Hi all!
The ICD-11 is scheduled to be released June 2018 and Gaming disorder seems to be included.
http://www.who.int/substance_abuse/activities/gaming_disorders/en/
- Will we get an overflow of new clients?
- Are clinicians prepaired?
Opinions?
Best
John-Kåre
we are not necessarily prepared - an understanding of the definition will be needed as well as training on associated, particularly evidence-based interventions. I think there's also a major challenge for counseling and health care professionals to become familiar with all the issues, and to become adept in differentiating gaming disorders, their symptoms and trajectories from other presenting conditions. Finally, those of us who prepare future counseling and health care professionals and/or who offer continuing education must work to include this content in training and education.
Hi Ali! Interesting. Which diagnostic system do you utilize in Iran?
Best
John-Kåre
With a bit of common sense and some immediate preparation, I think clinicians could be reasonably well prepared.
My first suggestion would be to screen potential clients for readiness to change - determine whether they are coming for help because their excessive behaviour is of high concern to them and is addressing it a priority. I would be inspired by the 23 years of continuous clinical trials of Martha Sanchez-Craig in this regard, as she was able to demonstrate superior outcomes for those meeting this fundamental criterion. Conversely, those coming as a result of pressure from others (parents, spouses, employers, etc.) tended to do poorly. Potential clients who reported attending due to external pressure were asked to take time away and return once change became a priority for them.
Second, I think it will be important to offer clients the choice between abstinence and controlled use outcomes - again, Sanchez-Craig found that giving clients the power to select their preferred goals significantly improved outcomes. Controlled use should be defined as being free from negative consequences of any concern.
Third, I would recommend a Cognitive-Behavioural/Motivational Intervention blend (CBMT) for the clinical architecture, one which combines CBT and MI in order to achieve a powerful mix of client retention and engagement in the change process.
Fourth, and again the research backs this up, a choice of delivery formats should be used, including self-directed (both a paper and pencil manual and on-line), self-directed with assistive coaching, and individual counselling (6-8 sessions delivered face-to-face, by telephone, or interactively on-line). Finally, booster sessions should be available on demand to assist with solving problems that arise after specified counselling has been completed.
All of the above emerged from Sanchez-Craig's work at Toronto's Addiction Research Foundation, and were initially applied to problem drinking, but subsequently to smoking, and problematic use of prescription drugs. The elements of program design and delivery are well specified in program manuals (client handbooks and counsellor guides) and stand-alone therapist's manuals.
In my view, a project to adapt and apply this seminal work to gaming should be undertaken in the immediate future and subjected to associated clinical testing. A training program for counsellors should be developed as part of this process. As with Sanchez-Craig's programs, a standardized evaluation should be built in, consisting of initial and post completion assessments, and follow ups at 6, 12, and 24 months. What is most needed at this point is a group of counsellor/researchers to undertake this work at this early juncture.
I have attached a brief program description for one of Dr. Sanchez-Craig's programs ("DrinkWise") to illustrate in part some of the points I raise above. Note that this text identifies a target group of "problem drinkers", whose circumstances were posited as less severe than the commonly viewed "alcoholic". Subsequent research established similar positive outcomes for this latter group. Note also, a bibliography of the related research is appended. Full disclosure: I was the CEO of the organization that worked with Dr. Sanchez-Craig to develop DrinkWise and its smoking cessation cousin, QuitCare.
A final note: as is the case with gambling, counsellors will face the confounding reality that excessive involvement is, in large part, the cultivated outcome of a broad range of deceptive and manipulative mechanisms knowingly built into the gamer/gambler's experience. This fact can be expected to undermine success, and should be specifically addressed as an educational module within the program, potentially using strategies developed in media literacy educational programs.
Best wishes,
Rob
That is inevitable, gaming disorder is pandemic and produces several secondary problems not limited to mental but also musculoskelethal disorders.
Well, it was included in DSM-V in 2013. Please have a look at
https://www.psychiatry.org/psychiatrists/practice/dsm