An app-based training for adolescents with problematic digital-media use and their parents (Res@t digital): protocol for a cluster-randomized clinical trial

BackgroundDigital media-use disorders (DMUD) in adolescents are a rising phenomenon associated with psychological distress, comorbid mental disorders, and high burden on affected families. Since the ICD-11 introduced criteria for gaming disorder, these can now be transferred to describe additional DMUD associated with social media platforms and streaming services. Most evidence for effective treatments comes from cognitive-behavioral therapy (CBT). However, interventions based on theoretical models for adolescents and their parents are widely missing, leading to a significant clinical gap.MethodsRes@t digital (Resource-Strengthening Training for Adolescents with Problematic Digital-Media Use and their Parents) is the app-based translation of the first model-based digital intervention for adolescents with DMUD and their parents based on CBT. It comprises separate but content-related modules for adolescents (Res@t–A) and parents (Res@t–P), applying multimodal techniques. The effectiveness of Res@t will be evaluated within a multicenter cluster-randomized controlled evaluator-blinded pre–post follow-up trial with the waitlist control group (CG). In addition to the Res@t program in the intervention group, both groups will receive treatment as usual within primary child and adolescent psychiatric/psychotherapeutic healthcare. The primary outcome addresses DMUD symptom reduction after 10 weeks. Secondary outcomes are related to a reduction in psychological and family-related problems and an increase in parental self-efficacy. All outcomes will be assessed using standardized self-report measures. A total of 1,334 participating adolescent–parent dyads from a large clinical network throughout Germany are planned to be included in the primary analyses based on an intention-to-treat approach, applying linear mixed models.DiscussionAssuming superiority of Res@t over the control condition, the intervention has the potential to provide evidence-based treatment for a significant number of help-seeking families, supporting local healthcare structures and resources. It is a promising program for practicable implementation and flexible use in different settings.Clinical trial registrationhttps://drks.de, DRKS00031043

Res@t: Resource-Strengthening Training for Adolescents with Problematic Digital-Media Use and their Parents

<jats:p> Abstract: Aims: Given rising prevalence of digital-media related disorders (DMRD, i. e. the problematic use of digital games, social media, and streaming platforms) in children and adolescents, the new therapy program Res@t (Resource strengthening program for adolescents with DMRD and their parents) aims to close a significant evidence-based treatment gap. It addresses affected adolescents and their parents in different settings. Methods: Res@t is a fully manualized CBT program based on current research results and clinical experiences. It was initially developed for adolescents with problematic gaming (Res@t-A) and their parents (Res@t-P) in a face-to-face group setting. A digital translation into a fully automated application (Res@t digital [Res@pp]) should allow support independently of available local therapy options or the use within blended therapy. Besides DMRD symptom reduction in adolescents through Res@t-A, Res@t-P shall increase parental self-efficacy. Pilot-study data of Res@t-P within a pre-post-follow-up design showed promising effects on a decrease of parental stress perception and an increase of family functioning, as well as on DMRD symptom reduction in affected adolescents. However, a missing control group and rather small sample size reduces interpretability. Res@t-A is currently being evaluated within a comparable design. Multi-center randomized controlled studies are planned to evaluate the effectiveness of all offline and digital program versions. Conclusion: Res@t is the first manualized treatment program focusing on adolescents with DMRD and their parents for different settings (group therapy, digital application). Effective treatments addressing both target groups are highly warranted. </jats:p&gt