Course Description

Internet-connected technologies have become deeply integrated into work, education, relationships, recreation, and daily life, creating new challenges for behavioral health professionals attempting to distinguish normal digital engagement from clinically problematic behavior. This course examines current definitions and diagnostic controversies surrounding PIU, problematic smartphone and social media use, gaming, and other internet-related behaviors. Participants will explore reinforcement processes, the Interaction of Person-Affect-Cognition-Execution (I-PACE) model, emotion regulation, experiential avoidance, executive functioning, and other mechanisms that may contribute to persistent digital behavior. Particular attention is given to distinguishing high engagement from diminished behavioral control and clinically meaningful functional impairment.

Participants will learn practical approaches to screening, functional assessment, differential diagnosis, and case conceptualization while considering commonly associated concerns such as depression, anxiety, ADHD, loneliness, sleep disturbance, and family conflict. Evidence-informed treatment strategies include cognitive behavioral therapy, motivational interviewing, ACT- and DBT-informed interventions, behavioral activation, environmental restructuring, digital hygiene, family interventions, and relapse prevention. This is a NBCC and Florida Board Approved course for 3 CE hours.

Please review the course materials prior to purchasing the course. Often, individuals will print a copy of the course worksheet to complete while they review the course material. Once you are ready to complete the course, please enroll in the course and complete the course requirements, including the course post-test and course survey. You will receive your certificate automatically for printing or downloading after achieving an 80% or higher on the post-test and completing the course survey. 

Always Connected- Understanding and Treating Problematic Internet Use in Clinical Practice Course Text.pdf

Always Connected-Understanding and Treating Problematic Internet Use Course Worksheet.pdf

Course Author:  Bryan Glazier, PhD, LMFT, LMHC, FL Qualified MHC/MFT Supervisor 

Course Time/Location: 3 CE Hours, Location: www.directceu.com (web-based, asynchronous/home study) 

Course Text:   Always Connected: Understanding and Treating Problematic Internet Use, Bryan Glazier, PhD, LMFT, LMHC

Course Board Approval Statement(s): NBCC, Florida Board Approved

Directceu, llc has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7411. directceu, llc maintains responsibility for this program and its content.

directceu, llc (BAP # 50-17578) is approved by the Florida Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health Counseling. directceu, llc maintains responsibility for this program and its content.

 Financial Disclosure Statement

directceu, llc is committed to providing our professional colleagues with unbiased information. directceu does not accept commercial support and our course authors have no significant financial interests or other conflicts of interest pertaining to the material.

Learning Objectives:

Through the completion of this course, participants will be able to:

    1. Differentiate high digital engagement from problematic internet use by evaluating diminished behavioral control, functional impairment, psychological function, and consequences. 
    2. Describe major theoretical mechanisms associated with PIU, including reinforcement, cue reactivity, emotion regulation, cognitive expectancies, executive functioning, and the I-PACE model. 
    3. Identify common clinical presentations and psychiatric conditions associated with problematic digital behavior, including depression, anxiety, ADHD, loneliness, and sleep disturbance. 
    4. Apply evidence-informed screening, functional assessment, and differential-diagnostic strategies when evaluating problematic internet, smartphone, social media, and gaming behaviors. 
    5. Develop an individualized PIU case conceptualization incorporating triggers, cognitive and emotional processes, reinforcement, environmental factors, comorbid conditions, and protective functions of digital behavior. 
    6. Implement evidence-informed interventions including CBT, motivational interviewing, ACT- and DBT-informed strategies, behavioral activation, environmental restructuring, digital-hygiene strategies, and family-based approaches. 
    7. Construct individualized digital self-regulation and relapse-prevention plans that address environmental cues, alternative reinforcement, sleep, behavioral boundaries, and recurrence risk.
    8. Evaluate cultural, developmental, neurodiversity, privacy, telehealth, and ethical considerations when assessing and treating PIU in accordance with relevant professional ethical standards.

 

Course Syllabus:

I.  

Introduction to Problematic Internet Use

  • The role of digital technology in contemporary life 
  • Defining problematic internet use 
  • High engagement versus problematic behavior 
  • Clinical significance and functional impairment 
  • Moving beyond screen time 

II. Definitions, Classification, and Diagnostic Issues

  • Internet addiction versus problematic internet use 
  • Generalized versus specific problematic behaviors 
  • Gaming and other digital behaviors 
  • DSM and ICD considerations 
  • Diagnostic controversy and clinical implications 

III. Reinforcement and Neurobehavioral Mechanisms

  • Reward and reinforcement 
  • Positive and negative reinforcement 
  • Cue reactivity and craving 
  • Inhibitory control 
  • Habit formation 
  • The I-PACE model 

IV. Psychological Maintaining Mechanisms

  • Emotion regulation 
  • Experiential avoidance 
  • Boredom and stimulation seeking 
  • Fear of missing out 
  • Social comparison 
  • Cognitive expectancies 
  • Escapism and coping 

V. Clinical Presentation and Comorbidity

  • Depression 
  • Anxiety and social anxiety 
  • ADHD and executive-functioning difficulties 
  • Loneliness and social isolation 
  • Sleep disturbance 
  • Bidirectional relationships with PIU 

VI. Assessment and Screening

  • Clinical interviewing 
  • Assessing control and impairment 
  • CIUS and Short CIUS 
  • Internet Addiction Test 
  • GPIUS-2 
  • Problematic Internet Use Questionnaire 
  • Strengths and limitations of screening measures 

VII. Functional Assessment and Case Conceptualization

  • Identifying the specific digital behavior 
  • Antecedents and triggers 
  • Psychological functions 
  • Reinforcement cycles 
  • Environmental influences 
  • Protective functions of technology 
  • Integrated PIU formulation 

VIII. Evidence-Informed Treatment

  • Current treatment evidence 
  • Cognitive behavioral therapy 
  • Motivational interviewing 
  • ACT-informed intervention 
  • DBT-informed skills 
  • Behavioral activation 
  • Matching treatment to maintaining mechanisms 

IX. Digital Hygiene and Behavioral Prescriptions

  • Stimulus control 
  • Notification management 
  • Increasing behavioral friction 
  • Device-free environments 
  • Scheduled digital use 
  • Sleep protection 
  • Intentional versus automatic use 

X. Reducing Digital Exposure

  • Reduction versus abstinence 
  • Digital detox evidence 
  • Behavioral experiments 
  • Smartphone reduction strategies 
  • Risks of overly restrictive approaches 
  • Building sustainable self-regulation 

XI. Maintenance and Relapse Prevention

  • Identifying high-risk situations 
  • Early warning signs 
  • Lapse versus relapse 
  • Rapid recovery planning 
  • Alternative reinforcement 
  • Maintaining behavioral change 

XII. Special Populations and Clinical Contexts

  • Children and adolescents 
  • College students and young adults 
  • ADHD and executive functioning 
  • Neurodivergent clients 
  • Family and relational factors 
  • Developmentally responsive treatment 

XIII. Cultural, Ethical, and Professional Considerations

  • Avoiding overpathologizing 
  • Professional competence 
  • Informed consent and autonomy 
  • Privacy and digital monitoring 
  • Social media and professional boundaries 
  • Telehealth 
  • Cultural and socioeconomic considerations 
  • APA, ACA, NASW, AAMFT, and NBCC ethical standards 

XIV. Integrated Clinical Case Studies

  • Depression and avoidant gaming 
  • ADHD and problematic smartphone use 
  • Adolescent gaming and family conflict 
  • Differential diagnosis 
  • Functional case formulation 
  • Treatment planning and outcome measurement 

XV. Conclusion and Clinical Integration

  • Six-step clinical framework 
  • Mechanism-based intervention 
  • Building a life that competes with digital reinforcement 
  • Functional definitions of treatment success 
  • Ten clinical principles for PIU treatment
  • Supporting intentional and flexible technology use