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Completed

NCT Number: NCT07806344

Group Cognitive-Behavioral Intervention for Problematic Internet Use in Nepalese University Students

Problematic internet use, using the internet in ways that interfere with daily life, is a growing concern among university students in Nepal, where studies report prevalence rates between 21.5% and 35.4%. Despite this, structured, evidence-based intervention trials in Nepalese academic settings remain scarce.

This study tested a six-session group program based on cognitive-behavioral therapy, which helps people change unhelpful behaviors around internet use. Sessions lasted 90 minutes and were delivered weekly by supervised Master's-level psychology students who completed 40 hours of CBT training, which the makes the program affordable and scalable for university settings.

Fifty-nine undergraduate students took part: 30 received the group program and 29 formed the comparison group. Both groups completed the Internet Addiction Test and the General Self-Efficacy Scale at five time points: before the program, immediately after, and at 2 weeks, 1 month, and 3 months later.

Students in the program showed significantly greater reductions in internet addiction symptoms than the comparison group immediately after the program (p = .049) and at 1 month, where a large effect was observed (d = -0.83, p = .003). At 3 months, the difference between groups was no longer statistically significant because the comparison group also continued to improve; however, the program group maintained a large reduction from baseline (d = 1.18). Students in the program also showed a significant increase in self-efficacy that remained stable through every follow-up (all p < .032). Adherence and acceptability were high: participants attended an average of 5.06 of 6 sessions, 80% attended at least 5 sessions, and satisfaction with the therapy reached 78.3% of the maximum possible score.

These findings suggest that a structured, group-based CBT program is an effective and acceptable approach for managing problematic internet use among Nepalese undergraduates and offers a potentially scalable framework for academic institutions in low-resource settings.

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Key information

Conditions

Problematic Internet Use Behavior Behavior, Addictive Compulsive Behavior Impulsive Behavior Internet Addiction Internet Addiction Disorder Technology Addiction

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Central Department of Psychology, Tribhuvan University

Kathmandu, 44600, Nepal

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Undergraduate students enrolled at colleges affiliated with Tribhuvan University, Kathmandu, Nepal
  • Internet Addiction Test score above 30 (mild, moderate, or severe categories of problematic internet use) at Phase 1 screening
  • Willing to provide informed consent and to attend scheduled group sessions

Exclusion criteria

  • IAT score of 30 or below at Phase 1 screening (did not meet inclusion criteria)
  • Declined to participate / unwilling to provide informed consent
  • Withdrawal before the first intervention session

Treatment and study plan

Group Cognitive-Behavioral Intervention for Problematic Internet Use

Behavioral

A six-session manualized group program for problematic internet use among Nepalese undergraduates delivered weekly in 90-minute sessions. Grounded in cognitive-behavioral therapy, Young's CBT-IA model, and Davis's cognitive-behavioral model of pathological internet use. Sessions 1-2: orientation, psychoeducation, behavioral monitoring, and planning healthier internet habits (behavior modification). Session 3: cognitive restructuring. Sessions 4-5: harm reduction and emotional/psychological drivers of addiction. Session 6: relapse prevention and consolidation. Culturally adapted for Nepalese youth through multidisciplinary expert review (clinical psychologists, psychiatry, Ayurveda/Yoga, clinical psychology residents). Facilitated by two Master's-level psychology trainees after 40 hours of supervised CBT training by the project lead, with weekly supervision and a structured manual for fidelity.

Primary outcomes

  1. Internet Addiction Test Score

    Time frame: Baseline (pre-intervention), Week 6 (post-intervention), Week 8 (2-week follow-up), Week 10 (1-month follow-up), and Week 18 (3-month follow-up)

    20-item Internet Addiction Test evaluating the severity of problematic internet use on a 0-5 Likert scale (Young, 1998); higher scores indicate more severe problematic internet use. In this study, scores ≥ 31 defined "mild" to "severe" problematic use.

Secondary outcomes

  1. General Self-Efficacy Scale Score

    Time frame: Baseline (pre-intervention), Week 6 (post-intervention), Week 8 (2-week follow-up), Week 10 (1-month follow-up), and Week 18 (3-month follow-up)

    10-item Nepali version of the General Self-Efficacy Scale assessing broad optimistic self-beliefs regarding general coping ability (Schwarzer et al., 1997); higher scores indicate greater general self-efficacy. Change from baseline was the analysis metric.

Other outcomes

  1. Satisfaction with Therapy and Therapist Scale-Revised Score

    Time frame: Weeks 1, 2, 3, 4, 5, and 6 (Immediately after each intervention session)

    13-item STTS-R (Oei & Green, 2008), administered online to the experimental group after each session with anonymity maintained from facilitators; higher scores indicate greater satisfaction with the therapy and the therapist. Analyzed using the Percentage of Maximum Possible method.

  2. Session Attendance

    Time frame: Week 6, based on attendance during Weeks 1-6 (experimental arm only)

    Number of the six sessions attended, used as an indicator of participant adherence

Sponsors and collaborators

Lead sponsor

Tribhuvan University, Nepal

Other

Registry information

Official study title

Effectiveness of a Group Cognitive-Behavioral Intervention for Problematic Internet Use Among Undergraduate Students in Nepal: A Quasi-Experimental Trial

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
Sep 8, 2026
Registry last updated
Sep 8, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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