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Article 84

Solution Focused Social Interest

A Targeted Approach to Treating Internet Addiction

Charles R. Crews, Janet G. Froeschle, and Jiaqi Li

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Paper based on a program presented at the 2011 American Counseling Association Conference, New Orleans, LA.

An escalating trend in counseling clinics, universities, K-12 schools, families, couples, military mental health and addiction centers is the problem of overuse, addiction, and compulsion to social media, video games, smart phones, tablets, and computers. Recently, a move towards mobile technologies has increased the use of technology by all demographics of the United States (Young & de Abreu, 2011). There is a common belief among mental health providers that addictions to these types of technologies be treated as one might treat substance abuse or gambling (Griffiths & Meredith, 2009; King, Delfabbro, & Griffiths, 2010b; Young & de Abreu, 2011). These traditional treatments may not be sufficient to address the comprehensive nature of Internet addiction. As a result, specific programs targeted toward Internet and technological addictions are needed.

Counselors who use a combination of solution focused group counseling techniques combined with existential theology, stress management techniques, and Adlerian social interest can curtail Internet addiction, improve relationships, and consequently, emotional health. The Solution Focused Social Interest Program offers positive social interactions through group sessions and community involvement for those overusing the Internet. Those addicted to the Internet learn healthy, productive ways to find meaning and connectedness in life as a result of this program. A definition and history of Internet addiction, profiles of those who overuse technology, consequences of Internet addiction, and theology/rationale precede a description of The Solution Focused Social Interest Program.

Definition and History

Internet addiction was first mentioned in an article published in 1989 by Margaret Shotton. The article was written in response to a public perception that many in society were becoming dependent on computers and attempting to escape life difficulties via technology (King, Delfabbro, & Griffiths, 2010a). O’Neill (1995) expanded on Shotton’s work in the article entitled, “The Lure and Addiction of Life Online,” published in the New York Times. O’Neill compared overuse of the Internet with gambling and other impulsive behaviors. Young (1998) became one of the first to state that Internet overuse could be an addiction. Since that time, the issue as to whether the phenomenon is an addiction, an impulse, or simply a means for escaping reality and enhancing social connectedness is debated (Griffiths, 2008; Griffiths, 2010; Kim, Namkoong, Ku, & Kim, 2008; King, Delfabbro, & Griffiths, 2010a). Despite the debated acceptance of the term “addiction” for those dependent on the Internet, many in the mental health profession endorse the terminology and offer definitions to explain the issue (Griffiths, 2010; Kim, Namkoong, Ku, & Kim, 2008; King, Delfabbro, & Griffiths, 2010b).

Internet addiction has been defined as an impulse control disorder not involving an intoxicant (Young, 1998). Many Internet addicts have been characterized as staying online to attain pleasure for over 38 hours per week. These individuals spend this time in chat rooms; viewing cyber porn; gambling, trading, or purchasing items online; surfing the web or searching databases compulsively; and/or playing or programming video games (Young, 1998). Those who overuse technology exhibit symptoms such as restlessness, moodiness, depression, irritability, loss of relationships, concealing the amount of time spent online, hopelessness, and guilt (Chak & Leung, 2004).

Profile

According to the Entertainment Software Association (2011), 72% of American households play computer or video games and the average age of a game player is 37. Nonetheless, various groups are touted as having particular issues with Internet overuse. For example, college aged students are particularly vulnerable given the flexibility of their schedules and opportunity for Internet access (Chak & Leung, 2004). Nonetheless, all ages, educational levels, as well as both genders, can be affected (Chak & Leung, 2004). Further, differences arise between the aforementioned groups when comparing technological activity. For example, well educated individuals spend time searching databases while those with lower educational levels more often play online games (Chak & Leung, 2004). In addition, females are more likely to use chat rooms and sites used for communication while males more frequently participate in online gaming (Chak & Leung, 2004).

Behaviors associated with those who overuse the Internet can be found in the literature. For example, Chak and Leung (2004) state that Internet addicts are more likely to be shy, believe chance shapes life outcomes, and feel others are irresistible. These researchers describe the Internet addict as someone who spends a great deal of time online in intense sessions. Wan and Chiou (2007) revealed that Internet addicts display higher intrinsic than extrinsic motivation. Young (1998) states that Internet addicts gradually spend less time with live human beings as they immerse themselves in technology and experience a variety of consequences including relationship and career difficulties.

Consequences

Growing concern exists regarding the negative consequences of Internet addiction (Baer, Bogusz, & Green, 2011; Liu & Peng, 2009; Tsai & Lin, 2001, 2003; Young, 1998). According to Liu and Peng (2009), negative consequences of Internet addiction can be classified into three general types: physical problems (i.e., fatigue, physical pain, reducing sleep time, skipping meals); personal life problems (i.e., conflicts with friends or family, low social engagement, decreased time management skills); and professional/academic programs (i.e., missing work or school, deteriorated performance). More importantly, poor mental health and depression were found to be associated with Internet addiction in adolescents (Young & Rodgers, 1998; Yang, 2001). In a recent study, additional mental health consequences for those addicted to the Internet have been suggested, including: anxiety, obsessive compulsive disorder, or attention-deficit disorder (Address hidden problem of Internet, 2010). Likewise, in their study of 175 adolescents, ranging in age from 13–17, Mitchell, Finkelhor, and Becker-Blease (2007) found that 79% of those overusing the Internet were characterized by significantly higher rates of online sexual exploitation, victimization, unwanted exposure to pornography, and risky or inappropriate behavior.

Additional concerns related to Internet addiction are directly linked with social issues. Dowell, Burgess, and Cavanaugh (2009) suggested that participation in one at-risk behavior increased chances the individual would participate in additional health risk behaviors (e.g., tobacco use correlates with alcohol consumption). Further, Ko, Yen, Yen, Lin, & Yang (2007) stated that Internet addiction leads to more serious problems such as lying, kleptomania, lessened concentration, lower school grades, poor school attendance, dropping out of school, running away from home, and other family crises. According to the Kaiser report (Rideout, Foehr, & Roberts, 2010), 84% of those between the ages of 8 and 18 in the United States had Internet access in their homes and as Internet use increased, so did the probability that one might become addicted to the Internet (Rideout, Foehr, & Roberts, 2010). As a result, targeted and theoretically based counseling interventions are needed to address Internet overuse and addiction. Following is a description of the theoretical basis and rationale for such a program.

Theoretical Background

Several theoretical principles are imbedded within the Solution Focused Social Interest Program as detailed in the following section. For example, tenets of solution focused, Adlerian social interest, stress management, and existential tenets are found imbedded within the program. Solution-focused techniques are based on de Shazer’s (1988) theoretical counseling model. The theory is based on exploring previous successes that enable individuals to see change as a possibility (via exception techniques); amplifying and building upon existing strengths (via complimenting techniques); and rating personal improvements (via scaling techniques). Individuals then choose to focus on positive events rather than on problems and utilize personalized techniques based on past successes (De Jong & Berg, 2002; de Shazer, 1988).

Alfred Adler’s (1964) social interest may be an important component in programs targeted toward treating internet overuse and addiction. Alfred Adler (1964) believed individuals have the ability to live cooperatively as social beings, develop social interest, and contribute to the good of society. According to Adler, social interest was a measure of mental health and therefore, giving back to society could improve one’s well being. Further, Adler contended that social interest instilled meaning in life and added fulfillment where none existed. Thus, social interest might help those who overuse the Internet by facilitating friendships and face-to-face networking. Existential theorists agreed with Adler that human beings have an existential nature that questions the meaning of their own existence and that relationships are crucial for mental health. Two ways of being (as described in existential theory) are imbedded in the nature of Internet addiction: the Mitwelt and the Umwelt. The Mitwelt is a mutual awareness between both individuals in a relationship whereas the Umwelt depicts seeing others as instruments for self satisfaction rather than as unique human beings. Creating loving relationships as part of the Mitwelt helps the individual manage existential isolation (the feeling of being totally alone). In other words, in order to have a healthy relationship and consequently, better mental health, these relationships must be participated in such that a full experience of the other person is obtained (Sharf, 2011). Because the Internet offers a false sense of belonging (rather than the aforementioned full relationship experience), effective programs must replace Internet relationships with true relationships.

Real world relationships carry risk of rejection and anxiety whereas Internet relationships have few social risks. As a result, the Internet may be used to avoid both normal and existential anxiety. Managing this anxiety is crucial if the Internet addict is to successfully minimize or eliminate online contacts and/or overuse. As a result, Benson and Klipper’s (1975) Relaxation Response is incorporated in the program to help Internet addicts manage the normal anxiety of forming realistic relationships.

Benson’s and Klipper’s (1975) Relaxation Response involves attaining a state of deep relaxation that changes both emotional and physical responses to stress. Participants begin releasing tension by breathing deeply and relaxing muscles throughout the body. Froeschle and Crews (2010b) contend that results can be attained in few sessions and effects after a session may last throughout the day. Benefits include both improved physical and emotional health (Benson, 1982; Benson & Goodale, 1981; Froeschle & Crews, 2010a; Froeschle & Crews, 2010b; Goodale, Domar, & Benson, 1990; Hoffman et al., 1982). As such, Internet addicts are more likely to alleviate anxiety associated with the formation and maintenance of real world relationships.

Assisting those who overuse technology requires theoretically based interventions rather than relying on traditional substance abuse treatment models alone. New programs must be targeted such that they treat issues specific to Internet overuse and addiction. One such program, the Solution Focused Social Interest Program, will be described as follows.

The Intervention

The following program closes the gap between traditional substance and process addiction treatment with a new method for treatment of overuse, addiction, and compulsion to social media, video games, and other current technologies. Program techniques include: stress management; exceptions, compliments, and scaling found in solution focused brief therapy; Adlerian social interest, and existential theories. Each step in the process is described as follows to aid implementation.

Program Description

First, counselors meet with clients individually to obtain consent, intake information, and screen clients to ascertain the appropriateness of group participation. Those needing additional assistance are referred for individual counseling. Next, groups of 7-8 participants are assigned a day and time to meet for a minimum of eight hour long weekly meetings.

Week 1. The first session begins by having participants introduce themselves to the group. As participants introduce themselves, the counselor compliments each person. For example, the first person might say, “My name is X (participant’s name) and I joined this group because my family thinks I spend too much time online.” The counselor would respond by saying, “You have much courage in joining this group and must be a great husband/father for caring so much about your family as illustrated by showing up today.” Complimenting continues as each person introduces themselves. In this way, rapport and a feeling of belonging is created between group members and the counselor.

Next, group members are paired and asked to discuss consequences they are facing due to time spent online. Each person lists things they have overlooked or ignored as a result of Internet use. Young refers to this as a “personal inventory” (Young, 1999).

After approximately 20 minutes, dyads are asked to join the large group again. At this point, each person in the group is asked to fill in the blank on the following statement. “I learned             (participant fills in the blank) during this exercise.” Each person responds and the counselor continues complimenting each group member.

Week 2. The second session begins by having participants describe what is going better this week. As each person responds, the counselor compliments each person and follows up with an exception question. For example, the first person might say, “This week I thought about the consequences of using the Internet so often. I didn’t reduce my time spent online but I was more conscious of the fact that I am hurting myself and my family.” The counselor would respond by saying, “You were able to focus on the consequences of using the Internet so often. This shows your desire to make changes and your ability to recognize the need for change. This is a good first step” (complimenting to show personal strengths). Next, the counselor says, “Tell me about a time when you were able to walk away from the Internet and do something with your family or for work” (exception question). After each response, the counselor asks, “What was different at that time?” The counselor restates what each person says making sure to point out things the person did that influenced better behavior.

Next, dyads and/or triads are formed from within the large group. Each group discusses the following question, “What activities might you enjoy in the community that would help others?” Triads discuss and assist one another with ideas. After approximately 20 minutes, responses are shared within the large group. The counselor asks each group member to decide on a community service (social interest) activity and report the idea to the group the following week.

Week 3. The third session focuses on helping clients commit to a social interest activity and make personal goals to stop or reduce Internet use. Group members are asked to describe things that have improved since the following week. Once again, the counselor uses complimenting and exception questions to help clients realize personal contributions to better behaviors. For example, each person is asked to describe one thing that worked over the past week in curtailing or eliminating Internet use. Participants are asked to rate their progress on a scale from 1-10 with the number “one” meaning little progress in lowering Internet use and “ten” meaning perfect progress. The counselor says, “Using a scale from one to ten, rate your progress with “one” meaning very little progress and “ten” meaning outstanding progress.” When clients respond, the counselor compliments the person for making an effort and then asks, “What would it take to move up one number in your progress over the next week?” A group discussion and weekly goal setting ensues.

Next, each person describes a social interest activity in which they would like to participate. The counselor asks each person to detail steps they must take to start this activity and asks for a commitment to start this activity before the next session.

Week 4. During session four, focus is placed on understanding meaning in one’s life through social interest or other activities beyond Internet use. Further, additional goals for curtailing Internet use will be established. For example, (when asked an exception question) a client might state they used to be more cognizant of time before abusing the Internet. This client might be asked to set an alarm at certain times indicating a stopping point for Internet use. Next, clients describe their experiences regarding social interest activities. The counselor compliments perseverance in completing this project. In addition, clients are asked the following question, “How did this experience help you find meaning in your own life?” The group discusses the responses. Clients are asked to bring a pillow and blanket to the fifth session.

Week 5. Session five introduces clients to stress management techniques and continues goal setting and discussions of social interest benefits. This session begins as the counselor asks clients to state what is going well in social interest activities, Internet use, or completion of targeted goals. Once again, clients are complimented to point out personal strengths that enable success, and exception questions are used to help target strategies.

Next, stress management techniques are introduced. Clients are told that stress and anxiety can be reasons people use the Internet. For example, the counselor says, “People may use technology to escape risks of forming connections in the real world. The anxiety felt when establishing real relationships can be reduced by learning stress management techniques.” After this rationale is explained the program is conducted for approximately 30 minutes as follows.

Each person is asked to find a comfortable place on the floor or to stretch out in a chair. Once everyone is settled and comfortable, the lights in the room are extinguished. The counselor begins by saying, “I want you to take a deep breath in through your nose and out through your mouth. As you exhale, say to yourself, I am relaxed.” The counselor then audibly breathes in, says, “I am relaxed,” and exhales (to model for clients). Next, the counselor says, “Your head feels very heavy. Picture all the tension in your head dripping out of your body. As the tension drips off your head, it becomes very heavy. You couldn’t lift your head if you wanted to. You are becoming as relaxed as you wish to be.” Next, the counselor says, “Take another deep breath in through your nose and out through your mouth. Say to yourself, I am relaxed, as you exhale.” Once again the counselor models these behaviors audibly for clients to follow. The counselor continues by helping clients relax each part of the body from head to toe. Once the head is relaxed, the counselor moves to the shoulders, back, waist, and continues to the toes. Between each comment about relaxation, clients are asked to breathe and state, “I am relaxed.

Once a state of relaxation is reached, the counselor reverses the technique by counting backwards slowly from ten to one. For example, the counselor says, “I am going to count backwards from ten to one. As I count down, you will become more aware of your surroundings. Ten, you are aware you are in this room. Nine, you begin to feel your limbs. Eight, you are aware of those around you.” This continues until the count of “one” whereby clients are asked to open their eyes slowly and sit up when ready. After a couple of minutes, the counselor turns on the lights.

Next, clients are asked to process this experience. They are asked, “What was this experience like for you? How might this help you with social interactions? How might this help curtail Internet use?” Each person is given an opportunity to comment. The counselor ends by asking clients to try this mentally at home when feasible.

Additional Weekly Sessions. Additional sessions are an extension of the fifth session. Each week, clients describe what is better, are asked exception questions to ascertain weekly or permanent strategies and goals. Relaxation techniques are utilized until clients feel comfortable initiating the techniques at home. Finally, social interest activities are discussed. Sessions continue for up to eight weeks or until clients no longer need assistance and termination occurs.

Conclusion

Social media use is increasing, the video game industry has surpassed all other entertainment technologies in revenue, and computers, tablets, or smart phones are in over 90% of American households (Young & de Abreu, 2011). Professional counselors are in optimal positions to assist those clients overusing or addicted to the Internet. The Solution Focused Social Interest Program targets specific client needs via solution focused brief therapy, Adlerian social interest, stress management techniques, and existential premises rather than relying only on traditional addiction treatments. Utilization of the aforementioned program can help clients curtail Internet addiction and/or overuse and, therefore, manage the accompanying mental, physical, academic, and family consequences.