Event Summary by Mary Mulvihill, Ph.D.
The May 13thlocal showing of “Screenagers”, a new documentary on teen screen use, by pediatrician, Dr. Delaney Ruston, Seattle, was sponsored by Hannah’s House, a local non-profit. Hannah’s House serves dual custodyand high conflict families, often referred by family court for mandated treatment. Complexco-parenting issues arise during these protracted custody battles. Susan Griffin LMFT, Director, put together the screenings (morning session for professional CEU’s and afternoon session for parents). CAMFT, San Diego Chapter was a co-sponsor with San Diego Psychological Association. After viewing the film, subject matter experts presented on their respective specialty areas followed by a panel discussion.
Angie Coulter LMFT, MT-BC & Marc Rosenberg BCBA MFTI, personable young family therapists, presentedhow they address the common digital dilemmas in their Encinitas-based private practices and their work with charter schools. They reviewed signs of screen addiction, including their impact on learning and provided excellent behavioral strategies to moderate screen use. Aggressive counter reactions are sometimes seen when device access is restricted. An interesting sub-group is teens on the autistic spectrum, who are drawn todigital devices to cope with social awkwardness and where parents often appreciate the peace and containment that comes from teens becoming absorbed in digital devices or games. There are many things parents can do, form being a good role model to providing alternate recreational activities. Marc & Angie provided down to earth advice about managing this issue within the family system
Mary Mulvihill Ph.D. a Professor in the Graduate School of Public Health at SDSU, brought a public health approach, using the example of distracted driving, which is often modeled by parents, and picked up easily by teens without timely, thoughtful intervention. She presented a 5 Step Habit Breaker Intervention protocol, that is simple and can help guide a desired habit change. Based on operant behavior theory, this protocol uses observations, education & goal setting, cue alteration, reinforcement and/or punishment, & coaching to rewire the brain and form a newdigital habit. This protocol can be used in private practice with guidance from the therapist, to promote change. Changing one digital behavior often generalizes to others, which can them be focused on specifically.
Ethan Marcus J. D., CFLS, an expert in familylaw (and former stand-up comedian), brought in the legal perspective for families trying to work out custody arrangements in family court. Since the portion of assets assigned to the children are prorated to each parent depending on how much custodial time they have, an adversarial elementcan easily be activated. During family dissolution, often there is maladaptive mourning, which manifests in high conflict and other troublesome child or parent behaviors. Kids who vent on social media, may find their posted comments used incourt proceedings. Attorneys have to educate judges, one by one, about what environmental supports, including digital device rules, are healthy for the child. Adherence to these can then form a basis for the court awarding more or less custodial time and financial resources to a particular parent. Digital device access is new area for the court to consider.
Panel Discussion: Moderator Susan Griffin LMFT brought up the importance of parental engagement in their children’s digital use, and a need for clinicians to assess that use. Important information can be gained about what is happening and affecting the child’s welfare. For example, a case where a divorced father, anxious about losing connection to his children, was found to be texting his daughter up to 80 times during the school day. There was a consensus that very often parents do not know what their children are really consuming online, and how important it is for them to become engaged in finding out.
Especially important is maintain parent access to digital devices by knowing the passwords, so they can be accessed if needed. A school psychologist brought up a recent threat assessment involving a 5th grade girl, where the parents were not aware of her worrisome online communications, and deeply shocked to see them.
Dr. Mulvihill clarified in response to a query the risks of hands free phone use (as high as drunk driving, but lower than texting &driving) vs. talking to a passenger, listening to music, or podcasts (all lower than hands free phone use).
There was considerable interest in howMarc Rosenberg & Angie Coulter negotiate and implement parent-child behavioral contracts as one approach, which needs to be done with youth input, family discussion and good timing. They noted that often parent’s also have a “screen addiction” issue, poignantly shown by a young child describing conversing with a parent on their device. Parents can get immersedandneglect kids, so they need to look at their own screen behavior, as well as their children’s. screen behavior.
The Problematic and Risky Internet Use Screening Scale (PRIUSS) assessment tool for assessing screen use in an office setting was recommended. Susan Griffin also felt that some addiction measures, which could be modified for “process” addictions might be useful and appropriate. It was discussed that engaging with parents and teens to review phone content together during therapy sessions might be useful in some situations but this raises questions for informed consent (including office forms) and client privacy which would need to be addressed.
A participant brought up a need to find a new discourse about digital devices, so it was not framed as an adversarial parent-child (or student/teacher situation) issue. A language with which to talk about this issue is still developing.
There was a concern raised about the teen drama series, 13 Reasons Why. Dr. Mulvihill stressed the importance of watching shows with teens, or even playing their video games with them to see what they experience. This may open up discussion and be important training in media literacy, auseful skill, given the volume and intensity of media, that must typically be digested.
She also brought up clinician/parent awareness of widespread viewing and social media sharing of porn, among y ever younger boys. The potential adverse impact onbrain circuitry for sexual functioning is notable. Erectile dysfunction in otherwise healthy young men may result after frequent, prolonged porn consumption.
The panel wrapped up with asking for comments from the sparse group of professional attendees about why they thought only 10 professionals (vs. 60 parents) signed up for the Screenagers event. It was felt that parents see the effects of screen overuse and must deal with these behaviors on a daily basis, while clinicians have to ask about it to even know what is going on. With the exception of obvious sleep disruption, digital device over use may not be on most clinician’s radar yet, as far as the importance to children’s health & well-being (sleep habits, study habits, social skills development, process addiction, etc.). The consensus was that digital device overuse is an emerging area, which is new for many, and not commonly viewed as part of the clinical domain until very problematic. Future trainings need to continue, participants thought, especially as technology evolves, affecting all of us - clients& therapists, every day in so many ways.
Overall, it was a stimulating and thought provoking discussion about an emerging issue in clinical practice.
Stay tuned for future CE trainings and public education events on this timely topic!
Thanks to Susan Griffin, LMFT, and her staff at Hannah’s House for planning & leading this interesting event!