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Harv Rev Psychiatry. 2010 Mar-Apr;18(2):131-8. doi: 10.3109/10673221003684000.

Navigating the internet safely: recommendations for residential programs targeting at-risk adolescents.

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  • 1Harvard Medical School and McLean Hospital, Belmont, MA 02478, USA.


Adolescence is a period during human development characterized by a variety of biological, psychological, and social changes. Navigating these changes can be a stressful experience for both adolescents and their families. To complicate matters further, the Internet has altered the landscape of human interaction in a way that may accentuate deficits in the capacity for self-sustaining, reciprocal peer relationships. Adolescents suffering from emotional and behavioral disorders may be especially prone to this influence, as evidenced by our observation of the growing clinical trend of adolescents admitted to inpatient and residential psychiatric units who present with a history of risky cyber-behaviors. Within these settings, education for adolescents and their families around appropriate use of the Internet, as well as social training for the online management of the impulsivity and poor judgment that is so often characteristic of adolescence, is vital. Milieu models employed in the treatment of emotionally troubled adolescents must adapt so as to incorporate the identification of problematic attachment behaviors not only in real-time relationships, but also as those behaviors inevitably occur in more troubling and potentially destructive ways over the Internet. The article addresses this need by offering recommendations for the creation of a skills-based, Internet-focused curriculum for inpatient and residential programs targeting at-risk adolescents. Evaluating the association between online communication habits and the evolution of disturbances in attachment systems is an important future direction for research aimed at safeguarding the emotional and physical well-being of all adolescents.

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