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Group Cognitive-Behavioral Intervention for Problematic Internet Use in Nepalese University Students

1. september 2026 opdateret af: Suraj Shakya, Tribhuvan University, Nepal

Effectiveness of a Group Cognitive-Behavioral Intervention for Problematic Internet Use Among Undergraduate Students in Nepal: A Quasi-Experimental Trial

Problematic internet use, using the internet in ways that interfere with daily life, is a growing concern among university students in Nepal, where studies report prevalence rates between 21.5% and 35.4%. Despite this, structured, evidence-based intervention trials in Nepalese academic settings remain scarce.

This study tested a six-session group program based on cognitive-behavioral therapy, which helps people change unhelpful behaviors around internet use. Sessions lasted 90 minutes and were delivered weekly by supervised Master's-level psychology students who completed 40 hours of CBT training, which the makes the program affordable and scalable for university settings.

Fifty-nine undergraduate students took part: 30 received the group program and 29 formed the comparison group. Both groups completed the Internet Addiction Test and the General Self-Efficacy Scale at five time points: before the program, immediately after, and at 2 weeks, 1 month, and 3 months later.

Students in the program showed significantly greater reductions in internet addiction symptoms than the comparison group immediately after the program (p = .049) and at 1 month, where a large effect was observed (d = -0.83, p = .003). At 3 months, the difference between groups was no longer statistically significant because the comparison group also continued to improve; however, the program group maintained a large reduction from baseline (d = 1.18). Students in the program also showed a significant increase in self-efficacy that remained stable through every follow-up (all p < .032). Adherence and acceptability were high: participants attended an average of 5.06 of 6 sessions, 80% attended at least 5 sessions, and satisfaction with the therapy reached 78.3% of the maximum possible score.

These findings suggest that a structured, group-based CBT program is an effective and acceptable approach for managing problematic internet use among Nepalese undergraduates and offers a potentially scalable framework for academic institutions in low-resource settings.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

59

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Nepal
    • Kathmandu
      • Kathmandu, Kathmandu, Nepal, 44600
        • Central Department of Psychology, Tribhuvan University

Deltagelseskriterier

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Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Undergraduate students enrolled at colleges affiliated with Tribhuvan University, Kathmandu, Nepal
  • Internet Addiction Test score above 30 (mild, moderate, or severe categories of problematic internet use) at Phase 1 screening
  • Willing to provide informed consent and to attend scheduled group sessions

Exclusion Criteria:

  • IAT score of 30 or below at Phase 1 screening (did not meet inclusion criteria)
  • Declined to participate / unwilling to provide informed consent
  • Withdrawal before the first intervention session

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Ikke-randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Experimental
Participants received the six-session group cognitive-behavioral intervention for problematic internet use, delivered weekly in 90-minute group sessions. Delivered across three cohorts: Cohort 1 (single college: n = 8), Cohort 2 (single college: n = 12), and Cohort 3 (mixed colleges: n = 10). Assessed at baseline, immediately post-intervention, 2 weeks, 1 month, and 3 months.
Adfærdsmæssigt: Group Cognitive-Behavioral Intervention for Problematic Internet Use
A six-session manualized group program for problematic internet use among Nepalese undergraduates delivered weekly in 90-minute sessions. Grounded in cognitive-behavioral therapy, Young's CBT-IA model, and Davis's cognitive-behavioral model of pathological internet use. Sessions 1-2: orientation, psychoeducation, behavioral monitoring, and planning healthier internet habits (behavior modification). Session 3: cognitive restructuring. Sessions 4-5: harm reduction and emotional/psychological drivers of addiction. Session 6: relapse prevention and consolidation. Culturally adapted for Nepalese youth through multidisciplinary expert review (clinical psychologists, psychiatry, Ayurveda/Yoga, clinical psychology residents). Facilitated by two Master's-level psychology trainees after 40 hours of supervised CBT training by the project lead, with weekly supervision and a structured manual for fidelity.
Ingen indgriben: Control
Participants received no intervention during the trial period. Assessed on the same schedule as the experimental group: baseline, immediately post-intervention, 2 weeks, 1 month, and 3 months. Delivered across the same three cohorts (Cohort 1: n = 8; Cohort 2: n = 11; Cohort 3: n = 10).

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Internet Addiction Test Score
Tidsramme: Baseline (pre-intervention), Week 6 (post-intervention), Week 8 (2-week follow-up), Week 10 (1-month follow-up), and Week 18 (3-month follow-up)
20-item Internet Addiction Test evaluating the severity of problematic internet use on a 0-5 Likert scale (Young, 1998); higher scores indicate more severe problematic internet use. In this study, scores ≥ 31 defined "mild" to "severe" problematic use.
Baseline (pre-intervention), Week 6 (post-intervention), Week 8 (2-week follow-up), Week 10 (1-month follow-up), and Week 18 (3-month follow-up)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
General Self-Efficacy Scale Score
Tidsramme: Baseline (pre-intervention), Week 6 (post-intervention), Week 8 (2-week follow-up), Week 10 (1-month follow-up), and Week 18 (3-month follow-up)
10-item Nepali version of the General Self-Efficacy Scale assessing broad optimistic self-beliefs regarding general coping ability (Schwarzer et al., 1997); higher scores indicate greater general self-efficacy. Change from baseline was the analysis metric.
Baseline (pre-intervention), Week 6 (post-intervention), Week 8 (2-week follow-up), Week 10 (1-month follow-up), and Week 18 (3-month follow-up)

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Satisfaction with Therapy and Therapist Scale-Revised Score
Tidsramme: Weeks 1, 2, 3, 4, 5, and 6 (Immediately after each intervention session)
13-item STTS-R (Oei & Green, 2008), administered online to the experimental group after each session with anonymity maintained from facilitators; higher scores indicate greater satisfaction with the therapy and the therapist. Analyzed using the Percentage of Maximum Possible method.
Weeks 1, 2, 3, 4, 5, and 6 (Immediately after each intervention session)
Session Attendance
Tidsramme: Week 6, based on attendance during Weeks 1-6 (experimental arm only)
Number of the six sessions attended, used as an indicator of participant adherence
Week 6, based on attendance during Weeks 1-6 (experimental arm only)

Samarbejdspartnere og efterforskere

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Sponsor

Tribhuvan University, Nepal

Efterforskere

  • Studieleder: Suraj Shakya, PhD, Tribhuvan University, Nepal

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

3. december 2024

Primær færdiggørelse (Faktiske)

5. august 2025

Studieafslutning (Faktiske)

5. august 2025

Datoer for studieregistrering

Først indsendt

27. august 2026

Først indsendt, der opfyldte QC-kriterier

1. september 2026

Først opslået (Faktiske)

8. september 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

8. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

1. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • TribhuvanU
  • TU-NPAR-079/80 EFRG-11 (Andet bevillings-/finansieringsnummer: Tribhuvan University)
  • ERBTU-081-001 (Anden identifikator: Tribhuvan University Ethical Review Board)

Plan for individuelle deltagerdata (IPD)

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UBESLUTET

IPD-planbeskrivelse

De-identified individual participant data and the study protocol will be shared upon reasonable request to the corresponding author, subject to approval by the Ethical Review Board of Tribhuvan University.

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