Problematic Internet Use: What does it look like and how do we deal with it? Addictions and Mental Health Ontario Conference, 2015 Lisa Pont, MSW, RSW

Objectives Describe services for Problem Gambling, gaming and Internet Use at CAMH Define Problematic Internet Use (PIU) Explain risks factors, benefits and impacts of PIU/gaming Discuss tips for Parents Identify treatment approaches

Problem Gambling Institute of Ontario at CAMH Clinical Services Education and Community Resources Policy Research

Terminology Shawn mentioned IGD and PIU is different. Research literature often encompasses both and the terms can be used interchangeably along with Internet Addiction, Video Game Addiction and more. For the purposes of this presentation, the term PIU is used to describe gamers and those browsing, reading and social networking online.

Bio-Psycho-Social Plus Model When looking at risk factors and thinking about prevention, assessment and tx, it is important to consider the BPS model.

Risk Factors ADHD Anxiety Depression Autism Spectrum Disorder Other excessive behaviours or addictions Low self-esteem Social difficulties Above average intelligence/other learning exceptionalities

Benefits Fun Like to feel in control Releases tension Relieves boredom Develop gaming skills Feel a sense of mastery Escape/Fantasy Relate back to risk factors/vulnerabilities.

What Makes Video Gaming Addictive? Achievement Cyber socializing Games are infinite In game currency The brain gets hijacked (intermittent rewards) Virtual world continues when person is offline Relate back to those that are particularly vulnerable.

Gaming Continuum No use Normal use At Risk/Serious use Harmful/Problem use Continuum of involvement, bi-directional, borrowed from substance use field, reflected in DSM 5 gambling disorder mild, moderate, severe. Will need to know this for activity. Can weave in terms like casual social, serious social, pathological to describe spaces along the continuum.

Signs/Consequences Spends long hours on computer School difficulties Skips chores/responsibilities Spends a lot more money on games Conflict with parents Mention that those with risk factors are more likely to suffer with negative consequences (exacerbate current problems as well as relieve them in the short term).

Signs/Consequences con’t Social isolation/withdrawn Few other activities and interests Appears down/anxious/irritable Sleep difficulties

Tips for Parents Connect Communicate Empathize and validate Set limits Pick your battles Monitor computer use Establish consequences Maintain consistency Discuss Importance of Involving Families. Often times barriers to limit setting and implementing consequences need to be addressed with families in order to facilitate change.

Tips for Parents Brief (30 seconds) One item at a time Choose the right time and place I messages Present focused More positive than negative *Self-care!

Treatment Landscape: PGTS, youth mental health organizations, private, in transition. Get help for related issues.

Treatment Approaches Cognitive Behaviour Therapy (CBT) Solution Focused Narrative Strengths Based Family involvement Comprehensive (bio-psycho-social) Psychiatric referral/psychometric testing, social skills, building leisure and support.

Activity Gaming Continuum Exercise

Activity Case Studies

Questions/Comments

Shawn.Rumble@hdgh.org Lisa.Pont@camh.ca