The scale of the problem motivating the research is striking. In Sweden, most children use the internet daily, and a recent report estimated that roughly 94 percent of children aged 8 to 12 play online games every day. A substantial proportion exceed the screen time limits recommended by the Swedish Public Health Agency. While digital media and gaming can confer real benefits, heavy and poorly regulated engagement carries notable mental health risks. The study distinguishes between excessive screen use, which simply describes a high amount of use, and problematic screen use, defined as poorly regulated digital-media use associated with functional impairment or negative consequences in daily life, such as difficulties at school, in social relationships, or in psychological well-being. Both patterns have been linked to inattention, poorer academic performance, depression, anxiety, stress, and sleep disturbance. Beyond these, gaming disorder stands as a distinct diagnosis in the ICD-11, characterized by impaired control over gaming, increasing priority given to gaming, and continuation despite negative consequences.

What sets P-FAME apart from many existing interventions is its target audience. Intervention research has traditionally focused on children and adolescents as the primary recipients of treatment, potentially overlooking how parental responses, emotional well-being, and everyday interaction patterns contribute to screen-related difficulties. The program is grounded in learning theory, emotion theory, and systemic developmental perspectives, and it integrates psychoeducation, structured homework assignments, support for generalizing strategies to everyday contexts, and peer support delivered through brief lectures, guided exercises, and therapist-led parent discussions. Across three sessions, parents first receive psychoeducation on screen use and its possible consequences, then learn to identify the behavioral functions, maintaining factors, and conflict triggers associated with their child’s screen use, and finally work on strategies to prevent and manage screen-related conflict, with emphasis on constructive family communication.

The study used a prospective single-group pre–post feasibility design. Participants were recruited from CAMHS outpatient clinics in Skåne during spring and autumn 2025, with clinicians informing families reporting screen-related difficulties about the study. Eligible participants were parents of children aged 6 to 12 who reported family difficulties related to the child’s screen use, spoke and understood Swedish, and had stable internet access. Three cohorts of families participated between April and November 2025, and questionnaires were administered two weeks before and two weeks after the intervention. In total, 29 parents of 22 children took part, with the children averaging 10.6 years of age. Notably, 95.5 percent of the children were boys, and 59.1 percent had an ADHD diagnosis, reflecting the profile of families seeking help for screen-related problems in this clinical setting.

The results were encouraging on several fronts. Attendance was high, with 52 percent of parents attending all three sessions and an average of 2.48 sessions completed, suggesting the online group format was feasible within routine outpatient care. On the primary outcomes, child weekly screen time fell by an adjusted 1,400 minutes per week after accounting for clustering within families, a difference that was highly statistically significant. Parent-reported screen time dropped from an average of roughly 3,509 minutes per week at baseline to about 1,936 minutes at post-intervention. Parental stress also declined significantly, with the total Parental Stress Scale score falling by 2.4 points and the stress subscale by 2.3 points. The largest standardized effect was observed for child weekly screen time, with a Cohen’s d of −1.81, followed by parental stress.

Not every outcome moved, however. Overall family functioning, measured with the SCORE-15 questionnaire covering family strengths, difficulties, and communication, did not change significantly from baseline to post-intervention. Reported screen-related rules, parental satisfaction, and most other secondary outcomes also remained statistically unchanged. The researchers note that a brief program may first influence concrete routines and parental stress, whereas broader relational functioning may require longer or more intensive family work, or simply more time before change becomes detectable. It is also possible that the SCORE-15 was insufficiently sensitive to short-term change in this context.

The team also explored whether a child’s ADHD diagnosis or age moderated the observed changes. Neither factor significantly altered the pre–post differences in the interaction models, with p-values ranging from 0.06 to 0.66. One age-by-timepoint interaction for family communication approached conventional statistical significance, with a descriptive pattern of greater reported improvement among younger than older children. The authors caution that the absence of significant moderation may reflect limited statistical power, restricted age variation, or measurement limitations, and that childhood includes age-sensitive periods for executive-function development, making age and self-regulatory capacity clinically plausible candidates for tailoring parent-mediated interventions in future, larger studies.

The researchers are careful about what these findings can and cannot establish. Because the study used a single-group pre–post design without a control condition, causal attribution is not possible; regression to the mean, expectancy effects, concurrent treatment, seasonal variation, and natural changes in family routines cannot be ruled out. Moreover, because parents received the intervention and reported many of the outcomes, expectancy effects, social desirability, and heightened awareness of screen use may have influenced the results, particularly for children under ten, for whom only parental reports were available. The measure of screen-related rules captured reported rule presence rather than enforcement, compliance, or effectiveness. The skewed gender distribution, with primarily boys and mothers participating, may also limit generalizability. The authors frame P-FAME as a promising low-threshold approach warranting further controlled evaluation rather than an established, scalable service model.

Despite these caveats, the clinical implications are significant. The observed reduction in screen time is theoretically meaningful given the documented associations between excessive screen use and inattention, poorer academic performance, depression, anxiety, stress, and sleep disruption, although its clinical meaning ultimately depends on what activities replaced screen time and whether the changes are sustained. The drop in parental stress is compatible with the possibility that structured guidance, peer support, and practical tools enhance parents’ perceived control, though this interpretation remains tentative. The study’s strengths include the use of standardized, validated measures, the inclusion of both parent and older-child perspectives, and delivery within a routine clinical digital format using Sweden’s Amni Care platform, with the Screens-Q questionnaire distributed in paper format.

Looking ahead, the research team calls for larger, more diverse trials with comparison conditions and longer follow-up periods to replicate the observed changes and test the mechanisms behind them. Future work could examine whether parent guidance can be tailored to baseline screen-use patterns, parental stress, child developmental stage, ADHD status, family functioning, or rule-setting practices, potentially leveraging personalization, real-time adaptive monitoring, and multimodal data integration, with attention to privacy and family burden. Implementation outcomes such as acceptability, engagement, adherence, technical access, and delivery fidelity also deserve explicit evaluation, since digital formats reduce access barriers but vary widely in effectiveness. Finally, because the study was conducted exclusively in a clinical CAMHS population, the authors recommend assessing P-FAME’s transferability to school health services, primary care, social services, and preventive settings before its reach can be extended beyond specialist mental health care. For now, the message for overstretched clinics and worried parents alike is cautiously optimistic: a short, online, parent-centered program may offer an accessible first step toward healthier family screen habits.

Subject of Research: A digital parent-focused intervention for problematic gaming and excessive screen use in children attending child and adolescent mental health services

Article Title: Effectiveness of the digital parental-family-centered program for problematic gaming and screen use in a clinical child and adolescent population

Article References: Claesdotter-Knutsson, E., Wilts, S., Werner, M., André, F., & Andersson, M. J. (2026). Effectiveness of the digital parental-family-centered program for problematic gaming and screen use in a clinical child and adolescent population. Public Health in Practice, 12, Article 100848. https://doi.org/10.1016/j.puhip.2026.100848

Image Credits: AI Generated

DOI: 10.1016/j.puhip.2026.100848

Keywords: problematic gaming, excessive screen use, parenting program, child mental health, CAMHS, digital intervention, parental stress, family functioning, gaming disorder, ADHD, screen time, public health