0. 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

1. 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

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

3. 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.

4. 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.

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

6. 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.

7. 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.

8. 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.

9. 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).

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Social isolation/withdrawn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

11. 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.

12. 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!

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

14. 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.

15. Activity
Gaming Continuum Exercise

16. Activity
Case Studies

17. Questions/Comments

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