PSY200 Southern New Milestone 2 Internet Addiction Case Study Paper

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PSY200

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In this milestone, you will be reading this Case Study. In the previous milestone, you focused on the addiction and its effects. In Milestone Two, you will want to focus on the assessment used as well as the addiction. Consider the following in this paper:

  • Case study client information and presenting problem
    • Identify the client (gender, age, race, profession).
      • Identify the addiction that this client presents with.
      • Does he have a substance addiction, like alcohol, prescription drugs, or illicit drugs?
      • Does he have a process addiction, like gambling, video gaming, or shopping?
  • Assessment
    • Identify the physiological procedure the client uses for administration of his addiction (oral, injection, watching videos, phone calls).
    • Describe the type of environment in which the client spends his time.
      • Is there support within the family?
      • Does the client hang around with friends who are using addictive substances?
      • Is the client working for a company where his addiction is encouraged?
    • What is the client's philosophical stand about his addiction?
      1. What is his motivation level for getting help?
      2. Is there a sense of hope or hopelessness?

Addiction information

  • Provide the history of the addiction. (Is it a substance or process addiction?)
    • What is the history of the addiction? Remember, there are many types of addiction, and not all were defined around that time. For example, video game addiction was not officially defined until 1995, while alcohol addiction was defined in 1941.
  • Differentiate between the physiological and psychological effects of the addiction.
    • Does the addiction physiologically affect the subject's behaviors and mental processes? If so, how?
    • Does the addiction psychologically affect the subject's behaviors and mental processes? If so, how?

Results

  • Discuss the results of this case.
    1. Did the client respond positively to the treatment?
    2. Did the client relapse?

Your paper should:

  • Be composed in MS Word and formatted in APA style
  • Be at least 3 pages in length, not including the title page and references page
  • Employ a minimum of two scholarly sources

For additional details, please refer to the Case Study Milestone Two Guidelines and Rubric document.

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INTRODUCTION Internet game addiction is becoming a serious problem in countries such as the United States or South Korea which have wide access to the Internet. The definition of Internet game addiction varies. Young (1996) defines Internet addiction as "centralization of use of the Internet at the expense of other activities" and "putting priority on maintaining electronic relationships." DSM-V defines Internet addiction as: 1) excessive use, often associated with a loss of sense of time or a neglect of basic drives; 2) withdrawal, with feelings of anger, tension, and/or depression when the computer is inaccessible; 3) tolerance, with the need for better computer equipment, more software, or more hours of use; and 4) negative repercussions, with arguments, lying, poor achievement, social isolation, and fatigue (American Journal of Psychiatry, 2008). The prevalence of Internet addiction in South Korea varies from 2.3% in high school students (Choi et al., 2009) to 20.3% in adolescents (Ha et al., 2006). The prevalence of Internet abuse is 47% in high school students. Students with Internet addiction used the Internet for 3.5 hours (+/-2.4) per day, while non-addicted students used the Internet for 1.7 hours (+/-1.2) per day (Choi et al., 2009). A survey reported that 15% of 1,527 adolescents were classified as risky internet users. The more severe the Internet addiction, the more the use of games: 75.3% of the high-risk group used the Internet for games (Korea Agency for Digital Opportunity and Program, 2005). The prevalence of Internet addiction in the United States is from 0.3% in the general population (Shaw & Black, 2008) to 25% in undergraduate students (Fortson, Scotti, Chen, Malone, & Del Ben, 2007). Widyanto and McMurran (2004) reported that 86 young adults (mean age 28) spent 20 hours per week on the Internet for personal use. Game addiction has negative effects such as loss of interpersonal relationships, failure to address responsibilities, distraction from other aspects of life, and poor health (Steward, 2004). Related factors of game addiction include hostility (Chiu, Lee, & Huang, 2004), little or no self-confidence (Griffiths, 2000), depression (LaRose, Lin, & Eastin, 2003), loneliness (Nalwa & Anand, 2003), low self-esteem, stress, impulsiveness (Cho & Lee, 2004), and low self-control (Song, 1998). Interventions for Internet game addiction include a value facilitation program (Jang, 2005), cognitivebehavioral therapy to increase self control (Lee, 2005), a self-growth program (Oh, 2004), self-control training (Kim, 2004), and a game desire control program (Pyo, 2003). Even though the effects of a 12-step program were evaluated on drug addiction, they were not evaluated on game addiction (Kristensen & Vederhus, 2005). Therefore, the purpose of this study is to describe a case study of a pilot intervention using a 12-step program combined with behavior modification and cognitive-behavior therapy to treat Internet game addiction in an adolescent. INTERVENTION Cognitive-behavioral therapy, a 12-step program, and behavior modification have all been reported as assisting in changing patients' unhealthy behaviors. Cognitive behavioral therapy intends to change behaviors by changing beliefs. Individuals are required to analyze emotion, thought, behavior, and others situations when patients involve themselves in unhealthy behaviors. Individuals are required to analyze any underlying beliefs that may be untrue, unrealistic, or counterproductive (Magill & Ray, 2009). A 12-step program uses an informal bio-psycho-social-spiritual model (Craig, 1993). In 1996, the American Society of Addiction Medicine reported that a 12-step program demonstrated the ability to identify the problem, define the solution, and design a program of actions necessary to bring about recovery (Fajardo, 2006). Behavior modification modifies behaviors using reinforcement, punishment, and extinction (eliminating the incentives for unwanted behavior) based on a learning theory that every behavior is learned by external conditions and learned behaviors are cancelled by learning. Token economy, which is designed to maximize effects in groups, helps a group gain tokens by acting out adaptive behaviors and encourages them to do more adaptive behaviors by exchanging tokens with a primary reinforcing agent (Lim, 2001). CASE DESCRIPTION A 16-year-old Korean adolescent, HC, was referred by his mother because of his negative attitude, depression, and overuse of the Internet. Even though he did not want to come to the US to live or study, his parents persuaded him to come here with his mother and brother. He has been in the US for 4 years. After coming to the US, he had difficulty speaking English. He withdrew from his friends. He started playing Internet games at the age of seven. The hours for playing games increased rapidly because he spent a lot of time alone after coming to the US. On the other hand, Koreans think manners are very important, especially between older and younger generations. While Americans call each other "you" regardless of their age, Koreans have many different words for expressing respect. HC has poor social relationships with his brother and Korean seniors because he does not use those respectful words. His mother worried about his negative attitude toward his father. For example, when his father visited him from Korea, and his father suggested something to do together, he usually answered negatively. HC expressed his need to reduce the hours of using games. He spent 3 to 5 hours on playing games on weekdays and 13 hours on weekends. He said that it was difficult to control, especially on weekends. THE PROCESS OF INTERVENTION Counseling consisted of five individual sessions that ranged in length from 30 minutes to 1 hour per week. Homework assignments were used to record HC's activities and how he spent his time. Thoughts, emotions, and behavior that helped to control his desire to play games were explored. The counselor and HC discussed how to manage his time during the week and stickers were used as a reward when he kept his promise. Discussion using one or two questions based on a 12-step program took place (On-line game anonymous, 2006). In every meeting, he explained what he did well in the last week. A contract was made to teach him accountability. If he was not on time, he paid one dollar per every 10-minute period he was late. Behavior Modification The first session focused on obtaining a general assessment. The second session focused on the assessment of game addiction and creating a contract for behavior modification. HC agreed to try to reduce the time spent on games and increase time spent on other healthy activities. It was explained that stickers would be given as positive reinforcement and a prize would be given when he gathered an agreed-upon amount of stickers during eight sessions. His mother promised to give him half the money he needed for a new computer if he reached his goal. The contract was in written form and signed by HC, his mother, and a counselor (Table 1). Also, HC was asked to record the time spent on games and alternative activities on paper (Table 2). In the third session, his mother said that he had decreased game-playing time but showed agitation because of reducing the time spent on games. He spent less than 1 hour per a day on weekdays, but spent over 3 hours per day during the weekend. On a weekend, he did not go to school and did not have anything to do. He tried to talk with his mother and watched television dramas instead of playing games. He received 5 stickers for reducing his game time and 20 stickers for engaging in healthy activities. In the fourth session, he reached his goal for only 2 days. He said that he woke up early, did homework, fared well on his exam, and exercised. He got two stickers for reducing game time, but he could not remember spending time on healthy activities. He skipped two sessions because he slept late in the morning. His mother said that he sat up all night hanging out with his friends. In the fifth session, he did not reach his goal for even 1 day. He spent over 3 hours on games every day, but he tried to spend time on basketball, talking, and bowling with friends. He explained that he did not come the last 2 weeks because he thought it was too much trouble and the place for counseling was far away from his house. He was asked whether he had a desire to continue counseling or not. He avoided giving an answer directly. He was given 1 week to think about this. After contacting the counselor, finally he said that he wanted to give up. Cognitive-Behavioral Therapy HC was encouraged to be conscious of how his time was spent more on games than he intended and to explain which emotions, thoughts, and behaviors contribute to overuse of games. He was encouraged to think about which factors were helpful in reducing time spent on games. HC was asked to record his thoughts, emotions, and behaviors related to games on a form each week (Table 3). In the second session, discussion centered on the reasons, and disadvantages of playing games, methods to use to decrease time spent on games, and how to increase his holistic health. He played online games because it was fun; he could meet people through online games, and feel satisfaction when he reached the goals of game scores. He wanted to reduce time on computer games because it interfered with his studying and was not good for his health. In the third session, a screening tool for measuring his game addiction was given because he did not accept that he was addicted to computer games. He thought that if he wanted, he could stop. He was encouraged to express emotions, thoughts, and behaviors related to games. He always felt bored at home. When he felt bored, he usually played computer games. He could not drive. His mother and brother were usually outside until the evening or later and he was often alone on weekdays. Those situations contributed to his game addiction. In the fourth session, he forgot to bring his homework. He expressed feeling burdened to do his counseling homework. The idea of cognitive-behavioral therapy was good, but it was difficult for him to practice daily. As time went by, he had difficulty accurately writing down his exact hours on different activities. In addition, two pieces of paper every week were given: one for recording his activities and time, another for recording his emotions, thoughts, and behaviors related to games. It was difficult for him to keep the records and bring them to the sessions. The main issue for him was managing his boredom. A suggestion was given for him to do something different with his time. After the fifth session, he started to learn golf and he was becoming more interested in golfing. Therefore, he could reduce his time on games. He and his mother were encouraged to spend time outside doing something such as playing golf. 12-Step Program Questions for each session were made based on the 12-step program (On-line game anonymous, 2006) (Table 4). For example, the goal of the first session was "we admitted we were powerless over on-line gaming and that our lives have become unmanageable." The counselor offered three questions to approach this goal. "Which part is difficult for you to control?" "Which part is easy for you to control?" and "Have you despaired about your failure of self-control?" He doubted the existence of God because he prayed for something but God did not answer. Therefore he doubted God could help with his problems. He did not feel the need to pray. In the fourth session, what harm he caused to others was discussed. He said that he lied often in online games to sell his items at a high price. He said that he used abusive words because his friend used those words. He said he would try to reduce abusive words. He was encouraged to apologize to people whom he harmed by lying and using abusive words. In the fifth session, demerits in his character were discussed. He said that he felt difficulty accepting authority figures, often used abusive language, had perfectionism, and played games excessively. He thought that his perfectionism contributed to game addiction because he made a goal for game scores and he wanted to reach the goal. He was encouraged to think about the reasons he had difficulty having relationships with older persons. He heard that he should use respectful language and manners when he met Koreans. He said that he did not want to behave differently between Americans and Koreans. He felt that it was like having a dual personality. His counselor empathized that he would have difficulty living with the expectations of two cultures. He was encouraged to think about other's perspectives. To have a good relationship with others, his counselor explained a need to act differently according to different cultural norms. RESULT OF THE INTERVENTION The program consisted of eight sessions originally. However, the counseling stopped after five sessions. During the counseling, there was some improvement. However, HC did not do his homework and did not keep his promise to reduce game hours. In the 2-month follow-up, his mother said that he had reduced his game time since he started golfing with her. DISCUSSION There are not many studies for intervention of Internet game addiction published in English. Young (2007) reported that cognitive behavioral therapy for eight sessions helped 114 middle-aged male patients to control Internet addiction. Collier (2009) introduced an inpatient therapy which consists of talk therapy, life-skills coaching, physical and nutritional education, work and home-maintenance skill-building, 12step meetings, and feeding goats and chickens. There is no report of the effect of this program. Shek, Tang, and Lo (2009) reported the effect of an Internet addiction intervention program which consisted of a motivational interview, individual counseling, a peer support group, and family-based counseling. The authors reported that this Internet addiction problem decreased in 59 participants after participating in the program for 15-19 months. Further studies are needed to develop interventions for Internet addiction and examine the effects. Just as with other diseases, prevention is more important than treatment in the case of Internet addiction. Ko, Yen, Chen, Yeh, and Yen (2009) reported that attentiondeficit/hyperactivity disorder, hostility, depression, and social phobia were predictors of Internet addiction. Therefore, screening attention-deficit/ hyperactivity disorder (ADHD), depression, hostility, or social phobia among children and adolescents is important to prevent Internet addiction. Medications are needed when depression or ADHD coexist with Internet addiction. Family intervention is needed to prevent Internet addiction. Park, Kim, and Choi (2008) reported that parenting attitudes, family communication, family cohesion, and family violence exposure were associated with Internet addiction. In this case, there was a lack of communication between the participant and parents. Education and counseling for parents is also important to prevent Internet addiction. For example, parents need to know how to have healthy communication with children, to have regular communication with their children, to check which Web sites their children often access. Parents have to put the computer in the living room not in the children's room and encourage healthy outdoor activities. For the best result from counseling intervention, group therapy would be better than individual psychotherapy because adolescents tend to pursue fun with friends. LIMITATIONS AND RECOMMENDATIONS The burden of homework in cognitive-behavior therapy might cause subjects to resist participation in the counseling. To increase participation, the therapist could assign homework one day per week. Providing a binder for record-keeping would help the subject to remember to bring the homework to the session. The most important reason for HC stopping the sessions could be that this counseling was not fun for him. He had previously experienced having group therapy for ten sessions with friends. At that time he wanted to continue the group therapy and he showed interest. Group therapy would be more effective for Internet game addiction. The length of time for counseling is also important because addiction recovery is not easy to accomplish in a short period of time. At least eight sessions would be helpful for a game addiction problem (G. H. Kim, 2003; J. H. Kim, 2003) PSY 200 Case Study Milestone Two Guidelines and Rubric In the previous milestone, you focused on addiction and its effects. In Milestone Two, you will want to focus on the assessment used as well as the addiction. Read this case study and write a short paper in which you address the following critical elements:  Case study client information and presenting problem o Identify the client (gender, age, race, profession). i. Identify the addiction that this client presents with. ii. Does he have a substance addiction, like alcohol, prescription drugs, or illicit drugs? iii. Does he have a process addiction, like gambling, video gaming, or shopping?  Assessment o Identify the physiological procedure the client uses for administration of his addiction (oral, injection, watching videos, phone calls). o Describe the type of environment in which the client spends his time. i. Is there support within the family? ii. Does the client hang around with friends who are using addictive substances? iii. Is the client working for a company where his addiction is encouraged? o What is the client’s philosophical stand about his addiction? i. What is his motivation level for getting help? ii. Is there a sense of hope or hopelessness?  Addiction information o Provide the history of the addiction. (Is it a substance or process addiction?) i. What is the history of the addiction? Remember, there are many types of addiction, and not all were defined around that time. For example, video game addiction was not officially defined until 1995, while alcohol addiction was defined in 1941. o Differentiate between the physiological and psychological effects of the addiction. i. Does the addiction physiologically affect the client’s behaviors and mental processes? If so, how? ii. Does the addiction psychologically affect the client’s behaviors and mental processes? If so, how?  Results o Discuss the results of this case. i. Did the client respond positively to the treatment? ii. Did the client relapse? Guidelines for Submission: This submission should follow APA formatting guidelines, use 12-point Times New Roman font and 1-inch margins, be at least 3 pages in length, not including the title page and references page, and employ a minimum of 2 scholarly sources that directly support your main ideas. Case Study Milestone Two Rubric Critical Elements Identify Client: Background Information Addiction: Assessment Exemplary (100%) Meets “Proficient” criteria, and analysis of the client is extensive and imperative to the case study Meets “Proficient” criteria and utilizes relevant examples to substantiate claims Proficient (85%) Provides a complete background history of the client Needs Improvement (55%) Provides an incomplete background history of the client Not Evident (0%) Does not provide background information Discusses the physiological procedure client uses to administer his addiction, the environmental elements the client is affected by, and the client’s philosophical stand about his addiction Does not provide addiction assessment information 20 Addiction Information: Identification Meets “Proficient” criteria and uses specific, relevant examples to substantiate claims through the synthesis of the scholarly research Meets “Proficient” criteria and uses specific and relevant examples to substantiate claims Identifies the addiction the client presents with and the background history of that addiction. Supports by referencing scholarly research Discusses if and how the addiction physiologically and psychologically affects the client’s behaviors and mental processes Discusses the physiological procedure the client uses to administer his addiction, but does not discuss the environmental elements the client is affected by and/or the client’s philosophical stand about his addiction Identifies the addiction, but does not provide a history of the addiction or does not support by referencing scholarly research Does not identify the addiction and its background history 20 Does not discuss the physiological and psychological effects of the addiction 15 Meets “Proficient” criteria and provides own feedback to the type of treatment used Submission is free of errors related to citation format, references, or other elements of APA style Discusses how the client responded to treatment and if he/she relapsed Submission has no major errors related to citation format, references, or other elements of APA style Discusses if the addiction physiologically and psychologically affects the client’s behaviors and mental processes, but discussion lacks how it affects the client’s behaviors and mental processes Discusses the results of the case, but discussion lacks mention of relapse Submission has major errors related to citation format, references, or other elements of APA style Does not discuss the results of the case 15 No attempt to apply APA style is evident within the submission 5 Addiction Information: Physiological and Psychological Effects Results Application of APA format Value 20 Articulation of Response Submission is free of errors related to grammar, spelling, and syntax Submission has no major errors related to grammar, spelling, syntax, or organization Submission has major errors related to grammar, spelling, syntax, or organization that negatively impact readability and articulation of main ideas Submission has critical errors related to grammar, spelling, syntax, or organization that prevent understanding of ideas Total 5 100%
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Number of words Breakdowns of tasks
I. Client Information
II. Assessment
III. Addition Information
IV. Results
Format APA
Number of pages- 3 pages
ReferencesRequested ones- 2 references
Citations
APA


case study milestone 2
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Submission date: 21-Nov-2019 12:31PM (UTC-0500)
Submission ID: 1218789790
File name: Case_Study_Milestone_Two.docx (17.66K)
Word count: 1000
Character count: 5055

case study milestone 2
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Submitted to Southern New Hampshire
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Running head: CASE STUDY MILESTONE TWO

Case Study Milestone Two: Short Paper
Name
Course
Date
University Affiliate

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CASE STUDY MILESTONE TWO
Case Study
Present Issue and Information of the Client

HC is a Korean who is currently living in the U.S. The client is a male adolescent who is
16-years-old and his staying with his brother and mother after leaving Korea. Since he came to
the U.S, HC due to his challenge in English communication or understanding it, he withdrew
from people and other peers. With that, to cover for his loneliness, the client began to have an
interest in playing internet games in order to manage his boredom when he was seven years old.
Currently, he has been completely addicted to Internet games where he spends on weekends
thirteen hours to play games while on weekdays he spends approximately three to five hours.
Due to that, he has lost control over the addiction, particularly on weekends. Furthermore, HC is
not having any other kind of addiction, such as substance abuse, but HC has a process addition,
which is video gaming (Yellowlees & Marks, 2007).
Assessment
The client is focusing on creating a contact for behaviour modification. First of all, the
client uses several physiological procedures for the administration of his addiction by actively
taking part in healthy practices and decrease gaming time (Shaw & Black, 2008). This issue will
be achieved by spending fewer hours, for instance, having a lesser time of playing games on
weekdays and during the weekend to spend 3 hours a day. Also, instead of playing games, he
decided to be watching television dramas. The client's nature of the environment is one of the
contributing factors of the client's addiction, although it is a conducive environment for
encouraging improvement and enhances behavioural change. However, on the other hand, his
situation had contributed too much on his gaming addiction. Since he was used to been left alone

CASE STUDY MILESTONE TWO

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at the h...


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