Journal of Technology in Counseling

Abstract
The use of the Internet continues to grow dramatically. With this increase in Internet use has come the potential problem of excessive Internet usage or "Internet addiction." Case studies already document serious consequences associated with excessive use of the Internet. It is important that counselors recognize the signs and symptoms of Internet addiction and whether Internet usage has negatively disrupted any major areas of the client's life. The purpose of this article is to present the characteristics, the consequences, and the emerging treatment approaches of Internet addiction.

Recent research has cited the potential problems associated with excessive use of the Internet (Brenner, 1997; Griffiths, 1997; Potera, 1998). This research was based upon reports that some Internet users were becoming addicted to the Internet in the same way that others can become addicted to alcohol, drugs, or gambling (Young, 1996, 1997a). "Internet addiction" has been questioned, if not ridiculed, in terms of whether or not it should be recognized as a valid mental health problem; it may simply be a symptom of other psychiatric disorders, e.g. depression, impulse-control disorder, obsessive-compulsive disorder. Also questioned is whether these problems are associated with the Internet as a whole or only certain applications (chat rooms, e-mail, online trading etc.) play a role in Internet abuse (Griffiths, 1995, 1996).

Internet usage has tripled in the last three years with continuing growth is expected. The Internet is becoming more easily accessible with schools, colleges, and public libraries all going online. Many employees now use the Internet as part of their workday. In addition, the cost of computers is becoming more affordable so the number of home computers is on the rise. With such ease of access, the Internet has become an integral part of our lives (Huang & Alessi, 1997). With these changes, it is anticipated that the number of those who excessively use the Internet will also continue to increase.
Whether Internet addiction is recognized as valid mental disorder or not, an emerging reality is that excessive use of the Internet has been shown to have serious consequences. The purpose of this article is to describe the characteristics of Internet addiction, discuss the consequences associated with it, and present emerging treatment approaches for excessive use of the Internet. Although the term "addiction" is not a clinical term, it will be used in this article to define excessive behavior, which leads to interpersonal, financial, and/or occupational problems.

Characteristics of Internet Addiction

Internet addiction has been compared to both chemical dependencies and process addictions (Brenner, 1997; Griffiths, 1997; Young, 1996, 1997a). Brenner found that the effects of Internet addiction, like substance dependence, included tolerance (being told they're spending too much time on the Internet), withdrawal (finding it hard to stop thinking about the net if they haven't logged on in a while), and craving (failing at attempts to spend less time on the Internet). Despite such similarities, mental health professionals are reluctant to label Internet excesses as an addiction. Usually, the term "addiction" is reserved for those with chemical dependencies (alcohol, cannabis, opiates, and amphetamines). Excessive use of the Internet more closely resembles process addictions like compulsive gambling, spending, sex, or work in which no actual substance is ingested (Brenner, 1998).

Most Internet users don't become addicted. Among people who gamble or drink alcohol, about 5 to 10 percent develop problem behaviors, and some believe these figures are similar for pathological Internet users (Potera, 1998, p. 2). "With an estimated 47 million people currently online, as many as two to five million could be addicted" (p. 2).

Although what constitutes Internet usage as excessive has not been delineated clearly, Young's (1997b) Internet survey found that addicts spent an average of 38.5 hours per week on the Internet (separate from work-related uses) as compared to non-addicts who spend an average of 4.7 hours weekly. In another study, Brenner (1997) found that the respondents of his Internet Usage Survey who spent 19 hours per week on the Internet experienced at least 10 signs of interference in role functioning (e.g. failures to manage time, cutting short on sleep, missing meals).

Typical Internet behaviors among excessive users included participating in chat rooms, checking e-mail, scanning messages on Usenet groups, and playing multi-user games (Young, 1997a). More recently, a new and increasingly worrisome behavior called "net compulsions" has entered the arena of Internet addiction. Net compulsions include compulsive online gambling, compulsive use of online sex or porn, online auction addiction, and obsessive online trading. These behaviors are very addictive because of the following (How to Deal With Net Compulsions, 1999):

1. Accessibility. With the accessibility of the Internet, individuals have immediate access to hundreds of virtual gaming sites, online trading sites that provide up-to-the-minutes stock reports, online sex and pornography sites, and online auction houses providing any item imaginable. With the time constraints and hassles of visiting casinos, calling brokers, or going to a shopping mall removed, the Internet provides people with immediate gratification to satisfy their every impulsive whim. Accessibility of the Internet allows users the privacy, secrecy and convenience to engage in compulsive sexual behaviors at home.
2. Control. Individuals now can exercise control than ever over their online activities. For example, without the help of a broker, people can research stocks themselves and decide when to buy stock, what stock to buy, and how to monitor their accounts. Brokers are no longer the gatekeepers to investing.
3. Excitement. Excitement represents the emotional "rush" or "high" associated with winning (How to Deal With Compulsions, 1999, p. 1). In gambling, "the excitement of winning money reinforces the individual to keep playing. In trading, people can watch the stock market to view profits made that day. At the auction house, the ability to conquer others as the highest bidder can be intoxicating as one beats out others in the last precious seconds to win the desire prize" (How to Deal With Compulsions, 1999, p. 1).

Many Internet abusers use the Internet for social contacts, sexual stimulation and mate hunting (Young, 1997a). Establishing relationships on the Internet is a safe way for users to feel close to others without really being close. These virtual relationships provide the illusion of intimacy without the responsibility and realities of a face-to-face relationship. Internet addicts may suffer from low self-esteem, feelings of inadequacy, or disapproval from others. Thus, the Internet becomes a way for the user to create a persona and interact with others in a safe, idealistic world.

Whether Internet addiction becomes considered a valid mental disorder may depend upon the severity of consequences experienced by those who abuse the Internet and whether these consequences effect the abuser's recreational, social or occupational functioning. The consequences experienced by stereotypically young, male users include getting into trouble at work or becoming socially isolated except for Internet friends (Brenner, 1997; Shotton, 1989, 1991).
A study by Young (1997a) found the majority of those dependent on the Internet were not young, male users; rather, they were middle-aged women, particularly housewives. For example, a circuit judge stripped a mother of the custody of her two children after the judge claimed that she was so addicted to the Internet that she neglected her children (Campbell, 1997). This was the first time that Internet addiction was used as a key factor in a custody battle. The wife, a 40 year old woman, initially received custody of her and her husband's two children, ages 7 and 8. After the divorce, the mother began spending most of her time isolated in her bedroom on the Internet, locked away from her children, and she reportedly neglected them. Thus, the judge ordered primary responsibility for the children to be turned over to her husband. In addition, a 24 year old woman whose three children, ages 2, 3, and 5 were removed from her home due to neglect ("Police Say Woman," 1997). Her compulsion to surf the Internet reportedly broke up her marriage and the same compulsion later led authorities to remove her children. The mother neglected her children by locking them in their playroom -- with broken glass, debris, and children's handprints in human feces on the walls -- so as not to be bothered while on the Internet. The mother was charged with three counts of child endangering.

These examples demonstrate how excessive use of the Internet can lead to severe consequences effecting the functioning of the abusers. Those who experience severe consequences may not be the stereotypical young, male Internet users. In these cases, the consequences extended beyond the abuser and to the family. Due to the phenomenal growth of Internet usage, it is likely that mental health counselors will encounter clients experiencing severe consequences from excessive use of the Internet. Regardless of whether Internet addiction becomes established as an addictive disorder or is identified as a symptom of other psychiatric disorders, 21st century counselors need to be familiar with the signs of Internet addiction and some of the emerging treatment strategies.
Implications for Counselors

It is important that counselors recognize the signs and symptoms of Internet addiction. This includes not only determining the amount of time spent on the Internet, but also whether Internet usage has negatively disrupted any major areas of the client's life (e.g. recreational, social, occupational, legal, financial, physical or mental). Young (1997a) developed an online survey on her web page which counselors may wish to access http://www.netaddiction.com/index.html

The following items have been compiled as guidelines for evaluating possible Internet addicts:

1. How many hours is the client spending online each week?
2. Is the client needing markedly increased amounts of time on Internet to achieve satisfaction?
3. Does the client stay online longer than he/she intended?
4. Has anyone told the client that he/she spends too much time on the Internet?
5. Does the client call in sick to work, skip classes, go to bed late or wake up early to use the Internet?
6. Does the client become restless or irritable when off-line?
7. Has the client given up recreational, social or occupational activities because of the Internet?
8. Does the client continue to use the Internet despite recurrent problems it creates in his or she real life (work, school, financial or family problems)?
9. Has the client made several unsuccessful attempts to cut down the amount of time he or she uses on the Internet?
10. Is computer usage as associated with work or academic needs versus optional Internet use (e.g. chat rooms, e-mail, surfing)?
11. Does the client abuse substances or engage in other compulsive behaviors?
12. Is there a family history of addictive behaviors or substance abuse?

Treatments for Internet addiction are beginning to emerge. The treatment approaches recommended are similar to those used for compulsive behaviors like pathological gambling or compulsive overeating (Potera, 1998). Traditionally, counselors who specialized in the treatment of addictions integrate individual, group (treatment and support), and family counseling with a heavy emphasis on abstinence. Abstinence is frequently included in the treatment plans for individuals suffering from alcoholism, drug addiction, and compulsive gambling. However, individuals experiencing process addictions like compulsive overeating or compulsive spending must learn moderation and not total abstinence. Internet addiction may fall into that category if the computer is used as part of the client's work or educational setting. In such cases, teaching clients how to set limits, balance activities, and schedule time without complete abstinence can be successful for some clients (Potera, 1998). For example, like a compulsive overeater who would set limits by committing to abstinence from particular triggering foods (sweets, butter, potato chips), an Internet addict may decide to abstain for visiting chat rooms.

Group counseling appears to be the predominant modality for treating addictions (Clark, Blanchard, & Hawks, 1992; Fisher & Harrison, 1997). The support, confrontation, and insight gained from other individuals experiencing similar cognitions and emotions facilitate therapeutic recovery. Millions of recovering addicts have experienced success from attending 12-step support groups (e. g. Alcoholics Anonymous, Narcotics Anonymous, Overeaters Anonymous, etc.). Internet addicts may experience similar success in attending a group designed specifically for individuals excessively using the Internet. A number of these support groups have already been established in the United States. Online support groups exist through the Internet (Suler, 1996; Young, 1997b) [click on www.rider.edu/users/suler/psycyber/supportgp.html]. These may be controversial because Internet addicts typically use chat rooms or other interactive applications when using the Internet. Thus, an online support group might perpetuate or trigger the addict's need for excessive Internet usage rather than its therapeutic purpose to help the addict stop their compulsive behavior.

Conclusion

Computer technology provides innumerable time-saving techniques, resources, improvement in work quality and the list continues. The Internet has become an integral part of that technology. Mental health professionals may argue about whether excessive use of the Internet qualifies as an addiction or mental disorder or even if it exists as a viable issue. One reality does exist: problems and consequences are occurring directly related to an individual's excessive use of the Internet. The consequences discussed in this article resulting from Internet addiction are real and have serious repercussions to the addict, to the family, and to society. As society moves deeper into cyberspace, it is tempting for the computer via the Internet to be the primary means of achieving connection and intimacy with others. The addictive qualities of the Internet offers potential addicts a new outlet for their compulsivity or dependency which in the past may have surfaced in other addictive behaviors or substance abuse.

Counselors need to become aware of the reality that excessive use of the Internet is a valid concern. They need to strive to understand the signs of Internet addiction as well as the most viable treatment alternatives. Future research should focus on further defining the phenomenon of Internet addiction in terms of relating it to genetic, biologic and psychosocial variables. In addition, research on prevalence rates, demographic information, and treatment modalities is needed. Support groups are already being developed specifically to treat the Internet addict. Research is needed to prove the effectiveness of these groups. In addition, further information is needed to determine if Internet addiction could stand alone as a mental disorder, like pathological gambling, or if it is simply a symptom of other psychiatric disorders.

References

Brenner, V. (1997). Parameters of Internet use, abuse and addiction: The first 90 days of the Internet usage survey. Psychological Reports, 80(3), 879(4).

Brenner, V. (1998, January). An initial report on the online assessment of Internet addiction: The first 30 days of the Internet usage survey. [Online]. Available: http://www.ccsnet.com/prep/pap/pap8b/638b012p.txt

Campbell, R. (1997, October 2). Mother addicted to Internet loses custody of her kids. The Orlando Sentinel, p. A1.

Clark, J., Blanchard, M., & Hawks, C. W. (1992). Group counseling for people with addictions. In D. Capuzzi & D. R. Gross (Eds.), Introduction to group counseling. (pp. 103-120). Denver, CO: Love.

Fisher, G. & Harrison, T. C. (1997). Substance abuse: Information for school counselors, social workers, therapists, and counselors. Boston: Allyn & Bacon. p. 287-312.

Griffiths, M. D. (1995). Technological addictions. Clinical Psychology Forum, 76, 14-19.

Griffiths, M. D. (1996). Behavioral addictions: An issue for everybody? Employee Counseling Today: The Journal of Workplace Learning, 8(3), 19-25.

Griffiths, M. D. (1997). Psychology of computer use: XLIII. Some comments on 'addictive use of the Internet' by Young. Psychological Reports, 80, 81-82.

How to deal with net compulsions (1999).[Online] Available: netaddiction.com/net_compulsions.htm

Huang, M. P. & Alessi, N. E. (1997). "Internet addiction, Internet psychotherapy": Reply. American Journal of Psychiatry, 154(6), 890.

Police say woman who neglected her children was Internet addict. (1997, June 16). The Associated Press.

Potera, C. (1998). Trapped in the web. Psychology Today, 31(2), 66-69.

Shotton, M. A. (1989). Computer addiction? A study of computer dependency. Basingstoke, UK: Taylor & Francis.

Shotton, M. A. (1991). The costs and benefits of `computer addiction'. Behavior & Information Technology, 10(3), 219-230.

Suler, J. (1996, May). Internet addiction support group. [Online]. Available:
http://www.rider.edu/users/suler/psycyber/supportgp.html

Young, K. S. (1996). Psychology of computer use: XL. Addictive use of the Internet: A case that breaks the stereotype. Psychological Reports, 79, 899-902.

Young, K. S. (1997a). Internet addiction: The emergence of a new clinical disorder. [Online]. Available http://netaddiction.com/index.html

Young, K. S. (1997b) Internet addiction support chat room. [Online]. Available: http://netaddiction.com/index.html