3 - (OP19) Feasibility and Effectiveness of Group-based IMPROVE Therapy for Problematic Internet Use in University Students: A Single-arm Pilot Study

Background: Problematic Internet Use (PIU) has emerged as a pervasive mental health concern, affecting approximately 40% of university students and causing significant academic and psychological impairment. The etiology of PIU involves multidimensional deficits within the Interaction of Person-Affect-Cognition-Execution (I-PACE) framework. While single-modality interventions like Cognitive Behavioral Therapy (CBT) have shown efficacy, they are often limited by suboptimal adherence and insufficient coverage of the complex, heterogeneous mechanisms underlying addiction. Multimodal integrative interventions are hypothesized to better address these complexities. To this end, we developed the IMPROVE program (Identify–Monitor–Plan–Real-world activities–Observe emotion–Vulnerability–Emotion regulation), a manualized group therapy integrating cognitive-behavioral strategies, mindfulness training, and socially interactive exercise. This pilot study aims to preliminarily evaluate the feasibility and clinical effectiveness of this protocol among university students with PIU.

Methods: A prospective, single-arm, pre-post pilot study was conducted. We recruited university students who self-reported distress related to internet use and voluntarily sought treatment. Participants underwent an 8-week IMPROVE group intervention (weekly 120-minute sessions). The intervention comprised three core modules: (1) CBT-based cognitive restructuring and motivational enhancement; (2) Mindfulness training for emotional awareness and regulation; and (3) Socially interactive exercise to ameliorate anhedonia and stress. Primary endpoints included feasibility (retention rate and satisfaction feedback) and preliminary effectiveness. Effectiveness was assessed by comparing baseline and post-intervention scores on the Internet Addiction Test (IAT), Patient Health Questionnaire-9 (PHQ-9) for depression, and Generalized Anxiety Disorder-7 (GAD-7) for anxiety. Paired t-tests and Cohen’s d were used to analyze outcome changes and effect sizes.

Results: Thirty-nine participants were enrolled, with 33 completing the intervention (retention rate = 84.6%; dropout rate = 15.4%). Feasibility metrics were excellent, with 100% of completers reporting being “satisfied” or “very satisfied,” and 85% rating the intervention as “helpful” or “extremely helpful” for their internet use problems. In terms of effectiveness, participants showed statistically significant reductions in PIU severity (IAT score: Baseline 51.06 vs. Post 41.58, Cohen’s d = 0.69). Notably, robust treatment effects were observed in comorbid psychopathology, with large effect sizes found for anxiety (GAD-7: Baseline 13.79 vs. Post 5.42, Cohen’s d = 1.83) and depression (PHQ-9: Baseline 17.48 vs. Post 6.76, Cohen’s d = 2.55).

Conclusion: The IMPROVE multimodal group intervention demonstrates excellent feasibility, high acceptability, and promising preliminary efficacy among university students with PIU. The results suggest that integrating behavioral, cognitive, and physiological (exercise) components may yield synergistic effects, particularly in alleviating comorbid emotional distress and reducing addictive behaviors.