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

1 september 2026 bijgewerkt door: 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.

Studie Overzicht

Toestand

Voltooid

Conditie

Interventie / Behandeling

Studietype

Ingrijpend

Inschrijving (Werkelijk)

59

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

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

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Nee

Beschrijving

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

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Preventie
  • Toewijzing: Niet-gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: 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.
Gedragsmatig: 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.
Geen tussenkomst: 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).

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Internet Addiction Test Score
Tijdsspanne: 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)

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
General Self-Efficacy Scale Score
Tijdsspanne: 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)

Andere uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Satisfaction with Therapy and Therapist Scale-Revised Score
Tijdsspanne: 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
Tijdsspanne: 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)

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Tribhuvan University, Nepal

Onderzoekers

  • Studie directeur: Suraj Shakya, PhD, Tribhuvan University, Nepal

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

3 december 2024

Primaire voltooiing (Werkelijk)

5 augustus 2025

Studie voltooiing (Werkelijk)

5 augustus 2025

Studieregistratiedata

Eerst ingediend

27 augustus 2026

Eerst ingediend dat voldeed aan de QC-criteria

1 september 2026

Eerst geplaatst (Werkelijk)

8 september 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

8 september 2026

Laatste update ingediend die voldeed aan QC-criteria

1 september 2026

Laatst geverifieerd

1 september 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • TribhuvanU
  • TU-NPAR-079/80 EFRG-11 (Ander subsidie-/financieringsnummer: Tribhuvan University)
  • ERBTU-081-001 (Andere identificatie: Tribhuvan University Ethical Review Board)

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

ONBESLIST

Beschrijving IPD-plan

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.

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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