CHAT, GAME, PORN, SURF AND NOW “SLEEP!”
Exploring the Efficacy of Hypnosis-based Interventions for Internet Addiction Disorders
According to the Office of National Statistics (UK) in the first quarter of 2017, 89% of adults in the UK had recently used the internet, with 99% of adults between the ages of 16 to 34 being recent internet users (Internet users in the UK, 2017). With the increasing accessibility, affordability and anonymity that the internet affords an individual when surfing, gaming or networking on social media platforms. Problematic use of the internet is being reported by mental health professionals, with individuals reporting their lives have become unmanageable because of their internet use (Young, 2007).
This problematic internet use, referred to as Internet Addiction (IA) is the behavioural addiction involving the excessive use of online applications that impact the lives of the affected individual (Kuss, Griffiths, Karila & Billieux, 2014). Griffiths (2005) argues that this form of behavioural addiction is no different from other accepted forms of addiction such as alcohol and heroine, and suggests six behavioural components to internet addiction; Salience, Mood modification, Tolerance, Withdrawal symptoms, Conflict, and Relapse.
With the prevalence rates in adolescence reported to be between 0.8% and 18% (Kuss & Griffiths, 2015) for example, Internet gaming addiction, it may be understandable why it is inevitable that around the world, mental health professions and other specialists who provide psychological treatments are reporting seeing clients who report behaviours consistent with Internet addiction (Young, 2007).
The effectiveness of psychological treatments for IA has been reported in numerous studies and articles (Kuss & Lopez-Fernandez, 2016; Zajac, Ginley, Chang & Petrey, 2017). Amongst the most popular and considered the most effective is that of Cognitive Behavioural Therapy (CBT) with an increasing acceptance that CBT should be considered the psychological therapy for IA (Young, 2007; Young, 2013).
CBT teaches the client to be cognitively aware of their thoughts and the relationship to their associated emotions, which compels the client to behaviour in the undesirable way (Young, 2007). It has been shown that this cognitive process can be effective for many individuals, but critics have raised a number of limitations of the approach. Pointing out that CBT may be less effective with over-intellectualising and less assertive clients, or with clients that may feel over-powered by the intellectual demands placed upon them by the therapist (Kottler and Shepard, 2007); and the CBT approach may take longer, requiring more sessions than other approaches (Roes, 2011). A review of clinical research surrounding IA conducted by Kuss and Lopez-Fernandez (2016) identified that typically a CBT programme for IA would last a duration of a few months ranging from 8 to 28 sessions, lasting between one to two hours. Placing a high financial burden on both the client or healthcare provider, and increasing the complication of managing the clients’ motivation for change over the period of the programme.
It is therefore, fully justified to explore other psychological interventions with the purpose of reaching out to clients in instances of where CBT has been less effective and reducing costs to healthcare providers. One possible intervention is Hypno-psychotherapy. Unfortunately, the credibility and reputation of hypnosis-based treatments as being an effective psychological intervention has had a mixed response from the mainstream therapy community, notably, due to its practice historically being associated with hysteria and entertainment (Davis, 2015).
However, there is a growing body of literature of sufficient quality, suggesting clear evidence for the efficacy of hypnosis for wide range of disorders such as pain control (Hawkins, 2001; Grondahl & Rovold, 2008; Accardi & Milling, 2009), anxiety disorders (Hammond, 2010; Baker, Ainsworth, Torgerson & Torgerson, 2009), Irritable Bowel Syndrome (IBS) (Radziwon & Lackner, 2017), the management of substance addictions (Hartman, 2010; Katz,1980), and increasingly used within the palliative care setting to
diminish physical symptoms and anxiety (Finlay & Jones,1996). With some evidence suggesting that hypnosis leads to a greater effect size when measured against the reduction of chronic pain and when compared with other psychological interventions (Adachi, Fujion, Nakae, Mashimo & Sasaki, 2014).
Further, there is some evidence to suggest that teaching clients self-hypnosis can provide effective treatment for some conditions, and be cost-effective because the need to have regular face-to-face consultations is reduced (Accardi & Milling, 2009; Landolt & Milling, 2011). This reduction in therapy costs has been explored further by Tan, Rintala, Jensen, Fukul, Smith and Williams (2015) who suggest that two sessions of self-hypnosis and listening to hypnosis recordings may be equivalent to eight face-to-face conventional hypnosis sessions. With such increasing body of evidence, it may be argued that it is now unethical not to inform patients about this treatment modality (Weisburg, 2008).
The evidence suggests that further research is warranted into the possible benefits hypno-psychotherapy can bring to a range of psychological disorders. However, currently, the author is not aware of any study exploring the efficacy for hypnosis-based interventions for Internet Addiction Disorders. It is proposed that hypnotherapy may provide an effective intervention along side the existing CBT approach and potentially reduce costs for healthcare providers and private clients.
Can hypnosis-based interventions provide a cost-effective, evidence-based psychological treatment for Internet Addiction disorders? And what would this therapy look like?