Treatment
Treatment is tricky, according to Orzack. "Like an eating disorder, you can't expect people to give it up completely," she says. "Tempting 'food' is all around at work, at school, and in their homes. You have to limit the time spent in front of a machine the way you limit the time spent at the table. Moderation is important, especially for the new generation of kids who begin to use computers in the first grade, or even before then."
One of the hardest things is to get people to come in and talk face- to-face with a therapist. They want to do it all on the Internet.
Orzack describes one man who spent all night on the Internet. He couldn't get up to go to work or keep appointments. She kept contacting him by Internet to remind him of his obligations until he finally came to see her.
Orzack and other therapists use the same treatment methods as they do with gambling, alcohol, or eating addictions. In one technique, known as cognitive-behavioral therapy, people are taught to monitor their thoughts and identify those that trigger addictive feelings and actions. At the same time, they learn new skills to cope with the addiction and ways to prevent, or handle, relapses.
In another technique, motivational interviewing, patient and therapist work together to set goals such as learning to recognize the difference between healthy and addictive computer use. "The efforts of patients are constantly reaffirmed, and they are not scolded for slips or failures," Orzack explains.
She uses a combination of both techniques, making "contracts" with people to specify how much time they will spend in front of a computer screen. As an example, she encourages them to set an alarm, or two alarms if needed, to signal when to turn to other activities. Orzack tries to get them to devote more time to other pursuits, such as exercising, talking with family and friends, and developing new recreational or social interests
The average treatment takes three months of regular sessions and telephone (not e-mail) checkups. But, Orzack acknowledges, some people require a year or more to deal with their bad habits.
"Nobody's ever cured," she says. "You just learn to deal with the problem."
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