Group Cognitive-Behavioral Intervention for Problematic Internet Use in Nepalese University Students
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.
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Tipo de estudio
Inscripción (Actual)
Fase
- No aplica
Contactos y Ubicaciones
Ubicaciones de estudio
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Kathmandu
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Kathmandu, Kathmandu, Nepal, 44600
- Central Department of Psychology, Tribhuvan University
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
- Adulto
- Adulto Mayor
Acepta Voluntarios Saludables
Descripción
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
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Prevención
- Asignación: No aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
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Experimental: 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.
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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.
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Sin intervención: 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).
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Internet Addiction Test Score
Periodo de tiempo: 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)
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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.
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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)
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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General Self-Efficacy Scale Score
Periodo de tiempo: 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)
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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.
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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)
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Otras medidas de resultado
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Satisfaction with Therapy and Therapist Scale-Revised Score
Periodo de tiempo: Weeks 1, 2, 3, 4, 5, and 6 (Immediately after each intervention session)
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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.
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Weeks 1, 2, 3, 4, 5, and 6 (Immediately after each intervention session)
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Session Attendance
Periodo de tiempo: Week 6, based on attendance during Weeks 1-6 (experimental arm only)
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Number of the six sessions attended, used as an indicator of participant adherence
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Week 6, based on attendance during Weeks 1-6 (experimental arm only)
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Director de estudio: Suraj Shakya, PhD, Tribhuvan University, Nepal
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- TribhuvanU
- TU-NPAR-079/80 EFRG-11 (Otro número de subvención/financiamiento: Tribhuvan University)
- ERBTU-081-001 (Otro identificador: Tribhuvan University Ethical Review Board)
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Descripción del plan IPD
Información sobre medicamentos y dispositivos, documentos del estudio
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