How do you address mental health and online presence with teenage patients?

There are four variables that I talk to parents/teens about:

1. Volume of screen exposure; low vs high. There is some data that pure volume is a risk factor, but not uniformly so.
2. Psychiatric vulnerability; low vs high. Some kids are more vulnerable (e.g., social and generalized anxiety disorder and depression) and may do less well with even limited exposure.
3. Disorders that are associated with social media sites that promote the disorder. Anorexia nervosa may be the best example. Given the world we live in, I worry about isolated and withdrawn (alienated/disaffected/bullied) youth who may be attracted to the dark and violent web. Too many tragic examples of this.
4. Parent social media use; low vs high. This is a little thought-about variable in...

While I agree with the answer above, the question of dosing and site choice is a critical one which I think warrants more time.

As I try to engage all my kids as partners in their treatment I dedicate time with them to just exploring interaction with media: what they see as benefits and risks, what I see as benefits and risks, and how to recognize when they may be venturing into troubled waters. I work with them to develop their observing self which is disengaged from the activity itself and capable of noticing danger signs:

• Why they’re using it
• How they’re using it
• The amount of use measured against other activities
• Chosen sites and their function
• Signs of addiction
• Substitution for/balance against more pro-social activities

We explore q...

The general reasonable guidance I believe remains about 1.5 to 2 hours per day, a maximum of electronic screen time not related to schoolwork or work.

1) Evaluations... How often? depends on after initial evaluation and if electronic screen time remains an ongoing issue... FOR THE INITIAL EVALUATION, HOWEVER, the answer is "Yes, 100 % of every evaluation."

This is in the category of suicidality, homicidality, psychosis, substance use, and physical and/ or sexual abuse. All MUST be addressed in every comprehensive initial assessment. Then, also supportive or detrimental factors like medical conditions, medications, current or past treatments (therapy or medications, or lifestyle medicine approaches) must be addressed, including electronic sc...