Targeted school intervention outperforms media lessons for teens at risk of gaming disorder
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School-based prevention programs are designed to help protect adolescents from gaming disorder and problematic online habits. But how effective are these interventions in promoting responsible use of video games and the internet?
A research team led by Dr. Katajun Lindenberg of the Institute of Psychology at Heidelberg University investigated this question as part of a statewide study involving approximately 1,800 adolescents from 44 secondary schools in Baden-Württemberg.
The results, published in the journal JAMA Network Open, show that, in the long run, a four-week behavioral therapy-based program achieved greater effects among participants at high risk of addiction than a media education program.
"Against the backdrop of ongoing debates about effective measures to protect the mental health of young people in the digital age, the question of effective interventions is highly relevant," emphasizes Lindenberg, professor of clinical psychology of childhood and adolescence at Heidelberg University and director of the Psychotherapeutic University Outpatient Clinic for Children and Adolescents.
Two school programs, different aims
In addition to much-discussed regulatory measures such as age restrictions, there are parallel calls for measures designed to empower young people to use video games and the internet responsibly. These include prevention programs based on behavioral therapy or media education approaches.
"Our research provides important empirical insights into which programs and content are particularly effective and which target groups benefit the most."
To this end, the scientists compared the behavioral therapy intervention PROTECTtraining and the media education program PROTECTinfo—two interventions developed for the school setting that are identical in duration and implementation effort but differ in content.
How the trial was structured
Gaming disorder and other problematic online habits—such as excessive use of social media—can lead to reduced mental and physical health among adolescents, as well as serious impairments in important areas of life such as school, family, friendships and leisure time.
To determine how effective school-based interventions are in preventing online addictive behavior, the researchers conducted a four-year randomized study involving adolescents ages 11 to 18.
As part of the study, 1,793 students participated in a four-week intervention consisting of four 90-minute sessions. Half of the adolescents completed the behavioral therapy program PROTECTtraining, which explained the vicious cycle of addiction and provided training in behavior change and emotion regulation.
A second control group participated in the media education program PROTECTinfo, covering topics such as media literacy, gaming, cyberbullying and legal aspects.
As part of the prevention study, the research team assessed the participants' online addiction behaviors and mental well-being at the beginning and end of the programs, as well as after four and 12 months. The researchers conducted a separate analysis for adolescents identified as having a comparatively high risk of addiction at the start of the study.
Biggest gains among at-risk teens
The final survey, conducted one year after the programs began, revealed that among adolescents without a risk of addictive behavior—the majority of study participants—there was hardly any measurable effect on their symptoms. In contrast, for adolescents at high risk of addiction, both interventions proved effective; however, the behavioral therapy intervention was significantly more effective.
"In a direct comparison, the behavioral therapy program is 50% more effective against gaming disorder and other problematic online behaviors than the media education program," Lindenberg stresses.
According to the Heidelberg researcher, these results also underscore that targeted measures tailored to at-risk groups in the school setting achieve significantly better results and are more resource-efficient than prevention programs implemented on a broad scale.
Publication details
Katajun Lindenberg et al, Cognitive Behavioral Therapy vs Media Literacy for Prevention of Gaming Disorder and Unspecified Internet Use Disorder, JAMA Network Open (2026). DOI: 10.1001/jamanetworkopen.2026.31942
Journal information: JAMA Network Open
Clinical categories
PsychiatryPsychology & Mental healthPediatricsChildren's health Provided by Heidelberg University Who's behind this story?
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