The Internet can serve as a double-edged sword. On the one hand, it provides many benefits and increases convenience. On the other, its use can be highly alluring, which may result in excess consumption, which manifests in behavioral addiction-like symptoms [1
]. Since Goldberg [2
] proposed the concept of “Internet Addiction Disorder”, many researchers have used similar concepts, such as Pathological Internet Use, Problematic Internet Use, Excessive Internet Use, and Internet Addiction [3
Although these concepts are slightly different, they all have two common characteristics: (1) addiction-like symptoms: compulsive use of Internet, withdrawal reactions, and tolerance, combined with inability of users to effectively control themselves; (2) as a result, their daily functions such as academic and social activities, as well as sleep and food intake, are impaired [4
]. We believe that the concept of Internet Addiction (IA) can best reflect the above characteristics and is widely used. While the term is controversial [5
], for convenience reasons, we will use in this study the term Internet Addiction to describe this phenomenon, while acknowledging the need of future research to fine tune its definition and boundaries. IA has been recognized as a public health concern [6
], which can correlate with poor health outcomes such as higher likelihood of being overweight [7
], impaired sleep [8
], increased suicidal ideation and attempt [9
], and increased depressive symptoms [10
College students can be highly susceptible to IA [11
]. Once freed from the strict control of high school and family, they tend to have free time at their disposal, which when coupled with easy access to the Internet can lead to IA [12
]. In addition, these students are experiencing changes in the environment with which they must learn to cope. For example, they face pressures on handling new interpersonal relationships and balancing learning and social activities [13
]. Consequently, students may seek to relieve these pressures via Internet use, which can result in IA [14
]. Among Chinese college students, IA is prevalent. Between 6.56% and 13.5% of Chinese college students may be classified as addicted to the Internet [15
]. Therefore, paying close attention to issues related to college students’ use of the Internet, and intervening if necessary, is critical for preventing IA and its adverse impacts [16
Various schools of psychotherapy have been applied to alleviate IA. Among them, solution-focused brief therapy (SFBT), as a relatively new paradigm of post-modern constructivism, has also been applied to IA cases. Specifically, Yang [17
] provided psychotherapy with an emphasis on SFBT and comprehensive family intervention to teenagers with IA, and reported positive results showing that SFBT can be an effective therapy for treating IA. SFBT evolved out of the clinical practice of Steve de Shazer, Insoo Kim Berg, and colleagues at the Brief Family Therapy Center in Milwaukee, Wisconsin, in the early 1980s [18
]. SFBT change processes were originally grounded in the constructivist approaches to communication and social interactional theories [19
]. Over time, SFBT also became associated with social constructionism and the philosophical, post-structural views of language such as in Wittgenstein’s language games [20
]. The main components of SFBT include looking for previous solutions, acknowledging problems but identifying that exceptions to the problem are key to the solution, focusing on present and future, as opposed to past-orientated questions, using validation, and utilizing techniques such as miracle questions, scaling questions, and coping questions [22
Due to the high cost of psychotherapy, people strive for a faster and more effective treatment, which has led to the widespread application of SFBT, such as for treating students’ emotional behavior problems [23
], substance abuse [24
], adolescent crisis events, suicide and self-harm [25
]. SFBT is not only applied to psychotherapy and counseling, but also applied in school class management, enterprise management and other fields [26
]. SFBT emphasizes using a positive perspective to comprehend people, expressing their affirmation, and fully trusting that people will understand the methods that suit them. It is complementary to traditional Confucian culture [27
] and compatible with it [28
]. As such, it is highly suitable for application in China, as demonstrated by large effects in Chinese populations [29
Comparing SFBT with Cognitive Behavioral Therapy (CBT), Jordan, Froerar, & Brovelas [30
] argue that professionals using CBT assume the expert role, aiming to identify problems in people’s thinking and behavior. But professionals using SFBT regard their patients as already having all the resources they need, defining their own role as supportive in eliciting the individuals’ strengths, and empowering people to articulate these into achievable goals for the future. Therefore, SFBT enables patients to look for possible behaviors to change, and puts patients in control as regulators of their behavioral changes. It is not only beneficial for patients to maintain behavioral change, but also helps them to improve self-efficacy, thus making it more suitable for college students’ self-exploration and continuous transformation. In addition, some studies have shown that SFBT used more of the client’s exact words, and used more positive language, than other therapies such as CBT and Motivational Interviewing (MI) [30
]. Therefore, SFBT may be more beneficial to relieve patients’ anxiety and their concerns towards the issue, thereby making it easier for college students who are sensitive and care about others’ evaluation and social pressures to accept this method and reduce their resistance. In addition, group counseling is an effective intervention for IA [32
]. Compared to solution-focused individual counseling, applying SFBT to group counseling makes the process lively, encourages group members to share their experiences and promotes psychological growth with mutual support and encouragement from the group. Nevertheless, the efficacy of SFBT in group counseling to reduce IA in Chinese populations is not fully established. We aim at ameliorating this gap in this pilot study.
Specifically, we focused on applying SFBT in group counseling and explored the intervention effects of solution-focused group counseling on IA in college students. By examining immediate and long-term post-intervention effects, we aim at clarifying if solution-focused group counseling improves IA in college students. Based on the above mentioned findings of prior intervention studies applying SFBT in different contexts, we hypothesized that participants in the experimental group (i.e., those who will accept five-week solution-focused group counseling aimed at alleviating Internet Addiction core symptoms, such as compulsive use, withdrawal and tolerance, and Internet Addiction related problems such as interpersonal, health-related, and time management problems) will show significant changes in these aspects, beyond the placebo effects observed in a control group.
This pilot study explored the intervention effect of solution-focused group counseling for college students’ IA. The results of the comparison between the two groups found that the change in total IA scores as well as in the dimensions of compulsive use, withdrawal (Sym-C & Sym-W) and tolerance (Sym-T) were significantly larger in the intervention compared to the control group. Within the experimental group, the scores in the four IA dimensions were significantly decreased and the change trend of the total IA score was similar for all subjects in the experimental group. In the dimension of time management problems (RP-TM), the follow-up test was significantly lower than the scores in the pre- and post-tests. In the other dimensions, the post-test was significantly lower than the pre-test, and the follow-up test was significantly lower than the pre-test. The score on the scaling question in the post-test in the experimental group was significantly higher than that in the pre-test, indicating that the members of the group subjectively felt improvements in IA after the group counseling. In addition, the open-ended responses revealed that Internet use time, attitudes toward Internet use and Internet use form, as well as many aspects of daily life of group members, have changed. Moreover, the satisfaction score of the experimental group for every-week group counseling was above 8.5 points, which showed that members valued the provided group counseling. Overall, the results described above indicated that solution-focused group counseling intervention has a positive effect on college students’ IA and can lead to healthier Internet use and lifestyles.
After group counseling, the experimental group experienced more significant changes than the control group in IA-Sym, including but not limited to compulsion and withdrawal symptoms (Sym-C & Sym-W), and tolerance symptoms (Sym-T). However, there were no significant differences between the experimental group and the control group with regards to interpersonal and health-related problems (RP-IH), time management problems (RP-TM), and other related IA issues. These results indicated that the characteristics and advantages of SFBT make this therapeutic approach highly targeted, symptom specific, and efficient. Specifically, SFBT helps group members to clarify their goals and find clues to realize their goals by helping them visualize themselves after they use the Internet in a healthier and responsible fashion and avoid IA symptoms. SFBT is effective for several reasons. It guides group members to actively think about the function of the Internet, and to restructure their negative attitudes about the Internet towards more positive views of Internet use. SFBT encourages members to actively explore positive experiences and coping strategies for rational uses of the internet, and to search for past successful experiences to help discover and replicate effective methods of overcoming IA and uncontrolled use. All of this is done in combination with brainstorming, interpersonal communication and sharing, and other related processes to enrich the treatment milieu. SFBT stimulates group members to put various methods into practice through homework, thus gradually boosting changes in members’ core IA symptoms. It should be noted here that the change in the experimental group is more significant and may be related to the effect of social desirability. Specifically, in the process of participating in group counseling, the experimental group establishes relationships with leaders and other members, and become eager for recognition and praise. This, coupled with clear goals of group counseling, may stimulate members to actively perform in line with group goals. Of course, this is also one of the motivations of the group. From the perspective of SFBT, the socially desirable responding of the parties is an important psychological resource, which can be used for achieving better results. Through asking questions, the parties can express their abilities and efforts in the process of answering, so that the parties can have a clearer understanding of how to make progress.
Research findings within the groups showed that the experimental group experienced positive significant changes in IA. The classification we employed is based on a study of a sample of 388 college students who completed the CIAS-R revised. They found that a cutoff of 46 separates normal from at-risk groups, and a cutoff of 53 separates at-risk from the Internet addiction group [32
]. According to this standard, the average Internet addiction score of the experimental group in this study belongs to the range of Internet addiction before intervention, the range of Internet addiction risk after intervention, and the normal range after six months. Although it is only a rough comparison of the average value, it reflects the clinical significance of the intervention effect to a certain extent. However, the experimental group showed different changes in different aspects of Internet addiction. In terms of core IA symptoms (IA-Sym), such as compulsion (Sym-C), withdrawal (Sym-W) and tolerance symptoms (Sym-T), and time management problems (RP-TM), the immediate effect of group counseling was quite positive and lasted to the follow-up test, six months later. In the Interpersonal and health-related problems (RP-IH) domain, there was no significant change after group counseling, but there was a significant improvement six months later. In addition, the open-ended reports after the follow-up period supported the quantitative data, indicating that experimental group members had experienced positive changes in Internet use and daily life. An earlier study [29
] found that the application of SFBT in China can have positive immediate effect. Extending this view, the current study demonstrated that in the form of group counseling SFBT can have both short-term and long-term effects. Additionally, the solution-focused group counseling of this study first stimulated changes in core problems, and those changes were mostly maintained after group counseling. While changes in other dimensions were not as rapid and obvious as changes in core problems, there was still the possibility of change after the group counseling. De Jong and Berg [40
] suggested that the professional value of SFBT is multidimensional. It encourages clients’ involvement, improves clients’ self-determination, maximizes their sense of empowerment, and promotes transferability. Specifically, SFBT helps clients to help themselves, maximizes client potential and resources in solving problems, and makes clients responsible for their own lives by applying what they got from the counseling to other scenarios through the process of creating solutions with counselors. Therefore, solution-focused group counseling not only achieved significant outcomes in treating core IA symptoms, but also had positive longer-lasting impacts on interpersonal relationships, learning, work and other life domains.
Many researchers have also conducted intervention studies on college students’ Internet addiction, but follow-up tests are often conducted within six or eight weeks after the intervention [34
]. We extend such studies in this paper, by focusing on long-term follow-up changes. Moreover, Cognitive-Behavioral Therapy has been widely applied to treatment of IA [42
], but the existing cognitive behavioral therapies mostly draw on results of well-developed studies in substance addiction and intervention treatments of other mental disorders. These treatments may not be as efficacious with college students, which is a specific clinical group that needs to use the Internet, but needs to learn to do so responsibly, even under conditions of total freedom. These reasons may account for the limited success of these therapies with IA cases [43
]. Besides shedding factors that have controlled their life, many college students lack self-control and behavior-selection strategies. Even if students make positive changes, these can be difficult to maintain. Moreover, each relapse to an addictive behavior will further undermine their self-efficacy [44
], thus leading to increased engagement in addictive behaviors and further loss of control. Based on the concept of SFBT, the current pilot study respected the subjectivity of college students and helped them dig deeper into their own resources and strengths to solve the problem. In addition, the form of group counseling promoted positive feedback among members. This is not only conducive to the improvement in the core IA symptoms, but also helps to maintain the change and to generalize the change to other life domains.
Several limitations of the current study are noteworthy. First, the sample size is small. The reliability and validity of major measurement tools such as CIAS-R cannot be fully verified, and the generalizability of the results may be limited. Future studies can consider increasing the sample size to verify the reliability and validity of the measurement tools and improve generalization of the research results. Second, the variables in this study are all self-reported, subjective and easy to be influenced by the effect of social desirability. Future research can consider obtaining more objective data from different approaches such as multi-subject evaluation by consultants, classmates, etc., and/or control for social desirability bias. Third, the sample included college students. The design of the focus solution group counseling program is based on college students’ cognitive development level and other psychological characteristics, and the Internet addiction level of the subjects is controlled. In the future, when the group counseling program is applied to other age, identity or Internet addiction level groups, it needs to be revised according to the specific situation. Fourth, changes brought by group counseling may be subtle and even unconscious. More sensitive indicators, such as using neurophysiology related technologies to explore brain structure and functions following SFBT [43
], can be used in future research to lay a foundation for improving IA interventions.