In a four-year, statewide study, researchers in Heidelberg tested the effectiveness of a behavioral therapy approach and media education

School-based prevention programs are designed to help protect adolescents from gaming disorder and problematic online habits. But how effective are these interventions when it comes to promoting responsible use of video games and the Internet? A research team led by Prof. Dr. Katajun Lindenberg of the Institute of Psychology at Heidelberg University investigated this question as part of a statewide study in which a total of approximately 1,800 adolescents from 44 secondary schools in Baden-Württemberg participated. The results show that, in the long run, a four-week behavioral therapy-based program achieved greater effects among participants at high risk of addiction than a media education program did.

“Against the backdrop of ongoing debates about effective measures to protect the mental health of young people in the digital age, the question of effective interventions is highly relevant,” emphasizes Katajun Lindenberg, who is Professor of Clinical Psychology of Childhood and Adolescence at Heidelberg University and directs the Psychotherapeutic University Outpatient Clinic for Children and Adolescents. In addition to much-discussed regulatory measures such as age restrictions, there are parallel calls for measures designed to empower young people to use video games and the Internet responsibly. These include prevention programs based on behavioral therapy or media education approaches. “Our research provides important empirical insights into which programs and content are particularly effective and which target groups benefit the most.” To this end, the scientists compared the behavioral therapy intervention PROTECTtraining and the media education program PROTECTinfo – two interventions developed for the school setting that are identical in terms of duration and implementation effort but differ in content.

Gaming disorder and other problematic online habits – such as excessive use of social media – can lead to reduced mental and physical health among adolescents as well as serious impairments in important areas of life such as school, family, friendships, and leisure time. To determine how effective school-based interventions are in preventing online addictive behavior, the researchers conducted a four-year randomized study involving adolescents aged 11 to 18. As part of this, 1,793 students participated in a four-week intervention consisting of a total of four 90-minute sessions. Half of the adolescents completed the behavioral therapy program PROTECTtraining that, among other things, explained the vicious cycle of addiction and provided training in behavior change and emotion regulation. A second control group participated in the media education program PROTECTinfo covering topics such as media literacy, gaming, cyberbullying, and legal aspects.

As part of the prevention study, the research team assessed the participants’ online addiction behaviors and mental well-being at the beginning and end of the programs as well as after four and twelve months. The researchers conducted a separate analysis for adolescents who had been identified as having a comparatively high risk of addiction at the start of the study. The final survey, conducted one year after the programs began, revealed that among adolescents without a risk of addictive behavior – the majority of study participants – there was hardly any measurable effect on their symptoms. In contrast, for adolescents at high risk of addiction, both interventions proved effective; however, the behavioral therapy intervention was significantly more effective.

“In a direct comparison, the behavioral therapy program is 50 percent more effective against gaming disorder and other problematic online behaviors than the media education program,” stresses Prof. Lindenberg. According to the Heidelberg researcher, these results also underscore that targeted measures tailored to at-risk groups in the school setting achieve significantly better results and are more resource-efficient than prevention programs implemented on a broad scale.

The then Federal Ministry of Education and Research (BMBF) and the former Baden-Württemberg Ministry of Social Affairs and Integration funded the research. The results appear in the journal “JAMA Network Open”.