self-awareness or self-knowledge The therapist will formulate a plan to achieve specific goals.
Craving and its coping methods
Third session	Behavioral techniques to cope with craving	Changing patterns of behavior	Self-control	Doing practices such as Delayed Self-punishment
Fourth session	Cognitive techniques to cope with craving	Changing the way clients feel Changing patterns of thinking	Control of spontaneous thoughts Distinguishing healthy from unhealthy feelings	Distraction Identifying high-risk situations for excessive internet use Developing strategies for coping with and avoiding high-risk situations and the desire to use Conflict resolution skills Stopping thoughts Positive thought replacement
Fifth session	Treatment of depression and anxiety	Education about depression, anxiety and helping the client understand their symptoms as part of an illness	Identifying and engaging in enjoyable activities such as hobbies, social activities and exercise Exposure therapy	Helping clients to establish enjoyable activities in daily affairs Awareness of mood and challenging negative thoughts Doing pleasurable activities Learning to manage powerful emotions like anger, fear, or sadness
Sixth session	Relaxation training	Tension reduction	Techniques such as deep breathing, coping self-talk such as “I’ve done this before, just take deep breaths,” and distraction	Stress reduction techniques Deep breathing exercises Muscle relaxation Positive mental imagery
Seventh session	Training Activation and Planning	Cognitive restructuring or reframing	Activity scheduling and behavior activation	Replacement training Techniques for overcoming laziness
Eighth session	Lifestyle techniques	Improving lifestyle skills	Overcoming poor physical, psychological, and social skills	Attention to physical health Changing diet Doing exercise Controlling weight Avoiding drugs and cigarettes Expanding social relationships
Ninth & tenth sessions	Training Methods for Logical Analysis of Thoughts (two sessions)	Analysis of doubt and hesitation	Recording daily thoughts, emotions and behaviors	Understanding oneself, one’s world, and other people, Mindfulness
Eleventh session	Training problem-solving skills	Learning how to solve problems	Engaging in more social activities	Definition of the problem Generation of alternative solutions Evaluating and selecting an alternative solution Implementing and following-up on the solution
Twelfth session	Cognitive errors and their types	Description of cognitive errors	Methods of dealing with cognitive errors	Description of 12 cognitive errors
Thirteenth session	Methods to cope with cognitive errors	Description of distorted cognitions	Cognitive restructure	Identifying and modifying the thought process Focus on challenging unrealistic thinking.
Fourteenth session	Prevention of relapse	Managing symptoms or preventing internet addiction relapses	Helping the client to maintain and continue to quit or avoid excessive use of the internet	Training the necessary guides to deal with internet addiction
Fifteenth session	An overview of techniques presented at previous sessions, questions and answers		Review of techniques

Sociodemographic variables	Experimental group	Control group
Gender
Male	14 (77.8)	17 (73.9)
Female	4 (22)	6 (26.1)
Age (mean ± SD)	21.7±4.2	21.04±3.7
Age (range)	18-28 years	18-27 years
Marital status
Single	15 (83.3)	17 (73.9)
Married	3 (16.7)	6 (26.1)
Housing situation
With parents	4 (22.2)	8 (34.8)
Dormitory	14 (77.8)	15 (65.2)
Education
Freshman or sophomore	13 (72.2)	14 (60.9)
Bachelor	2 (11.1)	3 (13)
MSc or higher	3 (16.4)	6 (26)

	Experimental	Control
Variables
Internet Addiction Symptoms
b*	62.22±15,1	53.47±6.02
a**	40.1±10.9	49.3±8.6
f***	36.2±6.6	46.2±5.4
Total Score Quality of Life
b	83.2±9.3	92.08±11.8
a	98.8±9.24	86.4±10.1
f	102.1±8.8	85.1±9.7
Total SCL-90-R score
b	117.8±30.1	118.17±76.98
a	79.1±30.1	96.3±84.1
f	55.2±21.2	85.2±77.5

Variable/stage	Sum of squares	df	Mean squares	F	p value	Power
Internet addiction
Pretest score	314.11	1	314.11	3.5	0.68	0.44
Grouping	1157.34	1	1157.34	13.01	0.001	0.94
Error	3380.01	38	88.94
Total	88584	41
Quality of life
Pretest score	0.64	1	0.64	0.07	0.93	0.51
Grouping	1351.1	1	1351.1	13.88	0.001	0.95
Error	3698.86	38	97.33
Total	351727	41
Mental health
Pretest score	69128.13	1	69128.13	3.4	0.71	0.44
Grouping	79473.5	1	79473.5	32.5	0001	1.00
Error	87973	38	2443.69
Total	379596	41

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[1] Correspondence: Seyyed Salman Alavi Psychiatry and Psychology Research Center, Roozbeh Hospital Tehran University of Medical Sciences South Karegar Street 1333795914 - Tehran - Iran E-mail:ss-alavi@farabi.tums.ac.ir