Background and aims
Clinicians and researchers are increasingly interested in investigating excessive use of video gaming recently named Internet gaming disorder (IGD). As is the case with extensively researched adolescent problem behaviors such as substance use disorder, several studies associate IGD with the young person’s family environment and the parent–adolescent relationship in particular. Evidence-based treatments for a range of adolescent clinical problems including behavioral addictions demonstrate efficacy, the capacity for transdiagnostic adaptation, and lasting impact. However, less attention has been paid to developing and testing science-based interventions for IGD, and at present most tested interventions for IGD have been individual treatments (cognitive behavioral therapy).
Methods
This article presents the rationale for a systemic conceptualization of IGD and a therapeutic approach that targets multiple units or subsystems. The IGD treatment program is based on the science-supported multidimensional family therapy approach (MDFT). Following treatment development work, the MDFT approach has been adapted for IGD.
Results
The article discusses recurring individual and family-based clinical themes and therapeutic responses in the MDFT-IGD clinical model, which tailors interventions for individuals and subsystems within the young person’s family.
Discussion and conclusions
Basic science developmental research can inform conceptualization of IGD and a systemic logic model of intervention and change. This paper aims to expand treatment theorizing and intervention approaches for practitioners working with frequently life-altering behaviors of excessive Internet gaming. We operationalize this aim by addressing the question of why and how parents should be involved in youth IGD treatment.
Disconnection and disengagement are frequent characteristics of interactions between parents and adolescents who present with substance use disorders. Excessive blame, defensiveness, and recrimination characterize day-to-day interactions within these families. Developmental psychopathology research reveals both short-and long-term effects of negative emotional patterns between parents and adolescents on the young person's development, as well as on the parents' functioning and their parenting practices in particular. Persistent expression and experience of negative emotions are also associated with poor treatment outcome, as they act as barriers to treatment engagement and change. This article demonstrates how research-based knowledge can guide therapeutic strategy and how emotions can be transformed in an empirically supported, family-based treatment: multidimensional family therapy. Transcripts with commentary from an adolescent, a parent, and from family therapy sessions illustrate emotion-related interactional transactions and interventions.
La clinique actuelle nous confronte régulièrement à des jeunes adultes désorientés, échouant dans leurs études, ne parvenant pas à nouer des relations durables et à se projeter dans l’avenir. Certains paraissent emprisonnés dans une relation ambivalente de dépendance et de frustration vis-à-vis de leurs parents. Des études récentes indiquent que dans la relation d’attachement à l’enfant, le rôle du père, loin d’être celui d’un simple tiers séparateur, est considérable dans l’aide au développement des capacités d’exploration et d’adaptation sociale. Après avoir passé en revue le champ théorique de l’attachement père-enfant ainsi que la relation d’activation, nous illustrerons nos propos de deux vignettes cliniques issues de séances en thérapie familiale. Nous verrons comment et dans quelles situations il peut être pertinent de se focaliser sur la dyade Père – Enfant dans la clinique du jeune adulte déprimé dans une perspective de restauration et d’activation des liens d’attachement.
Que savons-nous sur les émotions ? Que savons-nous de la régulation émotionnelle ? Quelles sont les modèles à notre disposition ? De quelle manière ces modèles contribuent ils à l’expérience clinique du psychothérapeute dans son travail avec l’adolescent ? Fort des résultats de la recherche et des propositions des approches psychothérapeutiques récentes, nous soumettons un certain nombre de propositions techniques et pratiques sur le travail émotionnel dans la psychothérapie de l’adolescent. Deux courtes vignettes cliniques illustrent ces propositions.
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