Gaming and internet addiction really can be successfully treated in the long-term with cognitive behavioral therapy, new research suggests.

While browsing the internet and gaming can undoubtedly be fine and good, for some people it can become a problem. That’s why, in 2018, the World Health Organization officially added a new entry to the International Classification of Diseases: gaming addiction, characterized by gaming habits extreme enough to become a negative impact on daily activities.

At the time, researchers thought cognitive behavioral therapy (CBT) might be a useful tool to combat the condition – it’s a relatively straightforward and practical therapy, widely considered the gold standard in treating other obsessive conditions like obsessive-compulsive disorder, anxiety, eating disorders, and so on.

Now, a new study published in the journal JAMA Open Network offers the first evidence in support of that hypothesis.

“To our knowledge, this cluster randomized clinical trial is the first to investigate the long-term effects of a manualized prevention program,” the authors explain. “This intervention effectively reduced symptoms of gaming disorder or unspecified internet use disorder over 12 months, which is a clinically, scientifically, and politically important step in dealing with this newly recognized disorder.”

The study followed over 400 students, aged between 12 and 18, who were considered “at-risk” – meaning they showed “elevated symptoms of gaming disorder and unspecified internet use disorder.”

These students were split into two sets: a control group who received no treatment, and an intervention group who underwent a CBT course called PROTECT.

Like any CBT course, PROTECT works by addressing negative thought patterns – getting brains out of a rut, basically. Specifically, PROTECT aims to change how patients cope with boredom and anxiety, thought to be the harbingers of an internet or gaming addiction. The students in the intervention group met in small groups with two trained psychologists who led them over four 90-minute CBT sessions during school hours.

Follow-up interviews were collected over the following year – first after a month, then four months, and finally twelve. While the researchers reported that “both groups showed a significant symptom reduction over 12 months,” the effect was “significantly greater” in the intervention group – a result that “indicates that the intervention had an effect that was above and beyond spontaneous remission,” according to the study.

In other words: the therapy had successfully reduced the severity of the disorder.

These findings are “especially timely” given the past couple of years, according to Dr Evelyn Stewart, a Psychiatry Professor at the University of British Columbia and founding director of the Pediatric Obsessive-Compulsive Disorder Clinic and Research Program at BC Children and Women’s Health Centre. In an editorial accompanying the study, Stewart – who was not involved in the study – pointed out the “myriad adverse effects of COVID-19 among adolescents” that may have contributed to an uptick in screen time for young people.

Today’s teens have had to cope with “a shift to online rather than in-person schooling; cancellation of sporting and other extracurricular activities; and increased family stress, parental demands, social isolation, and unstructured or unsupervised time,” Stewart wrote, which many have reacted to by seeking solace in gaming and online communities. As we know, that’s not necessarily a bad thing, but “unlike other pandemic-driven activities, such as gardening and bread-making among adults, internet use and gaming behaviors among youth have addictive qualities that could magnify long-term risk,” she explained.

The researchers are aware that their study has a few limitations: it’s only one study, with fewer participants than ideal, so it’s unclear how generalizable the results will be. On top of that, the very nature of gaming and internet use disorder means that people with these conditions often aren’t very good at engaging with self-help therapies, and most of the students who could have participated actually didn’t.

Nevertheless, the researchers think they’ve made an important first step in the treatment of a problem that’s never been more relevant.

“The excessive use of video games and internet applications has been growing (particularly during the ongoing COVID-19 pandemic) which underlines the need for prevention and early intervention.” the authors write.

“Knowledge gained from this trial could be used in follow-up studies with larger samples and high-risk participants to confirm the reduction in incidence rates.”