How to treat Social Media Addiction.

How is social media addiction diagnosed 

An obsession with usage, experiencing discomfort when not using, an increasing need for more usage, repeated unsuccessful efforts to cut down or stop, persisting use despite acknowledging its problems, misleading others about the extent of usage, using as a means to evade or alleviate negative emotions, sacrificing other activities, and risking or harming relationships or career due to excessive use. 

Differences between ICD-11 and DSM-5 

ICD-11: It categorizes disorders related to addictive behaviors, including gaming disorders, under a new section. Social media addiction, per se, isn't explicitly classified, but the criteria for gaming disorder might be applied to similar internet-use related disorders. 

DSM-5: It doesn't officially recognize social media addiction as a distinct disorder. However, it includes Internet Gaming Disorder in its section of conditions requiring further research. This suggests an acknowledgment of problematic internet use but doesn't extend specifically to social media addiction. 

Popular diagnosing scales 

As an alternative to the SOMEDIS-A (Social Media Disorder Scale for Adolescents), there are several other scales and measures developed to assess problematic social media use or internet addiction, especially in adolescents. Some of these include: 

 Social Media Disorder Scale for Adolescents (SOMEDIS-A): Designed to assess social media use disorder in adolescents. It's based on the criteria outlined in the ICD-11 for gaming disorders. The scale helps in identifying problematic social media use, which could be associated with psychological stress and other psychiatric disorders like depression.  

Bergen Social Media Addiction Scale (BSMAS): A widely used scale to assess the degree of social media addiction based on criteria like salience, mood modification, tolerance, withdrawal, conflict, and relapse.  

Social Media Addiction Scale (SMAS): Developed to measure addiction specifically to social media platforms, considering various aspects of usage and its impact. 

 Internet Addiction Test (IAT): A more general test for internet addiction, which can be applied to various online activities, including social media use. 

 Problematic Internet Use Questionnaire (PIUQ): This questionnaire assesses internet use that is problematic or potentially addictive in nature. 

Compulsive Internet Use Scale (CIUS): A measure that focuses on compulsive tendencies related to internet use, which can include social media. 

Online Cognition Scale (OCS): A scale that assesses behaviors and attitudes associated with problematic internet use. 

Treatment modalities 

Cognitive-Behavioral Therapy (CBT): Helps in identifying and changing negative thought patterns and behaviors associated with social media use. 

Mindfulness-Based Interventions: Focus on increasing awareness and mindfulness to reduce compulsive social media usage. 

Family Therapy: Especially useful for adolescents, involving family members to support changes in social media habits. 

Group Therapy: Provides peer support and helps in learning from others facing similar challenges. 

Motivational Interviewing: Helps in building motivation and commitment to change problematic social media use behaviors. 

Digital Detox and Lifestyle Changes: Encourages periods without digital devices and promotes engaging in alternative activities.  

Sample treatment plan 

Behavioral definitions: 

Consistently engages in social media use, which causes distress and/or dysfunction in occupational, relationships, social, or recreational areas of life. 

Unable to stop using social media or reduce the time spent browsing content or posting on social media. 

Presents with physical, emotional, or mental health conditions as a result of excessive or problematic social media use. 

Denies excessive social media use or its consequences on health, functioning, and relationships despite having received feedback or other strong evidence of the negative affect on self or others arising from social media use. 

Continues problematic social media use in spite of experiencing persistent physical, emotional, mental health, legal, financial, occupational, relationship or social problems directly caused by social media use. 

Spending more and more time creating and posting, consuming, or commenting on social media content to achieve the desired effect. 

Irritability, anxiety, depression, psychosomatic, or fictitious disorder symptoms when not using social media for any length of time. 

Neglects occupational, social, recreational, or ADL activities while using social media. 

Spends excessive resources, including money, time, and effort to access create, post, consume, and respond to social media posts. 

Is obsessed with the number of received likes, comments, and follows from other social media users and suffers distress when the numbers decline or stop growing. 

Continues excessive social media use despite the knowledge of the danger it is causing. 

Long-term goals: 

Accept the powerlessness and unmanageability over the problematic social media use and enter a recovery-based program. 

Establish a sustained recovery free from social media use. 

Achieve and maintain total abstinence from all social media, while increasing knowledge of the disease and its consequences. 

Improve the quality of life and restore full functioning in the occupational, relationships, social, and recreational realms while maintaining abstinent from social media. 

Participate in therapy and attend social support groups to help maintain obstinance and prevent a relapse with social media. 

Interventions: 

Establish rapport with the client toward building a strong therapeutic alliance; convey caring, support, warmth, and empathy; provide nonjudgmental support and develop a level of trust with the client toward him/her/their feeling safe to discuss his/her/their social media use and its impact on his/her/their life. 

Gather a complete social media use history from the client, including the length and pattern of his/her/their use, signs and symptoms of use, and negative life consequences (e.g. social, legal, familial, and vocational problems). 

Assess the client's level of insight (syntonic versus dystonic) toward the presenting problems (e.g. demonstrates good insight into the problematic nature of the described behavior, agrees with others' concern, and is motivated to work on change; demonstrates ambivalence regarding the problem described and is reluctant to address the issue as a concern; or demonstrates resistance regarding acknowledgment of the problem described, is not concerned, and has no motivation to change). 

Ask the client to make a list of the ways social media use has had a negative impact on his/her/their life (e.g. personally, medically, relationally, legally, vocationally, and socially) and the positive impact nonuse may have. 

Assign the client to write a list of reasons to be abstinent from addiction to social media. 

Discuss the negative effects the client's social media use has had on family, friends, and work relationships and encourage a plan to make amends for such hurt. 

Assess the client's intellectual, personality, and cognitive vulnerabilities, family history, and life stresses that contribute to his/her/their social media use-related disorder. 

Explore the client's high-risk self-talk and beliefs that weaken his/her/their resolve to remain abstinent; challenge the biases assist him/her/them in generating realistic self-talk that corrects for the biases and builds resilience. 

Use instruction, modeling, imaginal rehearsal, role-play, and cognitive restructuring to teach the client cognitive-behavioral skills (e.g. relaxation, problem solving, social and communication skills, recognition and management of rationalization, denial, and apparently irrelevant decisions) for managing urges and other high-risk situations. 

Assist the client in developing a detailed, written recovery plan (e.g. treatment activities, daily routine, basic self-care, relationships, spirituality, work stress, finances, family issues, etc.) that will identify supports and strategies that will be used in maintaining sobriety. 

Develop and implement a personalized relapse prevention plan that addresses the client’s risk factors with specific actions to take if risk factors are detected in order to prevent relapse. 

Develop an appropriate aftercare plan, including addressing any deficiencies in occupational, relationships, social, self-care, and recreational functioning.  

Encourage the client to build or join a social support network to promote sustained abstinence from social media use. 

Sample diagnostic questions for an adolescent or a young adult client 

1. I often use social media more frequently and longer than I planned to or agreed upon with my family. 

I often cannot stop using social media even though it would be sensible to do so or for example my parents have told me to stop. 

I often do not pursue interests outside the digital world (e.g., meeting friends or partner in real life, attending sports club/societies, reading books, making music) because I prefer using social media. 

I neglect daily duties (e.g., grocery shopping, cleaning, tidying up after myself, tidying my room, obligations for school/apprenticeship/job) because I prefer using social media. 

I often continue using social media even though it causes me stress with others (e.g., my parents, siblings, friends, partner, teachers) 

I continue using social media although it harms my performance at school/apprenticeship/job (e.g., by being late, not participating in class, neglecting homework, worse grades). 

Due to my social media use, I neglect my appearance, my personal hygiene, and/or my health (e.g., sleep, nutrition, exercise). 

Due to my social media use, I risk losing important relationships (friends, family, partner) or have lost them already. 

Due to my social media use, I have disadvantages at school/apprenticeship/job (bad grades, inability to continue to the next grade/no graduation, no apprenticeship or university spot, poor reference, warning/dismissal). 

How often did you experience such problems, conflicts, or difficulties due to social media use during the past year? Did this only occur on single days, during longer periods of several days to weeks or months, or was it almost daily?