JMIR Publications

ABSTRACT

Background:

Problematic use of digital technology has increased across the world. Despite growing research, evidence on treatment effectiveness across digital behaviours remains fragmented.

Objective:

To systematically evaluate and compare the effectiveness of therapeutic interventions targeted at problematic use of digital technology across various behavioural domains.

Methods:

A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines (PROSPERO: CRD420251052442). Electronic searches of PubMed, Scopus, and Embase (up to April 2025) were conducted. It identified 125 eligible studies, including 73 randomized controlled trials (RCTs), 32 non-randomized controlled trials, 14 pre–post studies, and 6 pilot studies. The Interventions that were assessed in these studies included psychological therapies,, digital/web-based programmes, exercise-based interventions, pharmacological treatments, neuromodulation, parent-focused programmes, virtual reality–based interventions, educational programmes, and multicomponent approaches. Random-effects meta-analyses using standardized mean differences (SMDs) were performed.

Results:

For problematic internet use, psychological treatments showed a strong effect (effect size = −2.68, p < .001). Digital interventions also showed significant benefit (effect size = −1.16, p < .001). For smartphone addiction, psychological treatments (effect size = −1.49, p < .001) and exercise-based programs (effect size = −3.07, p = .001) showed significant improvement. For gaming disorder, psychological treatments showed improvement (effect size = −1.01, p = .019), but results were mixed. There were limited studies to calculate pooled results for social media addiction, pornography use, gambling, screen time, and Over-The-Top content watching. No treatment studies were found for problematic Over-The-Top content watching. High heterogeneity and evidence of small-study effects were observed in several studies

Conclusions:

Overall, structured psychological therapies showed the most consistent benefit. These findings support structured interventions that aim for control of use and reduce cues linked to high use. Evidence remains limited for several emerging digital behaviours. More high-quality studies are needed in clinical settings and for less-studied forms of digital addiction.