You are on page 1of 15

Siti Inarah bt Hashim

G1515658

CONSULTANCY PROPOSAL

PROBLEM : INTERNET ADDICTION


Identification of Needs and Problems
• A 14 year old Malay boy from middle class family was brought by his
parents to hospital for refusal to go out of his room for about 4
months due to excessive online or internet preoccupation in which
later, he is being referred by the psychiatric department for
psychological intervention.
• Usamah ibn Shuraik narrated:
“… ‘O Allah’s Messenger! Should we seek medical treatment for our
illnesses?’ He replied: ‘Yes, you should seek medical treatment,
because Allah, the Exalted, has let no disease exist without providing
for its cure, except for one ailment, namely, old age’.”
(Tirmidhi)
Analysis of Needs and Problems
Effective, reliable methods of clinical psychological assessment would
involve multidisciplinary approaches and the need of data triangulation
from multiple sources (Butcher, Hooley & Mineka, 2014)
As such, the methods to identify the problem in this case are:
1)Clinical history taking
2)Interview with parents or other family members
3)Interview and investigate school performance, behavior, disciplinary
and attendance record
4)Other past medical history or hospital admission
5)Data, laboratory results or physical examination from medical team
Analysis of Needs and Problems - Diagnosis
• On clinical interview and assessment, the client show sign of irritability, agitated, look anxious and
refuse to answer the questions.
• During the interview with the parents, it was found that the client exchanged no more than daily
5 sentences with his parents (mostly for sustenance which was coerced) and refused to have
other forms of interaction. He mentioned that his virtual friends understand him better and
appear did not want to be socializing on the real world. On several attempts to pull him away
from his laptop, the client had demonstrated low mood symptoms (sad, depressed), anxiety and
irritability.
• On further questioning, it was found that the majority of time online was spent on online gaming
and social networking and the hours spent were up to 120 hours per week (17 hours daily).
• School record shows a marked declined in academic performance and prolonged on and off
absenteeism since 6 months ago in which the client is on the verge of being expelled by the
school administrator.
• Examination and history from medical team indicated significant weight loss with signs of
malnutrition and lack of sleep.
• Anxiolytic/antidepressant medication (SSRI) was administered (prior to psychology clinic referral)
and the client begin to calm down and show rationality afterwards.
Analysis of Needs and Problems - Diagnosis
• To establish the diagnosis, the adapted version of The Internet Addiction Diagnostic
Questionnaire (IADQ) (Young, 1998) was administered.
• IADQ is a highly valid and reliable assessment tool to diagnose Internet Addiction Disorder (IAD)
(Guan et. Al., 2012)and was first developed by Kimberly Young (1998).
• The diagnosis is confirmed as the client’s assessment met 5 out of 8 criteria.

• Addiction is not a strange concept from Islamic point of view as had been reflected in the story of
Al-Nuayman ibn Amr (one of the Prophet’s companion) who is known to have issues with alcohol
addiction. He was flogged twice for his misconducts and some of other companion almost gave
up on him, but the Prophet quickly intervened by saying:
“No, no, don’t do (such a thing). Indeed he loves God and His Apostle. The major sin (as this) does not put one
outside the community and the mercy of God is close to the believers.”
• The Prophet exercised patience and did not exclude him from society in the hope that he will be
able to reach the right path (leaved the alcohol consumption).
Formulation of Solution
• Cognitive behavioral therapy (CBT) therapy combined with pharmaceutical treatment has
the best outcome in treating the IAD (Pontes, Kuss & Griffiths, 2015)
• In this case, cognitive behavioral therapy for internet addiction (CBT-IA) (please refer to
Young, 2011 for details) is proposed to be used in the psychological intervention for the
client.
• CBT-IA consists of 3 phases:

1. Behavior Modification phase to control the compulsive internet use by gradually


decreasing the amount of time online

2. Cognitive Restructuring to identify, challenge, and modify cognitive distortions that lead
to addictive use (to combat the rationalizations that justify excessive online use)

3. Harm Reduction Therapy to address and treat co-morbid issues (include personal,
situational, social, psychiatric, or occupational) associated with the disorder for continued
recovery and relapse prevention
Formulation of Solution
CBT is a treatment involving revision the pathological pattern of
thought in order to change one’s feeling, thus the behavior as
well(Young, 2011)

Erroneous thought could be due to persuasion from the devil

Satan has made their deeds seem pleasing in their eyes. (an-Naml, 24)
Implementation of Solution
Behavioral Modification
• The client will be asked to fill in his daily internet log to evaluate computer behavior and to
establish a baseline for treatment.
Date and Time Event Online Duration Outcome

• Duration of the online activity, emotional state prior, during and after the activity, any triggering
factor will also be noted.
• Next the client will be ask to remove all evidence of problematic online behavior: gaming, social
networking bookmarks, to set alarm or timer to limit the online usage and exercise self control to
gradually decrease the use of online gaming and social networking

O you who have believed, decreed upon you is fasting as it was decreed upon those before you that
you may become righteous – (Al-Baqarah, 183)
Implementation of Solution
Cognitive Restructuring
• The client reported that he felt more respected when he is able to achieve up to certain level
during online gaming and his online friend valued him more as compared to non-virtual friends
• To address this, will undergo 12 weekly psychotherapy sessions in which this erroneous thought
will be challenge and change
• In order to change this pattern, the client will need to be convinced that online world is not the
only place in which he can be respected or valued. School and non-virtual friends are also
platforms to build self-esteem.
• When he is able to see the error in his way (acknowledging the online addiction), the more the
client will be able to challenge his erroneous thought independent of therapy.

• Verses in the Quran:


It is You we worship and You we ask for help. Guide us to the straight path (Al-Fatihah 1.5-1.6)
Implementation of Solution
Harm Reduction Therapy (HRT)
• To address other co-existing factors (self-esteem)
• Involve multiple parties: parents, school, medical team
• Parents may guide and encourage healthy behavior, socialization with the right kind of friends
• School and teachers involvement maybe needed in order to improve the client’s academic
performance

• “O Messenger of Allah, tell me something about Islam which I could not ask anyone about save
you.” He answered: “Say: ‘I believe in Allah’, and then stand firm and steadfast.” (Muslim)
Considerations
• Practical:
The goal of CBT-IA is not a total abstinence of online use since computer and
internet has become such as salient part of our daily life. The focus is on the
unhealthy component which cause pathological behavior
Parents need to constantly monitor their child for daily log input and
appropriate motivation for the treatment progress to occur

• Ethical: This intervention need to be consented by the parents since the


client is a underage

• Cost: 12 weekly psychotherapy and next follow-ups fees, transportation


and other associated team intervention (medical)
Evaluation of Outcomes
• IADQ will be re-administered during the follow ups (after 1,3 and 6
months)
• Apart from psychological assessment, evaluation will also be made on
physical health, academic performance, social and family relationship
• Should there be reduction the number of criteria being met in AIDQ
and improvement in social relation, academic performances,
psychological and physical appraisal, it can be concluded that this
intervention is successful in treating the IAD of this client.
Limitations

• Does not address the spiritual part of the client (focusing on


cognitive, affective and behavioral aspects only)
• Time (12 weeks therapy with follow up) needed – client may not be
able to comply and relapse is possible as the consequence
• Client may benefit from support group as well (Young, 2011)
• Suggestions: Suggest any religious experts or center in managing
addiction from spiritual or religious point of view, follow up or remind
the client on appointment should he miss and consider the client’s
participation in group therapy if need arise or better outcomes are
expected.
Synthesis

• Parents plays major role in raising and educating their children.


Teachers and school may help academically, clinician may offer
treatment program, but still it is still the parents who may determine
the course or path lead by their child.
Abu Huraira reported Allah's Messenger PBUH as saying “No child is
born but upon Fitra. He then said. Recite: The nature made by Allah in
which He created man, there is no altering of Allah's nature; that is the
right religion."
THANK YOU

You might also like