Evolution of specialist treatment of gaming disorder and internet addiction in Japan

Despite a relatively short history in the field of disorders, treatment evidence for gaming disorder (GD) and internet addiction (IA) has been gathered. Notwithstanding, in many countries, an understanding of treatment service delivery is lacking. In this study, we have investigated how treatment services at specialist facilities have evolved in Japan, historically and up to the current time, focusing on service delivery and treatment challenges at these facilities.

We firstly identified facilities providing specialist treatment for GD and IA using mailed questionnaire surveys, with the assistance of mental health and welfare centers, in 2016, 2018, 2020 and 2023. In order to elucidate how treatment was delivered, together with the related treatment difficulties, additional questionnaire surveys were conducted in 2020 and 2023 with specialist treatment facilities, as identified by the aforementioned surveys.

The number of facilities showed a 4.5-fold increase between 2016 and 2023. The service delivery was initiated, maintained, and led by facilities in response to treatment and consultation demand. Despite this increase in number, the geographical distribution has been uneven. With regard to treatment goals, the vast majority of facilities have focused on encouraging activities other than gaming rather than simply reducing gaming time. Notably, between 2020 and 2023, there was a tendency away from generalized and toward specialized treatment programs. Additionally, specialists faced a range of difficulties in treatment delivery, often related to the high comorbidity rate of neurodevelopmental disorders. However, during this period, specialists became increasingly adept at managing these issues.

The results suggested that the service delivery system for GD and IA has rapidly developed, driven by treatment facilities in response to growing treatment and consultation demand, which may be characteristic of, or even unique to Japan. The results also suggested that specialization of treatment programs and the skills of specialists in managing difficulties in the course of treatment may have advanced in a relatively brief period of time. Challenges to be addressed include a widening gap between the numbers of treatment seekers and the capacity of treatment providers, together with the skewed geographical distribution of facilities.