Table 1.

Approach for providers to social media use by youth and young adults: clinical questions and protective factors

Areas/questions	Prompts or specifics	Follow-up questions	Protective factors
Normalise, when possible, the use of electronics and devices Which do you use? How much time per day?	Teenagers spend an average of 6–8 h daily Options • Mobile phone • Computer/tablet • Gaming systems (X-Box, Wii, PlayStation) • Television • Other	Which do you use the most? Which is your favourite? Compared with the average teen, about how much screen time do you have daily? Do you use privacy settings? Have you lied about your age to gain access?	Purposeful networking/ communication Use focused on new friendships or building current relationship Emotionally stable, restrained or high harm avoidance Approachable, high social skills Serene, satisfied with life and high self-esteem
Screen for social networking accounts/profile. Which is your favourite? Why? Are you ‘friends’ with your parents or siblings? Do your parents limit your time? Daytime Evening/night Do your parents have your passwords?	Facebook Twitter Instagram YouTube Tumblr Google Plus Pinterest Email Snapchat Video-sharing platforms Chat rooms MySpace Other	Do you use media to deal with stress? How often? Number of hours per day? Does media use cause you stress, and if so, how? What do you post? Photos, posts, phone, school, city, birthdate? Videos: what kind? Have you posted or received inappropriate photos? Have your posts caused problems for you, a friend or family member? How many friends do you have? Do you personally know all of the friends on your social media? Have you interacted with strangers online, and if so, do you use your real name? Have you had bad experiences?	Open discussion of use and high level of supervision Those who may need more supervision Low levels of psychopathology Anxiety Depression Not psychotic Not autism spectrum disorder Not attention-deficit hyperactivity disorder Males Younger Lower-income family (i.e. may need more structure and support)
Screen for positive aspects of internet and media use	Which specific sites have been helpful to you?	Have you gotten health or mental health information online? Have you used self-help sites? Have you made friends or gotten closer to a friend online? Have you used apps for wellness? Have you ever helped a friend who felt suicidal online or via text/chat?	Parallel positive family involvement/function Interested/involved Higher functioning and education Positive relationship role modelling Positive peer relations Opposed to bullying Supportive Friendly actions/ pranks
Screen for problematic use or risky behaviour	Online use disrupts your sleep Visiting sites with sensitive topics that you do not want others to know Meeting others online that you do not know Times you were involved with or seen bullying or harassment Sexting	How often do you stay up at night on media? Have you visited sites regarding: Weapons Porn Suicide Anorexia Other? Have you interacted with strangers online, and if so, do you use your real name and identification info? Have you planned to meet up with someone you met on the internet? Have you ever been bullied or harassed online? Or have you bullied or harassed others online? Have you regretted posts or do not want friends/parents to see your posts? Have you ever sexted?	Interest shown and support offered Structured periods of access Reward systems in place Regular parenting schedules Consistent availability for chatting and encouragement Lower stress High stimulation/activity Autonomy supported if earned