Clinic for Interactive Media and Internet Disorders (CIMAID)

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The Clinic for Interactive Media and Internet Disorders (CIMAID) is a specialty clinic within the Division of Adolescent and Young Adult Medicine at Boston Children’s Hospital. Led by Michael Rich, MD, MPH and Michael Tsappis, MD, CIMAID is a multi-disciplinary team that evaluates and treats children, adolescents, and young adults whose excessive online activities have caused problems with sleep, school, social functioning, physical health, and mental health.

The CIMAID team accepts referrals of young people experiencing negative consequences of problematic media and technology use, supporting them to adopt and sustain healthy lifestyles and behaviors.

Referring a Patient / Requesting an Appointment

We accept patient referrals from clinicians and appointment requests directly from parents and guardians. To make a request, please download and complete this intake form and return to cimaid@childrens.harvard.edu. We can also be reached by fax at 617-730-0004.

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Frequently Asked Questions

We recommend that families seek a referral from their primary care physician or pediatrician. To request an appointment, please download and complete this form and return to cimaid@childrens.harvard.edu. The form asks about your child’s media and technology use, their physical and mental health, and their academic and social experiences.

If your child is 18 or older, please also have them complete this form and return with the intake form.

Our clinical team will review the form within 1-2 weeks, to determine if our clinic is a good fit for your child’s needs. If it is determined to be a good fit, you will receive a phone call to schedule your child’s first appointment. If it is determined to not be a good fit, one of our team members will follow up via phone or email to suggest other options.

The first visit is typically 90 minutes and includes both you and your child. These visits are typically done via virtual visits, however in some cases they will be conducted in person. During the intake appointment, the clinician will talk with each of you separately and together to better understand the issues surrounding your child’s media use. Following this visit, the clinician will determine the number and frequency of follow-up sessions, which are typically conducted virtually and range from 30-60 minutes in duration.

Your provider will work with you and your child on a PIMU management plan tailored to your child’s specific needs. Management plans may include

  • Medication, therapy, or consultation with your child’s current doctors and/or therapists;
  • Guidance on establishing clear expectations around media use; and/or
  • Guidance on other individual and family issues that may be affecting your child’s media use.

Patients can expect to have a brief series of follow-up appointments, typically 4 to 6, depending on your child’s PIMU management plan. When treating PIMU, remember that the goal is to help your child develop healthier behaviors surrounding their media use, and behavioral change takes time. These follow-up appointments will allow the provider to modify the PIMU management plan as needed, and will help guide you and your child through this process.

Due to licensing requirements, all new patients must be physically within the state of Massachusetts for their first visit. If it is prohibitive to come to Boston to be seen in person for the first visit, we can conduct the intake visit via telehealth as long as the patient is physically within the state of Massachusetts. All visits thereafter can be conducted via telehealth and across state lines.
Our waitlist fluctuates based on the patient’s availability and the schedule for their clinician. Currently, our clinicians typically see patients on Tuesdays. We are typically able to see new patients within 3-8 weeks.
At Boston Children’s Hospital, we can see patients up to age 26, however, to ensure consistency of care, we typically accept new patients at CIMAID up to age 24.
We accept all major insurance providers. If you require a referral or need to confirm that a specific provider is covered under your insurance, please contact us directly at cimaid@childrens.harvard.edu to be provided with your clinician’s medical number.

Many children and teens suffering with Problematic Interactive Media Use do not see their use as a problem and don’t believe it’s necessary for them to come to CIMAID. In some cases, they may even refuse to attend their appointment. Here are some things you can do to prepare your child for their visit:

  • Give your child advance notice; never surprise them with the CIMAID visit. Explain your concerns and share that the goal is to get a professional’s opinion on how to help your child live a healthier, more fulfilling life.
  • Explain that this is not a punishment. Help your child to understand that media use is a part of everyday life, so it’s important to understand how to take control of how their use of media makes them think, act, learn, and grow.
  • Many children and teens worry that they will have their device taken away, either by the doctor or by their parents. Reassure your child that everyone involved will work together to create healthy guidelines around media use and that the goal is not to force them to “quit” their technology, games, or apps.
  • Ask your child to think of questions to ask the doctor, so they can play an active role in their visit.

If you or your child are experiencing a medical emergency, please call 911 or go to the nearest emergency room.

Get our Family Digital Wellness Guide

Our Family Digital Wellness Guide is designed to provide parents and caregivers with information and guidance based on clinical evidence and scientific research. In it, we discuss both the benefits and risks of digital media use and provide strategies for parents and caregivers of children from birth through young adulthood.

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GO TO THE GUIDE

Problematic Interactive Media Use (PIMU)

It is estimated that 1.5-2.1 million adolescents in the United States experience disordered use of interactive media and technology that results in negative consequences to their social and mental wellbeing and academic outcomes. These problematic use profiles are often referred to by different terms, including gaming addiction, problematic internet use, pornography addiction, or internet addiction, among others.

The term “problematic interactive media use,” or PIMU, was coined by the clinical team at the Clinic for Interactive Media and Internet Disorders at Boston Children’s Hospital to capture the full spectrum of problematic usage of digital media and technology, including – but not limited to – video games, information-seeking, binge-watching, pornography overuse, and use of social media.

Children and teens experiencing PIMU may also experience other conditions, including Attention Deficit and Hyperactivity Disorder (or ADHD), social anxiety, generalized anxiety, depression, and substance use disorders . More research is needed to understand the extent to which the problematic media use causes these challenges versus these issues driving increased media use.

Learn more about PIMU in our guide on this topic.

Clinician’s Toolkit

Our Clinician’s toolkit contains research, anticipatory guidance, and patient education materials to help you to talk with your patients about the effects of media on their health, support your patients in building healthy media habits, and identify your patients’ problematic media use behaviors.

Go to the Clinician’s Toolkit