Video Game Addiction Treatment Levels Up in the United States
I know what you’re thinking.
“Can video game addiction really be a thing?”
According to the Diagnostic Statistical Manual (DSM-V), the answer is clear: no.
To families around the world with loved ones who have lost control of their video gaming behavior, the answer is: yes, absolutely.
Although already popular in many other countries, treatment for video game addiction is pretty new to the United States. Most programs, which have no accreditation process, are less than 10 years old.
Proponents of the diagnosis argue that video games and other electronic media hijack the same reward systems as drugs of abuse, leading to the same type of disordered brain activity we see in people who suffer from Substance Abuse Disorder.
Detractors say that internet addiction is simply a byproduct of other mental health issues, such as depression and social anxiety. These skeptics claim that a diagnostic criteria for so-called “gaming disorder” is unnecessary and too costly for an already overburdened insurance system.
But what type of treatment is available for this so-called “disorder?” Who is most at risk for “gaming disorder” and what does the prognosis look like for those completing treatment for this controversial diagnosis?
Video Game Addiction Treatment Options in the United States
As programs (and medical recognition) for gaming addiction began to develop overseas, treatment providers state-side took notice.
The Illinois Institute For Addiction Recovery in Peoria, Illinois began outpatient treatment for video game addiction in 1997. The first outpatient center to focus on internet addiction, the Center for Internet and Technology Addiction, opened in West Hartford, Connecticut in 1998. CITA announced in October 2018 that they have plans to open a residential treatment center for gaming addiction soon. reStart, the first residential video gaming addiction treatment center in the United States, opened in the summer of 2009 in Fall City, Washington. Bradford Regional Medical Center launched the first hospital-based internet addiction treatment and recovery program in the United States in Bradford, Pennsylvania in September, 2013.
Since these centers first opened their doors, hundreds of other outpatient centers have followed suit.
Most At-Risk for Gaming Addiction: Young Men
While anyone with regular access to a video game console is technically at risk of destroying their lives with too much gaming, most self-described video game addiction treatment professionals agree that young men are by far the most common admits to treatment programs.
Despite inroads by women, popular gaming culture is still largely a young man’s domain. Some practitioners, like Hilarie Cash, Chief Clinical Officer at reSTART in Washington, speculate that many young men lack the same drive towards sociability that most young women seem to possess. She argues that this lack of face-to-face relationship building leads to young men relying on video games as social and emotional outlets. Others wonder if socialization and gender expectations play a large role in separating casual users from hard-core problem gamers. Whatever the reason, the fact remains that very few women seek treatment for the disorder.
That being said, there are still hefty numbers of addicts online. David Greenfield, PhD, a clinical psychologist in Connecticut, estimates that between 6-10% of internet users exhibit signs of addiction. This echoes surveys in the United States and Europe which pin the percentage of internet addicts between 1.5% and 8.2% of internet users. The pursuits of internet addicts are varied, of course, but chief among the problem activities is internet gaming, pornography, and gambling.
Inside the Typical Video Game Addiction Treatment Center
A typical treatment program in the United States is focused on treating young men in a nature or summer camp-like setting. “Wilderness therapy,” sometimes a facet of traditional substance abuse treatment, plays a large role in many programs, as does a strict no-screens policy.
Patients can expect to be phone-less - or reduced to flip-phone only status - for the duration of their stay.
Individual therapy, group counseling, chore obligations, and mandatory social activities make up the typical schedule for a patient’s day at a gaming disorder treatment center.
An Official Diagnosis?
While the medical establishment in many other countries already recognizes internet and video game addiction as a serious threat, the United States has yet to officially classify the disorder. The Diagnostic Statistical Manual (DSM-V) lists Internet Addiction as a possible condition in the back of the book, indicating that experts are still weighing the diagnosis for possible inclusion in future editions. Gaming disorder is not on that list.
In 2017, the National Institute of Health announced that it will fund studies into internet addiction and possible best practices for treatment of the condition. This is the first time the condition has received any major study in the United States, although it has been studied extensively in other countries where the condition is more broadly accepted. Experts speculate that this research phase is the first step towards getting the diagnosis recognized in the DSM-V.
Because the diagnosis is not currently recognized by the DSM-V, insurance companies are not required to pay for treatment of individuals suffering from the controversial disorder. Treatment can easily exceed $30,000 and families without the means to pay out-of-pocket are often left without options.
Looking to the Future of Gaming Addiction Treatment
If the condition was recognized by the DSM and given a diagnostic criteria acceptable to insurers, it’s likely we would see a huge boost in the number of treatment programs available for gaming addiction.
If the condition was finally accepted by insurance companies, I would also expect there to be increased standards and certifications for programs purporting to offer treatment for gaming addiction. These improvements would increase the quality and consistency of care for patients, as well as the overhead costs for existing treatment centers. Programs that pre-date the change would have an advantage over new-comers as parents and loved ones search for “tried and true” providers with a track record, but competition for patients would no doubt intensify as more centers enter the playing field.
In the end, we’ll have to wait and see what the National Institute of Health study finds before we can really speculate on the future of the video game addiction treatment industry in the US. Ultimately, my guess is that the disorder will eventually become accepted, as it has in other countries, and video game addiction will join its place with other behavioral addictions in the mental health field. Until then, as with so many other conditions not recognized by most insurers, people suffering from the condition will have to either fork out the big bucks to get help or forgo treatment altogether.
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