Warning: Adult Drug and Alcohol and
Adolescent Residential Treatment Centers
Treating Technology and Video Gaming Addiction

Kenneth Woog, Psy.D.
Computer Addiction Treatment Program

 

Background

Fueled by the opioid epidemic and laws requiring health insurance companies cover substance abuse treatment, the number of licensed drug and alcohol treatment centers has been steadily increasing. Operators of many adult state licensed drug and alcohol treatment centers and adolescent residential treatment centers have expanded their marketing to suggest they now also treat addiction to video games and other forms of technology dependency.

While not legally allowed to treat online gaming or technology addiction as a primary condition, adult drug and alcohol treatment programs often claim to treat this problem as a "co-0ccurring condition". Putting video game addicts in residential programs with drug addicts and seriously emotionally and behaviorally disturbed individuals involves serious risk. The same can be said for placing a video game addicted adolescent into a residential treatment center with mostly delinquent, drug addicted youth. Known as "deviant peer influences",  exposure to the more problematic peers can increase the chance they will be influenced by them and leave worse off than when they arrived. I  have seen many adolescents sent to these facilities that experienced violence, aggression and even exposed to drugs and self harm (i.e. cutting) behavior.  

A search of Psychology Today's treatment centers with the treatment issue "video game addiction" will return (except perhaps 1 or 2 ) adult drug and alcohol treatment centers, adolescent residential treatment centers and wilderness programs. A similar Google search will return mostly websites that refer individuals to other treatment centers. Unlike Psychology Today, these online sales/marketing web sites refer individuals and families to these treatment centers in exchange for large commissions. I have seen individuals seeking treatment from us that were referred to these programs on the basis of a substance use disorder when this was clearly not the case. Not only is this unethical and illegal, it can be harmful and is unlikely to result in successful treatment. Because there is a mix of types of "co-occurring" disorders treated in these facilities it is extremely unlikely there is any specialized treatment methods related to video game or other forms of technology addiction. 
 

Adult drug and alcohol treatment centers

An adult residential drug and alcohol treatment center is generally a single family home (or multiple homes) located in a residential area that has been licensed by the state to allow up to 6 adults (in each home) to live and receive treatment there for substance abuse and related mental illness. This type of treatment program is often referred to as the social recovery model and originated with Alcoholics Anonymous (AA).  Because it is too expensive to place an addict in a acute care hospital, states enacted laws allowing private homes to be opened up for this purpose. This bypasses local housing and zoning ordinances which ordinarily prevent this type of use. By keeping an addict clean and sober for a period of time (30 or more days), involving them in a community of fellow addicts and introducing them to 12 step meetings (that they would continue after discharge), presumably they would be well on their way to recovery. Today this is big business with mansions converted to treatment centers charging more than $40,000 for a 30 day stay and residents likely to receive gourmet food and a wide gamut of luxury amenities, often located in high-end beachside communities.  With insurance often footing the bill and the emergence of healthcare loans, this has become a growing industry. Unfortunately for everyone, the statistics are grim. Only a small percentage of these residents remain sober after 1 year. Besides the deviant peer influences, I mostly have seen these programs as ineffective. The video game addict cannot easily relate to a heroin or meth addict and it can be counterproductive as they can remain in denial regarding the nature and extent of their issues. In speaking with young people about their experience in "rehab", I have heard that they could not relate to their fellow addicts, the meetings and treatment never addressed their issues and they generally did not find it helpful. Some enjoyed the luxuries during rehab but it really didn't change anything because they ultimately had to return after 45-60 days back to their bedroom in their parent's home.
 

Child and Adolescent Residential Treatment Centers

Child and adolescent residential treatment centers are state licensed (social services) facilities providing transitional housing and related treatment. These programs admit minors, younger than 17 1/2 years old for longer terms (6-18 months) than a traditional adult rehab. These facilities also may house many more youth then a traditional rehab and may offer more intensive therapy and education opportunities as well. Many long term facilities are located in states where laws favor parents and allow lockdown facilities. These facilities are generally not covered by insurance, although some of the treatment may.

Traditionally serving defiant, emotionally disturbed and substance abusing teens, these programs have expanded their treatment issues to include technology and videogame addiction. While these programs do provide the parents with some relief from their parenting struggles and hope that their child will improve, I still have several concerns about sending a video game addicted child to one of these programs. I feel it may be necessary when parents have no other options. When a child has such serious psychological/psychiatric problems that a professionally guided comprehensive psychiatric, psychotherapeutic and behavioral program fails, or if the home or community environment is dangerous or limits treatment availability, then a high quality therapeutic boarding school might be the best option. This would be the case for a child that has become chronically psychotic, suicidal, homicidal or extremely violent and dangerous in the home. If the child's behaviors have exceeded the parents capabilities, then this could be a good choice.

Besides being expensive, I have several concerns. First, often the problems in the home relate to parent-child conflict and this cannot be fixed by sending a child away. Individual, family and parent counseling/education may be required. Second, deviant-peer influences puts an immature, naïve youth at risk. Thirdly, isolation from family and local school friends (usually a casualty of the technology addiction) will not be resolved by sending a child away. Next, there may be no real treatment directly related to the technology dependency. Lastly, if the child is to return home, an after-care program will be necessary for successful long-term outcome. Why not establish the appropriate living  structure, individual/family/parent counseling and behavioral plan first rather than after?

 

Wilderness Programs

Wilderness programs represent another class of "treatment" being promoted for video game addiction. Originating as an intervention for defiant, commonly drug-using teens (i.e. "Brat Camp"), these program offer a tough outdoor experience with a guide/counselor that helps individuals move past their entitlement and comfort. These programs are located in states where this activity is authorized. States like Utah, which tends to have laws more favorable to parent's rights (than say California) are home to the bulk of these programs. I have heard favorable reports from both the parents and clients that participated in certain wilderness programs. Beware - not all programs are of the same quality, these programs are expensive and insurance does not cover most of the costs. Also the programs of which I am familiar do not make a claim that this is cure. They see their programs as an intensive start to recovery that will need to be continued when the individual returns home. Be wary of programs claiming to cure video game addiction. Again, one of my biggest concerns relates to deviant-peer influences. I would not recommend mixing gaming addicts with serious juvenile offenders or drug addicts. I would suggest programs that are most often focused on enrichment or adventure rather than "treatment" would be a better option to mitigate risk. Wilderness programs are often "successful" short-term because the parents can threaten to send them back if the problems re-emerge. They can fail long-term, however, if aftercare recommendations are not followed.