Prise en charge TCC d’une addiction aux jeux vidéo : l’expérience de jeu contribue à la thérapie - 02/09/13
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Résumé |
Le concept d’addiction au jeu vidéo n’est pas reconnu de manière universelle dans la littérature scientifique. Cependant, certains auteurs s’accordent à rapprocher les comportements excessifs de jeu vidéo avec les conduites d’addiction. Cet article présente en détails un cas d’addiction au jeu vidéo pris en charge par le biais d’une thérapie cognitive et comportementale (TCC) dans une consultation spécialisée sur l’addiction aux jeux vidéo. Le patient présente une problématique de jeu qui s’apparente clairement à une addiction. Une comorbidité d’anxiété sociale sous-jacente apparaît en cours de thérapie. Les méthodes thérapeutiques employées prennent source dans la description des TCC spécifiques à l’addiction au jeu vidéo. Une bonne connaissance du thérapeute concernant les univers de jeux vidéo nous semble améliorer l’alliance thérapeutique, centrale pour une prise en charge, dans le traitement de l’addiction aux jeux vidéo. La prise en compte du vécu cognitif, émotionnel et comportemental amené par le jeu vidéo s’est révélée être une méthode adaptée dans la thérapie. Les caractéristiques propres aux jeux vidéo, les motivations à jouer et l’expérience psychologique du joueur nous semblent être des variables essentielles à prendre en compte pour potentialiser l’efficacité des TCC appliquées à l’addiction aux jeux vidéo. La prise en charge de type TCC décrite dans ce suivi a été efficace pour atteindre un contrôle du comportement d’utilisation du jeu vidéo.
El texto completo de este artículo está disponible en PDF.Summary |
Introduction |
The concept of video game addiction is not universally accepted in scientific literature (Wood, 2008; Turner, 2008; Sim et al., 2012 [1 , 2 , 3 , 4 ]). However, some authors agree on linking excessive video game behavior to the concept of addiction (Vaugeois, 2006; Griffiths and Meredith, 2009; Porter et al., 2010; Romo et al., 2012 [5 , 6 , 7 , 8 ]). This article gives a detailed presentation of a case of video game addiction treated by cognitive-behavioral therapy (CBT) in practice specialized in video game addiction.
Method |
The therapeutic methods used came from specialized CBT techniques for video game addiction (Griffiths et Meredith, 2009; Romo et al., 2012; King et al., 2010 [6 , 8 , 11 ]). The assessment of game behavior was partly based on protocol from previous research (Taquet and Hautekeete, 2012 [12 ]). A semi-directive interview addressed the type of game and modalities of the game (console, PC, online, offline). Average playing time per week was calculated based on morning, afternoon and evening play for each day of the week. To assess the problem a French version of problem video game playing (PVP) was used (Tejeiro Salguero and Bersabé Morán, 2002; Bioulac et al., 2010 [13 , 14 ]). In addition to the PVP, we created a more exhaustive questionnaire, which is currently being validated, on video game addiction (QAJV), based on different contents related to addictions (Tejeiro Salguero and Bersabé Morán, 2002; Gooodman, 1990; American Psychiatric Association, 2003; Classification Internationale des troubles Mentaux et du comportement (CIM-10), 1992; Grüsser and Thalemann, 2006 [13 , 15 , 16 , 17 , 18 ]). A questionnaire of 140 items, currently in the process of validation, served to assess the cognitive-emotional and behavior processes in video game use.
Treatment |
The case study spanned 11 months, which corresponded to 17 consultations. The first four consultations (3months of treatment) concerned analysis of game behavior, assessment of change motivation, motivational work and elaboration of a functional analysis. The patient aged 19 had been playing video games since the age of 9. The problem became apparent 3years earlier when he decided to drop out of school. He played many different types of video games, both online and offline. The average playing time per week was 77hours. The PVP was 7/9 and the QAJV was 187/380. The excessive game behavior met the criteria of behavior addiction [15 ]. The 140-item questionnaire revealed certain expectations concerning the video game: pursuit of positive emotions, relaxation, immersion and cognitive avoidance of the negative aspects of daily life. Five consultations (3months) were necessary for the treatment centered on the video game behavior with auto-observation of game behavior and cognitive-emotional experience, support in reducing playing time, control of the stimulus, setting up alternative activities and work on the relationships. Six months into the treatment, satisfactory game control enabled the subject to enter into a phase of maintenance and relapse prevention, which corresponded to three consultations (2 months). The different situations presenting the risk of relapse were worked on (release of new games, video game expansion packs, relief-oriented use of video game, procrastination, online games, etc.). Ten months after the initial evaluation, the PVP was 0/9, the QAJV 6/380 and playing time 14. A significant social anxiety, masked by excessive game behavior and obsessions, appeared as a comorbidity during the therapy and was then eliminated. This article, based on the treatment of excessive video game behavior, does not deal in detail with the treatment of comorbidities.
Conclusion |
Good knowledge of the world of video games by the therapist seems to improve the therapeutic alliance in the treatment of video game addiction. This case study shows the reality of a video game player who has excessive game behavior, which resembles addiction. Without treatment focusing on the video games, it would have been impossible to effectively treat the social anxiety. The treatment of emotional and behavioral cognitive processes linked to video games was shown to be an adapted therapeutic method. The characteristics specific to video games (King et al., 2011 [25 ]), the motivations to play and the psychological experience of the player (Taquet and Hautekeete, 2012; Yee, 2006; Przybylski et al., 2010 [12 , 26 , 27 ]) seem to be essential variables to take into account to maximize the efficiency of CBT applied to video game addiction. The CBT treatment described in the report was efficient in achieving control of behavior in the video game use.
El texto completo de este artículo está disponible en PDF.Mots clés : Addiction, Thérapies cognitives et comportementales, Jeu vidéo
Keywords : Addiction, Cognitive behavior therapy, Video game
Esquema
Vol 23 - N° 3
P. 102-112 - septembre 2013 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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