Table 8 Free-text suggestions for supporting conversations about online activity
Suggested methods for normalising online activity | |
• Casual reference to other young people the clinician knows or works with, or the clinician’s own use, acknowledging that the online world is central to most people’s experience (both panels) | |
• Begin by asking about ‘benign, day-to-day use, such as favourite Tik-Tok dances or favourite socials ‘ (PP) | |
• Begin questions about harmful use with reassurance, for instance “sometimes when [young people] are struggling a lot, our brains seek out that kind of website” (YPP) | |
• Frame questions to openly accept the young person is online, thereby inviting them to talk about ‘which’ and ‘how’ rather than ‘whether’ (Both panels) | |
• ‘Talk casually’ and ask about online activity alongside normal topics such as school or sleep so it appears equally ‘commonplace’ and ‘not a massive deal’ (YPP) | |
• Demonstrate knowledge of popular sites, platforms, activities and language/ terminology | |
• Show understanding that the online world is fundamental to young people’s lives, can be good, and cannot merely be ‘cut off’ (PP) | |
Methods for supporting and empowering positive online activity | |
Safe online practice and behavioural tactics to: • reduce usage and exposure • provide strategies for coping with harmful content | • Use of online safety tools: reporting; blocking; use of filters to ‘clean’ feed and hide triggers (incl. trigger words and hash tags) • Use of safety apps to monitor and restrict use • Self-imposed time limits to reduce scrolling • Self-imposed screen breaks at specific times (e.g. at night, when more vulnerable/ likely to impact on sleep) • Self-imposed breaks from particular platforms • Unfollow accounts that trigger negative feelings or behaviours, including self-comparison • Limit communications to positive interactions and manage pressure to respond • Bookmark links to online help sites, resources, services and apps • Close and re-make social media accounts |
Promote insight and self-awareness | • Journaling and discussion to recognise and monitor impact of use: identifying what is helpful and unhelpful, challenging v. rewarding sites, risks and outcomes • Discussion around reasons for engaging with harmful/ inappropriate content and how use can be problematic • Discussion to reflect on online identity • Education, e.g. around online harms, algorithms |
Signpost/ facilitate positive online use | • Identify and focus on current beneficial uses (including supportive communities, sites and friendships) • Recommend ‘healthy’ content (e.g. positive influencers, social media promoting self-care, supportive communities) • Signpost and demonstrate positive online activities and resources (eg. support/ treatment apps, help-sites) |
Provision of offline alternatives | • Identify offline support network • Introduce/ devise alternative offline coping strategies (e.g. don’t scroll, call a friend) and methods of distraction or self-regulation (e.g. ‘calm boxes’, mindfulness) • Build-up regular offline activities |
Practitioner-patient communications | • Foster open, non-judgemental communication • Discuss what is upsetting online and explore patterns of behaviour and impacts in partnership • Follow-up on recommended tactics and use (incl. use of apps) • Incorporate into assessment and planning |
Help-seeking | • Encourage discussion with trusted offline adult contacts (e.g. parents, teacher, youth worker) about online activities, especially when upset/ worried by content |