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

1 september 2026 uppdaterad av: 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.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Studietyp

Interventionell

Inskrivning (Faktisk)

59

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Icke-randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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.
Beteende: 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.
Inget ingripande: 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).

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Internet Addiction Test Score
Tidsram: 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)

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
General Self-Efficacy Scale Score
Tidsram: 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)

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Satisfaction with Therapy and Therapist Scale-Revised Score
Tidsram: 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
Tidsram: 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)

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Tribhuvan University, Nepal

Utredare

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

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

3 december 2024

Primärt slutförande (Faktisk)

5 augusti 2025

Avslutad studie (Faktisk)

5 augusti 2025

Studieregistreringsdatum

Först inskickad

27 augusti 2026

Först inskickad som uppfyllde QC-kriterierna

1 september 2026

Första postat (Faktisk)

8 september 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

8 september 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

1 september 2026

Senast verifierad

1 september 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • TribhuvanU
  • TU-NPAR-079/80 EFRG-11 (Annat bidrag/finansieringsnummer: Tribhuvan University)
  • ERBTU-081-001 (Annan identifierare: Tribhuvan University Ethical Review Board)

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

OBESLUTSAM

IPD-planbeskrivning

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.

Läkemedels- och apparatinformation, studiedokument

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