In-session gaming as a tool in treating adolescent problematic gaming.

For some adolescent gamers, playing online games may become problematic, impairing functioning in personal, family, and other life domains. Parental and family factors are known to influence the odds that adolescents may develop problematic gaming (PG), negative parenting and conflictual family dynamics increasing the risk, whereas positive parenting and developmentally supportive family dynamics protecting against PG. This suggests that a treatment for adolescent PG should not only address the gaming behaviors and personal characteristics of the youth, but also the parental and family domains. An established research-supported treatment meeting these requirements is multidimensional family therapy (MDFT), which we adapted for use as adolescent PG treatment. We report here on one adaptation, applying in-session gaming. In-session demonstration of the "problem behavior" is feasible and informative in PG. In the opening stage of therapy, we use in-session gaming to establish an alliance between the therapist and the youth. By inviting them to play games, the therapist demonstrates that they are taken seriously, thus boosting treatment motivation. Later in treatment, gaming is introduced in family sessions, offering useful opportunities to intervene in family members' perspectives and interactional patterns revealed in vivo as the youth plays the game. These sessions can trigger strong emotions and reactions from the parents and youth and give rise to maladaptive transactions between the family members, thus offering ways to facilitate new discussions and experiences of each other. The insights gained from the game demonstration sessions aid the therapeutic process, more so than mere discussion about gaming.

Response to the Regulation of Video Games under the Youth Media Protection Act: A Public Health Perspective.

The Swiss Youth and Media Act, which is about to enter into force, is an attempt to provide a legislative framework for video game use. Among other inclusions, the law intends to make providers more accountable by taking measures to protect minors from harm that can be caused by improper use of video games. However, it is a challenge to create a legal framework that can adequately regulate the evolving features of video games. Legislators must find a suitable regulatory approach which takes into account the fact that there is an increasing convergence between video games and gambling, particularly with the introduction of loot boxes. Moreover, there is a need for regulation, including the prohibition of misleading designs, the introduction of additional protection for minors, and the assurance of transparency of transactions. Appropriate policy legislation and consumer-protection measures are needed to protect people using these types of products, particularly children and adolescents. Further work should focus on assessing game characteristics to refine regulatory models to promote safe gaming. Based on experiences from the field of psychoactive substances as well as that of gambling, it is now a matter of developing a matrix of harm with elaborated categories: a tool that makes it possible to evaluate the potential harms of certain game design in an evidence-based manner.

[Practical approach of media use in consultation with adolescents]. / Approche pratique des écrans en consultation avec les adolescents.

Digital media are central in our modern society and, as such, have an impact not only on teenagers but on most of us. Adolescents are among the most observed and stigmatized in terms of screens use. The encounter between the crucial developmental phase they cross and the neurobiological changes in their brains can be relatively «â€…noisy ¼. Because of the pervasive nature of screens in our daily lives and the potential effect on adolescent health, it is essential for health professionals to offer a systematic assessment of media use when consulting with an adolescent. This article provides practical tools for screening the use of media in consultation with the -adolescent and illustrates with a clinical story what lies behind the screens.

Les écrans occupent une place centrale dans la société et ont un impact non seulement sur les adolescents mais sur la plupart d'entre nous. Les adolescents figurent toutefois parmi les plus observés et montrés du doigt en termes d'utilisation d'écrans. La résonnance entre les modifications neurobiologiques de leur cerveau durant cette période de vie et l'utilisation d'écrans peut se manifester de façon relativement «â€…bruyante ¼. Étant donné le caractère ­omniprésent de ces derniers dans notre vie quotidienne et du potentiel effet sur la santé des jeunes, il est indispensable pour les professionnels de la santé d'intégrer l'évaluation ­systématique de l'utilisation des écrans en consultation avec un adolescent. Cet article propose des outils pratiques pour en ­investiguer l'usage et illustre au moyen d'une histoire clinique ce qui se cache derrière les écrans.