As clinicians and therapists working in the area of problematic internet use, we often get asked similar questions by concerned families, counsellors, and the clients themselves. We have thus put together a ‘Q and A’ that we hope will be a useful starting starting point.

QJust how common are internet-related problems?

A:  The quick answer is: we don’t really know, at least exactly. Numerous population- based studies have been done in the USA, Europe and Asia, but such studies are complex, costly and have methodological problems. To date, no large-scale studies have been done in Australia. It appears that between 5 and 10% of those people surveyed would have a ‘problem’, with a smaller percentage (maybe 3%) having a serious, or pathological, difficulty. Exact figures depend on the specific questions asked by the researchers.

QWe read about the risks and dangers of the internet and computers regularly in the media and press. Are these problems on the rise?

A:  The relatively new, exciting world of IT has opened up many powerful, cross- national and seemingly endless ways to communicate, obtain information, and entertain. It does appear that, along with the undoubted benefits that the Internet has brought to millions, associated problems, particularly in the young, are increasing. We do not yet know how quickly the rate is growing, nor if problem incidence will ‘plateau’ at a certain point.

QA family member, or someone I know, may be developing a problem... how do I go about helping him/ her?

A:  Well, maybe this NiIRA website and resource could be a good starting point! There are also many other web-based advice and treatment facilities, most based in the USA, where you can also purchase books and pamphlets about the disorder. At NiIRA, we believe that the initial ‘site’ of treatment should be within the family unit, involving the client themselves. A quick and useful ‘assessment tool’ for parents, devised by NiIRA is the ‘IMPROVE’ process – please see the dedicated webpage for details. Failing this, one could involve the school counsellor (if problems are present in the school setting), a local clinical psychologist, or, if you are very concerned about broader mental health issues, a qualified psychiatrist. We have found that a common stumbling block to starting help is getting the person to accept that they have a problem.

QI know that addictive behaviours tend to increase in severity over time, if left unchecked. Can this be true of PIU?

A:  This is an important point that is not clearly answered by the science as yet. It does appear that, for a minority of people, problems associated with the internet can worsen and become more intense over time, but clearly not all frequent internet users go on to develop a major problem. In fact, we stress that for most people, the internet is a highly enjoyable, useful, and engaging tool. There are likely to be underlying ‘vulnerability factors’ in the person which could predispose to developing a problem. This is supported by our own clinical experience, and by international research.

QIt seems, then, that prevention is better than cure!

A:  Absolutely. At NiIRA, we believe that the best way to deal with his whole issue is to prevent it arising in the first place. Many other countries, notably South Korea, have recently commenced active and Government-sponsored ‘education and prevention’ programmes in schools. To our knowledge, these have not yet been proven to be cost-effective, but for the majority of mental as well as physical health problems, we know that prevention is far more efficient than treating or curing once a disease has fully developed. We also know that treating addictions (eg. smoking, gambling, hard drugs) results in high relapse rates, and patients are often reluctant to acknowledge their problems and then do not engage fully in treatment.

QSo, my family member or friend is willing to try to address his problem. What options are available?

A:  This depends on the particular characteristics of his condition, as well as its severity. Many different ‘treatment modalities’ have been described in the international literature, ranging from individual therapies, to family and group-based treatments. Most treatments take ideas and principles from other so-called ‘process addictions’ such as gambling and sexual addictions. Another key decision will be whether an intense, in- patient setting is required. Currently, no such dedicated unit exists in Australia, but some private hospitals are beginning to accept adult clients with internet-related problems. Specialist units for teenagers have been running in the USA and East Asia for some years.

QI have read that PIU is not even considered a proper mental illness, by psychiatric experts.

A: That is correct. The field of psychiatric classification is a complex and difficult one, and is often slow. Notably, the next (fifth) edition of the DSM classification system is due out next year, and internet use problems may be included in this manual. It is currently a controversial issue.

QI have often been concerned about the effect of constant computer and internet exposure, from a young age, on children’s developing minds and brains. Could real damage actually be occurring?

A: This is another key area that is being researched. Some scientists fear that early exposure to computers and internet technologies may have a lasting effect on the developing brain, such as by somehow making heavy users have attention-deficit-like problems, but again this is a controversial area.