Abstract
Background
The increasing prevalence of gaming addiction among adolescents has emerged as a growing public health concern, linked to emotional dysregulation, poor academic performance and social withdrawal. Despite its significance, there is a limited availability of structured, school-based psychological intervention protocols specifically targeting this issue. Given the multidimensional nature of gaming addiction, there is a need for evidence-informed, developmentally appropriate modules that integrate emotional, behavioural and cognitive strategies to foster healthier digital engagement in youth.
Objective
This article outlines the development of a comprehensive behavioural intervention module designed to address the core behavioural and psychological correlates of gaming addiction, reduce symptom severity, sensation seeking, and impulsivity, and promote psychological resilience and well-being in adolescents.
Materials and Methods
The intervention module was carefully constructed through a comprehensive search of current research and structured in-depth conversations with key stakeholders. These systematic focus group discussions helped ensure that the module played an active role in addressing everyday challenges and was rooted in field-based insights. To evaluate the framework, the module was shared with 10 experts in this discipline. Notably, all 10 subject experts provided valuable input and feedback, helping revise and refine the module.
Results
A panel of 10 experts evaluated the module and provided feedback on its content relevance, conceptual clarity, precision, and effectiveness in supporting adolescents with gaming-related concerns. In light of their responses, minimal alterations were made, with most parts of the module being upheld. The mean content validity ratio (CVR) was 0.87, indicating strong consensus among experts on the content’s relevance.
Conclusion
The study validated a structured intervention framework to help manage problematic gaming behaviour and associated traits, such as impulsivity and sensation seeking, with an emphasis on promoting emotional balance and improved well-being.
Keywords
Introduction
Internet gaming disorder (IGD) involves an ongoing and uncontrollable urge to play video games, which severely hinders functioning in key domains such as school performance, social interactions and personal development. 1 WHO’s 2 inclusion of IGD in ICD-11 has elevated its status to a recognised mental health issue, prompting a global call for preventive and therapeutic efforts. The global adolescent population shows a 1.7%–8.5% who experience symptoms of IGD. However, prevalence rates differ based on geographical and cultural factors. 3 India’s adolescent population reveals a broad range of IGD prevalence among youth, from 1.3% to 19.9%, indicating a notable national concern.3, 4 In Central India, a study indicated a prevalence of 6.53% among school students, underscoring the need for preventive measures. 4 Among available treatments for gaming addiction, Cognitive behavioural therapy (CBT) is either used independently or combined with other strategies like mindfulness or familial interventions.5, 6 Schools may find it challenging to offer CBT due to requirements for trained professionals, expert supervision and tailored delivery.
As gaming addiction spreads, it has become evident that existing interventions are insufficient. This gap highlights the need for more comprehensive, multidimensional approaches to address gaming addiction. Self-determination theory (SDT), social learning theory (SLT), and the theory of planned behaviour (TPB) offer alternative frameworks that emphasise intrinsic motivation, social context and intentional behaviours in understanding and intervening in gaming addiction.7–9 These models consider broader factors beyond just thought patterns, addressing motivational and environmental factors that are critical in shaping gaming behaviour. Therefore, this study aims to develop a valid intervention model based on these theories to offer a holistic, evidence-based solution to prevent and treat gaming addiction in adolescents.
Material and Methods
The intervention module was developed based on core psychological theories along with recent evidence-based literature. The framework was shaped by established theoretical approaches and community input to effectively tackle problematic gaming among adolescents, while balancing the emotional and behavioural needs of adolescents struggling with gaming habits. SLT served as a key framework for understanding how external rewards and peer influence can shape adolescents’ gaming habits. This theory emphasises observational learning, peer modelling and vicarious reinforcement, guiding the incorporation of group-based simulations and the development of interpersonal skills. Elements from SDT were also incorporated to support self-motivation and to foster independent decision-making. Strategies that emphasise developing confidence, self-governance and emotional bonding help shift control inwards rather than towards gaming stimuli. Drawing on conceptual insights from the sensation seeking theory, this module includes exercises to address adolescents’ drive for stimulation, adventure and high-intensity experiences through movement and exploration-based activities, aiming to redirect risky digital engagement. Qualitative data supported the core concepts derived from structured focus group discussions with mental health experts, educators, caregivers and adolescents. Inputs and suggestions from stakeholders shaped the contextual fit and relevance to real-life situations that adolescents face. A total of 20 structured sessions were designed, each targeting key areas such as emotional control, self-discipline, behavioural redirection, impulse control and identity building.
Statistical Analysis
To determine the content validity of the module, a questionnaire comprising all 20 intervention items was shared with a group of field specialists using Google Forms. The panel consisted of psychiatrists, clinical and counselling psychologists, school counsellors and academic heads with experience in adolescent health. Responses were collected using a 4-point The items were rated on a 4-point scale for both relevance and clarity,with response options ranging from 1 (not relevant/not clear) to 4 (highly relevant/very clear). Lawshe’s 10 formula was used to determine the content validity ratio (CVR) and item-content validity index (I-CVI) metrics. Items with CVR ± ≤ 0.6 were flagged for revision or removal. As a result, 15 items remain unchanged, while five items (items 8, 9, 14, 17 and 19) were suggested for review. The experts’ suggestions were incorporated to enhance the final draft of the intervention module.
Results
A total of 10 experts provided their assessments of intervention components targeted to address gaming addiction among adolescents. The experts’ ages ranged from 30 to 50 years, and their professional experience ranged from six to 45 years. The feedback given was statistically analysed, and both relevance and clarity scores were derived using standard CVR and I-CVI metrics. A CVR cutoff score of 0.60 for item inclusion was determined using Lawshe’s method. A total of 15 of 20 items were found acceptable in terms of both relevance and clarity and were included in the final intervention protocol (Table 1). Expert feedback indicated that five module components (items 8, 9, 14, 17 and 19) were flagged for removal due to limited practical relevance, difficulty in execution during short interventions and complexity of delivery. These included components focusing on CBT-based restructuring, peer motivation, group storytelling and role-play tasks. This intervention protocol was recommended for six weeks. To ensure feasibility and engagement, some interventions were combined to make them more manageable and engaging for adolescent participants, thereby helping to maintain session variety while preserving the intended psychological impact. For example, sessions covering psychoeducation and the basics of gaming addiction were integrated to deliver a more holistic and streamlined participant experience. The behavioural planning sections were integrated into the digital wellness session to facilitate smoother delivery. Likewise, topics such as emotional coping, social and emotional learning (SEL), and stress management were grouped based on their thematic alignment, fostering a mutual focus on resilience-building. Based on the expert’s recommendation, the programme is scheduled to be implemented over six weeks, with biweekly sessions, resulting in a total of twelve 45-minute sessions, as indicated in Table 2.
List of Interventions Validated by Experts.
Finalised List of Interventions Approved by Experts for Managing Gaming Addiction.
The CVR was calculated using the formula
10
:
where
ne = number of experts indicating ‘essential’,
N = total number of experts.
Discussion
The study involved developing a framework to reduce problematic gaming among adolescents, combining theory-driven strategies and expert panel recommendations. The design was based on alternative psychological models beyond the realm of CBT, specifically including the principles of SDT, SLT, sensation seeking 11 and the behavioural intention focus of the TPB. This module outlines the development of 12-session school-based interventions to balance adolescents’ gaming habits. Like other psychosocial interventions, the current protocol integrates a blend of activities that focus on experiential, reflective, social and regulatory techniques tailored to adolescents’ developmental needs. The validated module spans six weeks and includes two 45-minute sessions per week, as recommended by field experts. Core activities in the protocol integrate diverse components, including psychoeducation, gaming habit journaling, emotional enhancement through mandala art, digital wellness planning and strategies for goal setting, problem-solving, decision-making and relapse prevention. The validation confirmed that the activities are feasible, relevant, age-appropriate and adaptable to diverse cultural and educational settings. This module was designed primarily for school-going adolescents, as this developmental period is vital for fostering emotional regulation, self-discipline and responsible digital habits. Adolescents at this age are generally more influenced by structured psychosocial learning than those in later educational stages. The academic environment further provides consistent structure and support, making it well-suited for preventive interventions. Although the programme’s theoretical foundations, such as behavioural regulation and cognitive restructuring, can be extended to college populations, the current model remains age-specific to the school environment. Prior evidence-based efforts, such as the multimodal psychotherapeutic model for IGD, 12 have already focused on young adults, highlighting that this study fulfils a distinct developmental need by focusing on adolescents at a formative phase of digital habit formation. The panel also recommends group-based sessions due to their potential to foster peer interaction and support the key aspects of adolescent development. While most experts recommended face-to-face delivery to ensure interaction, supervision and reinforcement of healthy digital behaviour, this module can be adapted for hybrid settings as needed.
In line with the intervention goals, this module focuses on an offline approach to promote digital distancing and enhance real-world social interaction. The multi-component module supports active participation and sustains interest throughout the learning process. This content validation process ensures a solid foundation for feasibility testing and iterative refinement.
Conclusion
The module, developed with expert feedback, represents an early effort to lay the groundwork for a standardised protocol to address excessive gaming behaviour among adolescents. Through the integration of theoretical foundations and expert recommendations, the module consists of 15 practices consolidated into a six-week, biweekly, 12-session intervention plan. Validation through CVR and I-CVI metrics revealed high clarity and relevance for the majority of items, although select items were identified for revision. Based on the validation outcomes, findings indicate the module’s practical utility for implementation in therapeutic practice with adolescents. To extend the utility of the intervention, a pilot trial with adolescents will help determine the intervention’s practicality and user engagement, setting the stage for a full-scale randomised controlled trial.
Footnotes
Acknowledgement
The authors acknowledge all the experts for their valuable suggestions and inputs in developing this module, as well Sri Ramachandra Institute of Higher Education and Research for their assistance in the smooth completion of the study.
Authors’ Contribution
S.L conceptualized and designed the study, conducted data collection and analysis, and drafted the manuscript. D.C.M and S.J.K contributed to the study design, provided methodological guidance and supervision, critically reviewed and revised the manuscript, and approved the final version for publication.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
Funding
The authors received no financial support for the research, authorship and/or publication of this article.
Supplementary Material
Statement of Ethics
The researchers obtained ethical approval from the Institutional Ethics Committee of Sri Ramachandra Institute of Higher Education and Research (IEC-NI/24/APR/93/61), and participant consent was sought before the commencement of the study.
Informed Consent
Informed consent was obtained from all participants prior to their inclusion in the study. Participation was voluntary, and confidentiality was maintained throughout the study.
References
Supplementary Material
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