Tron Wilder • Steven Baughman

Addressing Behavioral Addictions in Adolescents:Creating a School-wide Culture of Prevention

Special Issue

Behavioral Addictions

It is the phone call that no school administrator wants to make, but unfortunately, it is becoming more and more frequent. These calls combine equal parts concern for the student’s welfare and frustration at not knowing the best way to handle a difficult situation:

Mr. Jones, this is Principal Smith.1 I am calling to schedule a meeting with you regarding Simon and his future at our school. When we met at the beginning of the semester, our concern was about the frequency with which Simon was engaging in Internet gaming and his two violations of the school’s acceptable-use policy by visiting inappropriate Websites. We shared reports from his residence-hall dean and teachers. The dean reported that Simon frequently played games throughout the night. His teachers reported that he often missed his 8:30 a.m. class and if he attended the others, would sleep through them.

At that first meeting in September, with the help of the school counselor, we worked out a behavior plan for Simon that included removing the game console from his room, limiting his Internet use, and his agreeing to attend his classes on time. At our second meeting in November, we notified you that a game console had been found in Simon’s room, he persisted in playing into the early hours of the morning, and continued to miss his classes.

We added weekly meetings with the school counselor to his behavior plan. He has skipped these weekly follow-up meetings, has not been showering or leaving his room, and for the third time has violated the school’s acceptable-use agreement. We are concerned that his behavior may be indicative of a deeper problem. He is combative and resistant, and unfortunately we do not have adequate professional resources to help him. We think it is time to seek help from a mental-health professional.

The concern on the other end of the line is palpable. The parental response may range from exasperated frustration about not knowing what else to do if their son or daughter can’t attend the local Adventist school, a resigned “Thanks for all that you’ve done; we understand the decision,” or even an outright hostile, combative argument about how the school has “failed” the teen in question. Regardless of the response, the administrator is often left feeling as if more could have been done, but frustrated about not knowing what. What, then, is the best course of action for educators when a student is struggling with a behavioral addiction?

While they may not always develop into addictions, behaviors such as overeating, excessive technology use, or repeated viewing of pornography are all growing issues that school administrators must be prepared to address. And while behavioral addiction is a newly emerging concept, understanding what it is and how Adventist schools, despite their limited resources, can create a preventative culture can help prepare our educators to better meet their wholistic goals of balanced mental-physical-spiritual student development.

Behavioral Addiction in Adolescents

Before determining how to address behavioral addictions, it is important to understand what types of actions fall into this category. While addictions have been traditionally understood as dependence on substances such as drugs or alcohol, experts are increasingly finding that, when engaged in compulsively, activities like those listed above, along with other behaviors such as shopping, working, or even exercising, can grow into a “non-chemical” or “behavioral” addiction.2 “Behavioral addiction” is defined as “the use of repetitive actions, initiated by an impulse that can’t be stopped, causing an individual to escape, numb, soothe, release tension, lessen anxiety or feel euphoric.”3 Although behavioral addiction was proposed as a new category in the recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5),4 there is currently no diagnostic model that includes the criteria necessary to identify behaviors as addictions in a clinical setting. Nonetheless, behavioral addictions are increasingly being recognized as treatable forms of addiction.5

Many behaviors to which people can become addicted are essential day-to-day activities such as eating, recreation, and technology use. However, as has occurred with many of God’s good creations, Satan has corrupted useful activities, turning them into activities with potentially harmful social, mental, and physical consequences. This is particularly a matter of concern with high school and college students, who are especially vulnerable to addictive behaviors.6 Among adolescents, the most common and problematic addictive behaviors include food, gambling, exercise, sex/pornography, spending, the Internet, and video/computer games.7

Students struggling with behavioral addictions may also have problems with underlying issues such as depression, loneliness, social impairment, aggression, or distractibility that cause them to resort to addictive behaviors as a way of coping.8 In fact, more often than not, individuals identified as having behavioral addictions are also diagnosed with another co-occuring disorder.9 Unfortunately, the incidence of adolescent mental-health problems like these is not likely to decrease any time soon, as mounting pressure to be successful in school and a debilitating fear of failure continue to plague students in increasing measures.10

As many faculty members and administrators can attest, these behavioral addictions are, with frightening rapidity, affecting students in Seventh-day Adventist schools. One group of researchers studying students ages 13-19 attending Adventist day, boarding, and self-supporting schools in the North American Division concluded that more than 25 percent of the students they surveyed reported wrestling with issues such as getting insufficient exercise; poor sleeping habits; being shy; feeling lonely, depressed, or sad; and having poor eating habits, among a variety of other issues that could all potentially lead to poor coping skills and an increased likelihood of developing behavioral addictions.11

Successful Approaches for Adventist Schools

Many schools, including Seventh-day Adventist institutions, are ill prepared to handle the growing problem of behavioral addictions due both to a lack of trained personnel, as well as a lack of understanding about how to respond to addictive behaviors.12 Because of this lack of resources and training, a typical response in many Adventist schools may likely involve a well-intentioned but undertrained group of staff members meeting to address a behavioral addiction as if it can be fixed by a short suspension from classes and a student’s promise to never engage in the behavior again. This disciplinary approach is often reactive and rooted in the traditional, punitive method of handling misbehavior such as drinking or smoking on campus.

While addictive behaviors are certainly harmful, behaviors such as Internet use or excessive exercising are not dealt with effectively through fear-based abstinence messages. In fact, while relatively little research has analyzed punitive approaches to behavioral addictions specifically, research indicates that these approaches have not effectively addressed addictive substance use in schools.13 Instead, students need to understand addictive behavior, and be taught with solid, research-based approaches that increase awareness, support, and education in addressing these types of addictions.14 Additionally, educators must seek to address the underlying causes of the addictions, rather than focusing solely on the behaviors.

Prevent Rather Than Punish

What then should Adventist educators do to help students struggling with behavioral addictions? First, it is critical to remember the essential purposes for which Adventist schools were founded. Adventist educators are charged with training their students “to be thinkers, and not mere reflectors,”15 while remembering the dangers of students becoming “assimilated to the world rather than to the image of Christ.”16 Balancing these two responsibilities can be challenging and even frustrating at times, but both are essential in helping students develop strong characters. With this fundamental perspective in mind, Adventist educators can develop and implement programs that proactively help and encourage students as they are developing their characters, rather than expecting students to already possess the maturity and determination to make the right decisions about behaviors that could lead to addiction.

Research results from the 2002 National Longitudinal Study of Adolescent Health17 indicated that one way to prevent students from engaging in harmful behaviors is to ensure that they feel connected to the school. Being proactive and responding appropriately when students first begin to show signs of a behavioral addiction18 are key factors in helping them feel connected to the mission of a school.

Educational institutions should implement supportive policies, such as offering more counseling and educational resources, in-school and after-school interventions to reduce anxiety and stress, and positive behavior mentoring.19 Furthermore, creating a warm and welcoming school climate allows students to sense sincere support from staff members and increases their willingness to talk to adults without fear of punishment.20 For more information on strategies and actions school administrators can take to increase school connectedness, visit this page. 21

Proper Training and Support

A quality program designed for use in a school setting must include proper staff training and support to enable them to identify and interact with students exhibiting potential signs of addictive behaviors.22 Because the majority of Adventist K-12 schools do not have the budget to hire full-time school counselors,23 the responsibility for caring for the emotional and mental-health needs of students often falls to the faculty and staff. This presents a difficult challenge for teachers with little training in how to effectively deal with students’ mental-health needs and who are already overwhelmed with the demands of working at understaffed schools. The author of a previous article in The Journal of Adventist Education on making mental health a priority in Adventist schools24 proposed several steps that school administrators can take to improve the mental-health services offered at our schools. Several of these suggestions can be modified to deal with behavioral addictions, especially in schools with limited training and/or resources.

  1. Provide workshops by trained professionals to help teachers recognize the warning signs and help students at risk for behavioral addictions. (One helpful resource is found at http://www.mentalhealthfirstaid.­org/.)
  2. Consider employing a school counselor or contracting with a mental-health professional who can provide ongoing education and support for school staff on how to deal with addictive behaviors. (A “roving counselor” could be coordinated at the conference level to help offset the costs for local schools.)
  3. Investigate community resources to which students struggling with behavioral addictions can be referred.25 (Note that effective treatment for behavioral addictions often involves similar approaches to those employed for substance abuse such as 12-step programs, motivational enhancement, psychosocial treatments, cognitive behavioral therapy, and medication.)
  4. Create a school-wide behavior-support system. (For resources and information, see http://www.pbis.org/school/swpbis-for- beginners.)
  5. Ensure that behavioral addictions and appropriate measures of addressing them are included in the student handbook. This shows that the school is committed to the wholistic development of each student.

Peer Support Programs

While most educators who work with teenagers and young adults realize that the peer group is a major factor in adolescent behavior, they often perceive its influence negatively. Peer pressure has widely been seen as the starting point of all sorts of adolescent problems such as addiction, sexual experimentation, and even suicide.26 Therefore, school staff typically respond by attempting to exert more control over peer relationships.27 Educators thus fail to recognize the potential of peer supports to empower and encourage young people struggling with many types of problems. Peer-support programs can be an incredibly effective method of positively utilizing peer influence.28

Rather than isolating and ostracizing struggling students, and possibly increasing the likelihood of addictive behaviors, peer-support programs enlist the aid of student leaders to develop ways to connect students to the school culture. When implemented appropriately, peer-support programs have proved effective in improving school climate and peer relationships, decreasing violent behavioral incidents, lowering suspension rates, and empowering students to act responsibly.29 By adapting the peer-support model to meet students’ specific needs, these programs may actually help prevent addictive behaviors from becoming more serious.30 For a detailed resource guide to implementing a peer-support program, see http://www.partnersagainsthate.­ org/publications/Peer_Leadership_Guide.pdf.31

Family Support

School staff must involve family members early in the resolution process when adolescents are struggling with addictive behaviors. Because students dealing with addictions may not recognize their need for help, referrals for treatment often come from others such as parents or teachers. Occasionally, these students may view the school and parental involvement as an intrusion into their personal lives, so if educators and families do not work together in a positive and productive way, treatments are unlikely to succeed. Family counseling, education about addictive behaviors, as well as strategies for coping with anger and loss of trust represent important aspects of successful treatment.32

Ongoing, open communication between students and faculty and between faculty and parents is essential to ensure that potential problems are addressed, although everyone must recognize that dealing with addiction is a continual process. When a student is receiving intensive community-based support, the principal should keep in contact with both the student’s family and, as possible, care providers to see what additional steps school personnel should take to help the student dealing with the behavioral addiction. When the treatment plan is to be implemented at school, parents should form an integral part of the execution. Further, resources should be provided to enable parents to provide support in the most helpful way at home.

Self-identity and Spiritual Support

Finally, an effective approach to behavioral addictions will provide students the opportunity to better develop their self-identity and spiritual values.33 Students should be taught the importance of prayer and reliance on divine help as they walk the path to recovery, and every effort should be made to direct them to counselors or behavior therapists who are willing to include these components as part of the treatment. Navigating through this tumultuous developmental period is an extremely challenging and complex task for any adolescent, so teaching coping skills will help empower all teens. “Successful treatments must not only address the [addictive] behavior but also help an adolescent navigate the normal developmental tasks of identity formation that are often neglected while [the behavior] is being used as a means of coping with life’s problems. Treatment should focus on effective problem solving and the social skills necessary to build self-esteem.”34 This, along with the support of a counselor or therapist who is willing to include the belief system as part of the treatment, are significant components of spiritual support.

Seventh-day Adventist institutions should be places where students can find the support and encouragement they need to struggle with problematic behaviors, including addictions. In fact, research indicates that because of their religious philosophy, Seventh-day Adventist schools may have a significant advantage in addressing behavioral addictions, as religious devotion has been shown to be a significant protective factor against adolescent addictions.35 Although innate sinful human nature should not be seen as justifying misbehavior, there can be great comfort in recognizing that “all have sinned, and come short of the glory of God” (Romans 3:23, KJV). As one Adventist researcher has pointed out, there can be a tendency for Adventists to depict people struggling with addiction as “morally weak” and to assert that if they would only pray harder, they wouldn’t have the problem.36 Adventist school staff must be diligent in protecting students from internalizing a sense of worthlessness, and instead should use the real challenges they are experiencing as “teachable moments” to help them better cope with the temptations and struggles of sin as they seek to develop a character that better reflects the Creator.

Conclusion

Ultimately, every Seventh-day Adventist school will face situations involving behavioral addictions. Administrators thus must develop plans and policies that assist students dealing with these types of behaviors in research-based, preventative ways rather than the traditional punitive measures schools have generally implemented. Schools should develop training programs for staff and faculty to help them identify warning signs of addictive behaviors and investigate resources on how to handle these situations when they arise. School faculty, staff, administrators, students, and families should work together to create a school environment that promotes safe discussion of addictive behaviors with which students may be struggling. Finally, and perhaps most importantly, a program should be in place that supports students struggling with addictive behaviors in a way that facilitates their personal growth, identity, and spiritual development and prepares them for “the joy of service in this world and for the higher joy of wider service in the life to come.”37


This article has been peer reviewed.

Tron Wilder

Tron Wilder, Ph.D., is an Associate Professor in the School of Education and Psychology at Southern Adventist University in Collegedale, Tennessee. Prior to joining the faculty at Southern, he served in several public school districts in Tennessee and Georgia as a school psychologist, where his work focused on assessing students with emotional, behavioral, and learning difficulties and working with teachers and parents to develop plans to assist students experiencing difficulties. Dr. Wilder is passionate about reaching and teaching students with a variety of learning styles.

Steven Baughman

Steven Baughman, M.Ed., has been the Principal at Indiana Academy in Cicero, Indiana, since 2013. He previously spent 10 years teaching English and history at Highland Academy in Portland, Tennessee.

NOTES AND REFERENCES

  1. R. I. Brown, “Gambling Addictions, Arousal, and an Affective/Decision-making Explanation of Behavioral Reversions or Relapses,” The International Journal of the Addictions 22:11 (May 1987):1053-1067. doi: 10.3109/10826088709027469; Nady El-Guebaly et al., “Compulsive Features in Behavioral Addictions: The Case of Pathological Gambling,” Addiction 107:10 (October 2012):1726-1734. doi: 10. ­ 1016/j.biotechadv.2011.08.021; Luke Clark and Eve H. Limbrick-Oldfield, “Disordered Gambling: A Behavioral Addiction,” Current Opinion in Neurobiology 23:4 (August 2013):655-659. doi: 10.1016/j.conb.2013.01.004.
  2. Kathryn Yung et al., “Internet Addiction Disorder and Problematic Use of Google GlassTM in Patient Treated at a Residential Substance Abuse Treatment Program,” Addictive Behaviors 41 (September 2014):58-60. doi: 10.1016/j. addbeh.2014.09.024.
  3. Derek D. Reed, “Ultra-violet Indoor Tanning Addiction: A Reinforcer Pathology Interpretation,” Addictive Behaviors 41 (February 2015):247-251. doi: 10.1016/j.ad dbeh.2014.10.026.
  4. Sergey Krivoschekov and O. N. Lushnikov, “Psychophysiology of Sports Addictions (Exercise Addiction),” Human Physiology 37:4 (July-August 2011):509-513. doi: 10.1134/S0362119711030030.
  5. Clark Watts and Donald Hilton, “Pornography Addiction: A Neuroscience Perspective,” Surgical Neurology International 2:1 (February 2011):19. doi: 10. ­ 4103/2152-7806.76977.
  6. Kent C. Berridge and Morten L. Kringelbach, “Neuroscience of Affect: Brain Mechanisms of Pleasure and Displeasure,” Current Opinion in Neurobiology 23:3 (June 2013):294-303./j.conb.2013.01.017. See also Ann E. Kelley and Kent C. Berridge, “The Neuroscience of Natural Rewards: Relevance to Addictive Drugs,” The Journal of Neuroscience 22:9 (May 2002):3306-3311.
  7. Kristen Weir, “Is Pornography Addictive?” Monitor on Psychology (April 2014): http://www.apa.org/monitor/2014/04/pornography.aspx. Accessed July 16, 2015.
  8. Steven E. Hyman, “Addiction: A Disease of Learning and Memory,” The American Journal of Psychiatry 162:8 (August 2005):1414-1422.
  9. Isaac Marks, “Behavioural (Non-chemical) Addictions,” British Journal of Addictions 85:11 (October 1990a):1389-1394.
  10. Seyyed Salman Alavi et al,, “Behavioral Addiction Versus Substance Addiction: Correspondence of Psychiatric and Psychological Views,” International Journal of Preventive Medicine 3:4 (April 2012):290-294.
  11. World Health Organization, Management of Substance Abuse (2015): http://www.who.int/substance_abuse/terminology/definition1/en/. Accessed June 7, 2015.
  12. American Psychiatric Association, Highlights of Changes From DSM-IV-TR to DSM 5 (2013): http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf. Accessed July 15, 2015.
  13. Marks, “Behavioural (Non-chemical) Addictions,” op. cit.
  14. __________, “Reply to Comments on ‘Behavioural (Non-chemical) Addictions,’” British Journal of Addictions 85:11 (November 1990b):1429-1431.
  15. Neil V. Watson and S. Marc Breedlove, The Mind’s Machine: Foundations of Brain and Behavior , 2nd ed. (Sunderland, Mass.: Sinauer Associates, Inc., 2016).
  16. K. S. LaForge, V. Yuferov, and M. J. Kreek, “Opioid Receptor and Peptide Gene Polymorphisms: Potential Implications for Addictions,” European Journal of Pharmacology 410:2-3 (2000):249-268. doi: 10.1016/S0014-2999(00)00819-0.
  17. Berridge and Kringelbach, “Neuroscience of Affect,” op cit. See also A. E. Kelley and K. C. Berridge, “The Neuroscience of Natural Rewards: Relevance to Addictive Drugs,” The Journal of Neuroscience 22:9 (May 2002):3306-3311.
  18. Ibid.
  19. Peter W. Kalivas and Nora D. Volkow, “The Neural Basis of Addiction: A Pathology of Motivation and Choice,” American Journal of Psychiatry 162:8 (August 2005):1403-1413. doi: 10.1176/appi.ajp.162.8.1403.
  20. Berridge and Kringelbach, “Neuroscience of Affect,” op. cit.
  21. Eric J. Nestler, “Molecular Basis of Long-term Plasticity Underlying Addiction,” Nature Reviews Neuroscience 2 (February 2001):119-128.
  22. Kalivas and Volkow, “The Neural Basis of Addiction,” op. cit., p. 1408.
  23. Christopher M. Olsen, “Natural Rewards, Neuroplasticity, and Non-Drug Addictions,” Neuropharmacology 61:7 (December 2011):1109–1122. doi: 10.1016/j.neu ropharm.2011.03.010.
  24. Marks, “Behavioural (Non-chemical) Addictions,” op. cit.
  25. Ibid., p. 1391.
  26. J. E. Grant et al., “Introduction to Behavioral Addictions,” American Journal of Drug and Alcohol Abuse 36:5 (September 2010):233-241.
  27. bid.
  28. Donald W. Black et al., “Family History and Psychiatric Comorbidity in Persons With Compulsive Buying: Preliminary Findings,” American Journal of Psychiatry 155:7 (July 1998):960-963; Judson A. Brewer and Marc N. Potenza, “The Neurobiology and Genetics of Impulse Control Disorders: Relationships to Drug Addictions,” Biochemical Pharmacology 75:1 (January 2008):63-75. doi: 10.­1016/ ­ j.bcp.2007.06.043.
  29. Niels G. Waller et al., “Genetic and Environmental Influences on Religious Interests, Attitudes, and Values: A Study of Twins Reared Apart and Together,” Psychological Science 1:2 (1990):138-142.
  30. R. D. Stoel, E. J. De Geus, and D. I. Boomsma, “Genetic Analysis of Sensation Seeking With an Extended Twin Design,” Behavior Genetics 36:2 (March 2006): 229-237.
  31. G. M. Heyman, Addiction: A Disorder of Choice (Cambridge: Harvard University Press, 2009), p. 173.
  32. Hyman, “Addiction: A Disease of Learning and Memory,” op. cit.
  33. Heyman, Addiction: A Disorder of Choice, op. cit., p. 173. The argument is augmented in Heyman’s “Addiction and Choice: Theory and New Data,” Frontiers of Psychiatry 4:31 (May 2013):1-5. doi: 10.3389/fpsyt.2013.00031.
  34. Heyman, Addiction: A Disorder of Choice , ibid., p. 173.
  35. __________, “Addiction and Choice: Theory and New Data,” op. cit.
  36. H. Hansen, “Faith-based Treatment for Addiction in Puerto Rico,” Journal of the American Medical Association 291:23 (June 16, 2004):2882.
  37. M. E. McCullough and B. L. B. Willoughby, “Religion, Self-Regulation, and Self-Control: Associations, Explanations, and Implications,” Psychological Bulletin 135 (2009):69-93. doi: 10.1037/a0014213.
  38. G. L. Xiong and P. M. Doraiswamy, “Longevity, Regeneration, and Optimal Health: Does Meditation Enhance Cognition and Brain Plasticity?” Annals of the New York Academy of Sciences 1172 (2009):63-69.
  39. R. J. Davidson et al., “Alterations in Brain and Immune Function Produced by Mindfulness Meditation,” Psychosomatic Medicine 65:4 (July 2003):564-570. doi: 10.1097/01.PSY.0000077505.67574.E3.
  40. McCullough and Willoughby, “Religion, Self-Regulation, and Self-Control,” op. cit., p. 84.
  41. See 1 Corinthians 10:13 (ESV). All Scripture texts in this article are quoted from the English Standard Version. Scripture quotations marked ESV are from The Holy Bible, English Standard Version, copyright © 2001 by Crossway Bibles, a division of Good News Publishers. Used by permission. All rights reserved.
  42. See also James 4:7 and Hebrews 2:18, as well as the implied promise of deliverance found in the prayer of our Lord in Matthew 6:13. Ephesians 6:11 to 18 also provides a list of spiritual disciplines that can serve as a protective shield against temptation.