Effectiveness of Internet Addiction Interventions in Adolescents: Systematic Review

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INTRODUCTION
Internet use is a common problem among teenagers.Internet addiction among teenagers is a problem resulting from increasing users.Internet addiction in adolescents has a negative impact and influences school achievement, social activities, and the process of student interaction with their families (Uysal & Balci, 2018).Adolescents are more susceptible to internet addiction (Liu et al., 2015).According to Dewi et al., (2020) internet addiction in teenagers is one of the factors that can influence the occurrence of cyberbullying among teenagers, both as perpetrators and victims.In the case of internet addiction, changes in behavior occur due to excessive use of the internet and use of it for things that are not useful (Du et al., 2010;Zhong et al., 2011).For this reason, it is necessary to develop effective strategies such as scheduling Internet use, changing the duration of Internet use, supporting students to create Internet use record sheets, encouraging students to spend more time with friends, engaging in direct activities, limiting Internet time, providing time with parents, choice of friends, school attendance in healthy internet use (Uysal & Balci, 2018).
Programs to overcome internet addiction problems need to be developed and evaluated.The development of evidence-based programs will have an impact on increasing efficiency so that it can contribute to the formation of healthimproving behavior in adolescents.Education and consultation should be provided to adolescents and parents regarding healthy internet use (Uysal & Balci, 2018).According to several studies, social cognitive theory is the most widely used theoretical framework for behavior-based programs designed to change individual behavior (Du et al., 2010;Zhong et al., 2011).
To be able to overcome the problem of internet addiction, appropriate intervention is needed (Liu et al., 2015).Therefore, a review is needed to assess the effectiveness of interventions used to reduce the level of internet addiction in adolescents and to describe and discuss research regarding internet addiction interventions in adolescents, so that we can find out what interventions can be used in cases of internet addiction in adolescents.teenagers and what interventions are appropriate for internet addiction problems based on several studies.This literature study aims to examine and research the impact of internet addiction interventions on adolescents and evaluate the effectiveness of internet addiction intervention programs on adolescents through a systematic review.

METHODOLOGY
Three databases, including PubMed, Science Direct, and Scopus were used to obtain relevant articles as data sources.These articles were selected based on the inclusion criteria for systematic reviews and meta-analyses (PRISMA) framework for critical appraisal of each We selected RCT research articles, conducting interventions for internet addiction in English-speaking adolescents.We excluded reviews, literature reviews, meta-analyses, systematic reviews of articles, books or book chapters, dissertations and theses.

Study inclusion criteria
The inclusion criteria for this study consist of: 1. English language articles published between 2008 and 2021 2. Using design (RCT)

Using interventions for the purpose of reducing levels of internet addiction Exclusion criteria
The exclusion criteria used in this study are: 1.The article does not display the full text 2. Articles in the form of literature reviews, meta-analysis, systematic reviews Details of the search strategy for eligible articles are reviewed and analyzed in the following diagram:

Internet use in Adolescents
Factors that influence internet addiction include gender, age, class, financial situation, parental education (Uysal & Balci, 2018).Several studies reveal that gender influences internet addiction.Adolescent boys experience internet addiction more often than girls, this is because internet use in boys is higher than in girls according to (Uysal & Balci, 2018;Durkee et al., 2012).One of the reasons why teenagers are at risk when doing online activities is related to their parents, such as living separately from their biological parents, low parental involvement and parents who are not working (Durkee et al., 2012).Internet users are grouped into three categories: adaptive, maladaptive and pathological (Durkee et al., 2012).Some activities carried out by teenagers online include watching TV, visiting chatrooms and social networks (Durkee et al., 2012).

Efforts to Prevent Internet Addiction in Adolescents
To be able to prevent the problem of internet addiction in teenagers, support and cooperation from various roles are needed, including family, friends and teachers.In their research, Korkmaz & Kiran-esen, (2012) used peers in implementing a "perr training" intervention program for teenagers in Turkey, where friends who had successfully completed the training could become trainers for their friends.This program discusses the topic of internet addiction by getting to know friends better, group rules, responsibility towards colleagues, ethics, psychological support processes, developing communicative skills, selfknowledge, developing presentation skills, and obtaining information about safe internet use.The most frequently used online activity is playing games.Findings show that the use of the Healthy Internet Use Program reduces the level of internet addiction among adolescents (Uysal & Balci, 2018).
The family has an important role in preventing internet addiction in teenagers.Families, especially parents together with health workers, are needed to prevent and overcome the psychological impacts experienced by teenagers due to internet use (Dewi et al., 2023).The family plays an important role, especially parents, in supervising children's activities and carrying out good communication, so that children do not transfer their problems to the internet (Zhong et al., (2011).Teachers also have an important role in forming the character of their students, for this reason cooperation is needed with with teachers in providing information about healthy internet use.This is in line with research conducted by Uysal & Balci, (2018), which used intervention with school-based programs to be effective in reducing the level of internet addiction among Turkish teenagers.

Interventions that Can Be Used in Internet Addiction
Interventions that can be used for internet addiction problems include psychotherapy.This is in line with several studies.Research conducted by Korkmaz & Kiran-esen, (2012), stated that there was a significant difference in post-test scores in the experimental group compared to the control group (U = 40350.5,p <0.05) in the use of "perr training" therapy.The research results show that peer training has a positive effect on reducing the rate of internet addiction among teenagers in Turkey.The intervention was carried out in 10 sessions lasting 90 minutes.Psychotherapy interventions have been widely used to prevent and treat internet addiction in adolescents.The use of psychotherapy has been shown to be effective in internet addiction.The psychotherapy that is widely used is cognitive behavior therapy (CBT).
Several studies have been conducted on this therapy, including research by Du et al., (2010) who conducted a group-based CBT intervention of 8 sessions for 6-10 students by 2 child and adolescent psychiatrists, each session lasting 1.5-2 hours.There was a significant reduction in the level of internet addiction in the active group after the intervention and 6 months of follow-up.In line with that research, Mi et al., (2012), evaluated the effectiveness of CBT intervention in combination with bubropion to reduce online game use and major depression in China, which showed a significant reduction in online game addiction and anxiety as well as an increase in mean satisfaction scores.life & school adaptation in the intervention group.Huanhuan & Su, (2013) examined the effectiveness of CBT intervention to reduce the level of online gaming addiction in adolescents in Guangzhou China CBT by providing 12 sessions of therapy with sessions 2 times per week lasting 45 minutes.Meanwhile, the control group received basic counseling twice a week by a psychiatrist.The results of the study stated that there was no significant difference between the group that received CBT therapy and basic counseling therapy.This shows that psychotherapy carried out with both CBT and basic counseling therapy is equally effective in reducing the level of internet addiction in adolescents.
The use of psychotherapy was also used by Zhong et al., (2011) stating the same thing, the results of the study showed that, in the experimental group FAD increased significantly, this can be seen from the increase in OCS scores and total scores for OCS, so that family-based group intervention is effective in reducing Internet use and improving family functioning.Likewise with research conducted by Uysal & Balci, (2018) which used intervention with a school-based program involving parents and teachers in the Healthy Internet Use Program.This research is effective in reducing the level of internet addiction among teenagers.
Online-based interventions can also be given to teenagers who experience internet addiction.This is in line with research conducted by Su et al., (2011b) that the Healthy Online Self-helping Center (HOSC) intervention can help students reduce online use in China.The intervention uses an online program developed based on motivational interviewing procedures.The results of this study suggest that online ES can act as an alternative to traditional intervention methods.Apart from psychotherapy interventions, video-based interventions can also be used as an alternative option in reducing internet addiction in adolescents.Turel et al., (2014), conducted an evaluation of a video-based intervention for students to improve users' attitudes towards reducing internet use, as a means of preventing excessive and dangerous internet use.The research results state that instructional videos can be more educational in improving users' attitudes towards Internet use with changes in the video effect value, f2 from 1 to 0.15 which is a fairly high moderate effect.

CONCLUSIONS AND RECOMMENDATIONS
Internet addiction is a problem that often occurs as a result of the impact of increasingly rapid technological developments.The negative impact of internet use occurs in all age groups, especially teenagers.To be able to reduce or reduce the level of internet addiction, appropriate intervention is needed.From literature searches conducted by researchers, it was found that there are several alternative interventions that can be used to reduce internet addiction, especially in adolescents.Psychological interventions can be used and have effective results in reducing levels of internet addiction.This psychological therapy can be carried out using various methods including school programs, family-based, counseling reality therapy, school-based, psychosocial treatment.This psychological therapy can be used directly on individuals, groups or online, namely by using eHealth.Apart from that, psychological therapy such as CBT therapy can also be combined with administering the drug Bupoprion.The psychological interventions used, whether in the form of CBT or just basic counseling, have shown significant results in reducing levels of internet addiction.With this literature study, it is hoped that it can become a recommendation for intervention in overcoming the problem of internet addiction and its psychological impacts.

FURTHER STUDY
This literature study only assesses the effectiveness of interventions in overcoming Internet addiction problems in general from previous research, without knowing the causes of someone experiencing Internet addiction.So that the interventions carried out can be optimal and can avoid the occurrence of Internet addiction in teenagers, it is hoped that future researchers can examine the factors that can cause someone to experience Internet addiction.
article.Systematic search by searching the EBSCO, science direct and PubMed databases in May 2021 and ending on June 28 2021.Then carry out a further search to find relevant articles using the keywords: 'Intervention' OR 'Treatment' OR 'Therapy' AND 'Internet Addiction' OR 'Excessive Internet Use' OR 'Problematic Internet Use' AND 'Adolescents' OR 'Teenagers' OR 'young adults' AND 'Randomized Controlled Trials' OR 'RCT' OR 'Randomised Control Trials.To obtain articles relevant to internet interventions in adolescents, the publication period was limited to 13 years from 2008 to 2021.The (PICO) format was used to design the article criteria as follows; PICO components P: Teenager I: Internet addiction intervention C : Control group O: Decreased level of internet addiction Criteria for including articles in research