Clinical Case DiscussionsAdapting Dialectical Behavior Therapy for Treating Problematic Interactive Media UsePLUHAR, EMILY PhD; JHE, GRACE PhD; TSAPPIS, MICHAEL MD; BICKHAM, DAVID PhD; RICH, MICHAEL MD, MPH Author Information PLUHAR, JHE, TSAPPIS: Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, and Department of Psychiatry, Harvard Medical School, Boston, MA BICKHAM, RICH: Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, and Department of Pediatrics, Harvard Medical School, Boston, MA The authors declare no conflicts of interest. Please send correspondence to: Emily Pluhar, PhD, Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, 333 Longwood Avenue, Boston, MA 02115 (e-mail: [email protected]). Journal of Psychiatric Practice: January 2020 - Volume 26 - Issue 1 - p 63-70 doi: 10.1097/PRA.0000000000000439 Buy Metrics Abstract Over the past decade, clinicians have observed an increase in adolescents overusing interactive media, resulting in detrimental consequences such as disrupted sleep, inattention to academic tasks, and deterioration of social relationships. The recognition of problematic interactive media use (PIMU), the excessive and dysregulated use of interactive electronic media that affects mental and physical health, resulting in difficulty meeting developmentally appropriate functional capacity, has led to a call for therapeutic interventions. To date, there has been limited research on treatments for adolescents with PIMU. This article documents the therapeutic benefit of dialectical behavior therapy (DBT) adapted to treat PIMU and applied to a 15-year-old male individual with a history of dysregulated use of the Internet in the categories of gaming, pornography, information-bingeing, and social media. Outcomes were measured by diary cards, documenting the patient’s affective states, urges to engage in PIMU, the number of times he acted upon these urges, and collateral information provided by both parents and teachers from his school. Over the course of a 7-module DBT intervention covered during 14 sessions, the patient showed improvement in his targeted self-regulation behaviors of reducing nighttime screen use and decreasing frequency of pornography use. The patient showed academic improvement, as he was able to complete homework more effectively without being distracted by devices. We concluded that the application of this adapted DBT is potentially helpful in treating adolescents’ excessive and dysregulated use of interactive media and electronic devices, and that this treatment approach deserves further study. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.