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Serious games as additional psychological support: A review of the literature
Abstract
During recent years a new wave of video games, "serious games," has been developed and implemented as a psychotherapeutical complement in various treatments. The objective of our study was to systematically assess the literature on "serious games" and their effectiveness when employed as a complement or psychological support in the treatment of several illnesses. We searched electronic databases and reviewed studies published up until October 2010. The games included in the review were Re-Mission, Personal Investigator, Treasure Hunt, Play Attention and an unnamed video game. Two of the nine articles were descriptive; in the remaining seven studies a favorable outcome was obtained. The reported improvements included: elevated self-esteem, higher self-efficacy, increased knowledge, awareness of the illness, adherence to treatment and problem solving skills, and enhanced outcome on cognitive and behavioral aspects of aggression. In conclusion, well-produced serious games might lead to potential behavioral improvements for patients suffering from a range of medical illnesses.
... One of the benefits of the use of SGs in mental health is the improvement of the adherence to the treatment, by increasing the motivation, helping to develop positive relationships between patients and therapists and reducing the dropouts rates [58,67,107,108]. The SGs are a valuable part of modern psychotherapy, having advantages as not tied to specific therapy times. ...
Gambling disorder (GD) is associated with deficits in emotion regulation and impulsivityrelated personality traits. In recent years there has been an increase in the use of serious games (SG) to address these factors with positive results. The aim of this study was to analyze the efficacy of the intervention with a new SG (e-Estesia), as an adjunct to a CBT intervention for GD. The sample
comprised two groups (experimental group (n = 40) and control group (n = 64)) of patients with GD diagnosis. Both groups received 16 weekly CBT sessions and, concurrently, only the experimental group received 15 additional sessions with e-Estesia. Pre-post treatment with e-Estesia administered in both groups were: DSM-5 Criteria, South Oaks Gambling Screen, Symptom Checklist-Revised and measure of relapses, dropout and compliance of treatment. As regards the experimental group were also administered: Difficulties in Emotion Regulation Scale, Emotion Regulation Questionnaire, and Impulsive Behavior Scale. No statistically significant differences in the general psychopathological
state, emotion regulation or impulsivity were found when comparing the groups. However, patients enrolled in the e-Estesia intervention had significantly less relapses and better indicators of treatment compliance than the control group. Considering these results, the use of complementary tools such as SG are useful for addressing GD.
... A komoly videójátékok alkalmazási területe rendkívül széles és folyamatosan bővül: például oktatás és tréning, személyközi kommunikáció, egészségfejlesztés és egészségügyi ellátás (Laamarti -Eid -El Saddik 2014). A komoly játékokkal játszók aktív tanulási folyamatban vesznek részt, amely képessé teszi őket komolyabb témák hatékonyabb feldolgozására, ami által intenzívebben részt tudnak venni a játékban (Garris -Ahlers -Driskell 2002, Santamaria et al. 2011. ...
Két részes írásunkban eltérő funkciójú (szórakoztató, ismeretterjesztő, érzékenyítő, segítő, terápiás) videójátékokban vizsgáljuk meg a mentális betegségek ábrázolását. Megmutatjuk, hogy e problémákról nem csak a komoly (érzékenyítő, terápiás) videójátékok nyújthatnak hű és nem-sztereotipizált képet, hanem a szórakoztató válfajba tartozók is; s hogy e játékok a hagyományos reprezentáló elemeik (történet, kép, hang) mellett interaktív sajátosságaikat (játékmechanika, szimuláció) is kihasználva miképpen tudják érzékeltetni egyes mentális betegségek lefolyásának és tüneteinek jellegzetességeit. E videójátékok jelentős társadalmi hasznot hordoznak, amennyiben hozzájárulnak a mentális betegségekről alkotott laikus tudás növekedéséhez és a destigmatizációhoz, s amennyiben alkalmasak a mentális betegségekkel küzdők helyzetének javítására, esetenként e betegségek kezelésére is.
... Research has shown that the application of this therapeutic intervention in gambling disorder can result in a reduction in addictive behavior and the associated stress. When mindfulness is used in combination with traditional CBT interventions, it also affects transdiagnostic processes, such as rumination and thought suppression, and can ultimately increase cognitive and behavioral flexibility and improve quality of life [29,[59][60][61]. ...
Purpose of review:
Despite a significant body of literature related to the treatment of gambling disorder, there are still an insufficient number of evaluation studies regarding their effectiveness or firm conclusions on specific treatment elements that contribute to it. The aim of this article was to provide a review of scientific results regarding the treatment of gambling disorder, to present the most commonly applied modalities of treatment and to explore the elements of the most successful therapeutic interventions.
Recent findings:
A substantial body of literature has shown that the most successful therapeutic protocols are psychological interventions, especially based on cognitive-behavioral therapy/methods and/or motivational interviewing. Other interventions with promising results include different self-help interventions and mindfulness. Interventions such as couples therapy and support groups, may have positive effects in terms of increasing therapeutic adherence and retention, while pharmacotherapy is especially useful in patients with comorbidities.
Summary:
Gambling disorder is a complex mental health problem caused by a wide spectrum of different biological, psychological, and social risk factors. Treatment options for gambling disorder need to be wide, flexible, accessible, and economically justified, providing early inclusion, retention, and sustainability of long-term effects of the treatment, that is, abstinence and higher quality of psychosocial functioning.
... In a study, Read & Shortell [37] highlight several different games that have contributed to players' behavioral change. Further, Santamaria et al. [38] found that serious games can improve self-esteem and self-efficacy, and can lead to potential behavioral improvements for patients suffering from various illnesses. ...
A significant number of children worldwide struggle with school refusal. Games and digital tools represent a novel take on how to address this phenomenon. Our research aims to support children who are at risk or in an early phase of developing school refusal through serious games. In this paper we present current work, grounded in human-centered design, involving the application of a game design framework to elaborate on design elements and empirical evaluations of a serious game called Gnist (English: Spark). Based on this we discuss some implications for game design and key takeaways for researchers and practitioners working to design technologies for supporting children's well-being in attending school. We contribute to position serious games in a new context and anticipate our findings to be valuable to the Human-Computer Interaction community in general and specifically to the Child-Computer Interaction community.
... Σύγχρονα εργαλεία που μπορούν να βοηθήσουν στην διαχείριση των αρνητικών συνεπειών της Μετατραυματικής Διαταραχής του Στρες σε παιδιά σχολικής ηλικίας και να προωθήσουν την Μετατραυματική Ανάπτυξή τους, είναι τα σοβαρά ηλεκτρονικά παιχνίδια (Serious Games; Kengne et al., 2018). Τα παιχνίδια αυτά έχουν σκοπό να μεταφέρουν σημαντικά μηνύματα, στα πλαίσια ενός τρισδιάστατου κόσμου όπου η μάθηση και η καλλιέργεια των δεξιοτήτων επιτυγχάνεται μέσω της έκθεσης στην εικονική πραγματικότητα (Brezinka, Hovestadt, 2007;Santamaría et al. 2011). ...
Τα τελευταία χρόνια, ιδιαίτερη έμφαση έχει δοθεί στην μετατραυματική ανάπτυξη τωνπαιδιών, δηλαδή στην θετική εξέλιξή τους σε προσωπικό, κοινωνικό και πνευματικό επίπεδο μετάτην εμπειρία τους με τραυματικά γεγονότα. Η ανάπτυξη αυτή θεωρείται ότι μπορεί να επιτευχθείμέσω της χρήσης των σοβαρών ηλεκτρονικών παιχνιδιών (Serious Games). Σκοπός αυτού τουάρθρου είναι μέσα από μια βιβλιογραφική ανασκόπηση να παρουσιάσει την αποτελεσματικότητατων σοβαρών ηλεκτρονικών παιχνιδιών ως σύγχρονων εργαλείων μάθησης και προώθησης τηςΜετατραυματικής Ανάπτυξης, παιδιών σχολικής ηλικίας. Τα αποτελέσματα αυτής της μελέτης θαενθαρρύνουν τις προσπάθειες των εκπαιδευτικών, των επαγγελματιών υγείας και κοινωνικήςφροντίδας ώστε να ψηφιοποιήσουν τις παρεμβάσεις τους, επιδιώκοντας την ενδυνάμωση όλων τωνμαθητών, με σύγχρονα εναλλακτικά μέσα.
... When mental health-related video games are designed well, they have been shown to elevate self-esteem, selfefficacy, knowledge and awareness of illness, adherence to treatment and problem-solving skills, while lowering aggression. 14 One of the most successful in the facilitation of mental health improvement is a serious video game-a complex game with multiple levels and settings-called PlayMancer (PM), which targets emotional regulation and was specifically designed to help manage impulse control disorders. 11 13 The objective of the PM game is to develop emotional and cognitive skills, while reducing impulsivity. ...
Introduction
In recent years, serious video games have been used to promote emotional regulation in individuals with mental health issues. Although these therapeutic strategies are innovative, they are limited with respect to scope of treatment, often focusing on specific cognitive skills, to help remediate a specific mental health disorder.
Objective
Here, we propose a protocol for assessing the feasibility of a novel acceptance and commitment therapy (ACT)-based video game for young adults.
Methods and analysis
The Medical Research Council (MRC) framework will be used for developing a complex intervention to design and test the feasibility of an ACT-based video game intervention using a mixed-methods approach involving qualitative and quantitative data. The primary outcomes will include feasibility testing of recruitment processes and the acceptability of the intervention through qualitative interviews, attendance and rates of attrition. Secondary outcomes will involve a series of quantitative questionnaires to obtain effect sizes for power analysis, allowing for the ideal sample size for an appropriately powered, randomised controlled trial to be determined.
Ethics and dissemination
This study has been approved by the Psychology Department Research Ethics Committee (2020-4929-3923) at Swansea University in the UK. Dissemination activities will involve publications in peer-reviewed journals, presentations at local and national conferences and promotion through social media.
Trial registration number
NCT04566042 .
Therapeutic or serious games are considered innovative ways of delivering psychological interventions especially suited for children and adolescents, which can have a positive impact on mental health, while also being fun and easily accessible online. While most serious games for children and adolescents address specific issues, such as anxiety or depression, preventive measures received less attention. REThink is an online therapeutic game designed as a stand-alone prevention tool, aiming to increase resilience in healthy children and adolescents in a Rational Emotive Behavioral Therapy framework (David et al., 2019). The aim of this pilot study was to investigate the validity of in-game performance measurements or scores as indicators of the game effectiveness in building real life emotion-regulation abilities. We analyzed how scores of different game levels (addressing different skills) are associated with improvements in mental health and emotion regulation abilities. Our preliminary results suggest that in-game performance at some levels (scores) consistently reflect improvements in psychological functioning, while in-game performance at other levels are less associated with changes in real life self-reported psychological functioning. These results offer important information about which levels can be used as preliminary indicators of psychological improvements, and which levels need to be revised in terms of task or scoring. Overall, results of our study offer preliminary validation of REThink's game scoring system, while also suggesting the elements to be refined.
For decades, gaming has been a method used by psychologists and researchers to treat a wide range of psychological disorders and problems and its effectiveness has been confirmed. In recent years, prevention, treatment, and rehabilitation for various patients by using computer games have become increasingly popular by physicians, psychologists, and even patients. Of course, there is limited research on mental health interventions in the form of digital games, and even less to guide developers on how to develop such games, especially within the country. This article focuses on understanding how digital games are applied and developed in the treatment process and mental health interventions. This article has shown that these types of games can affect the process of psychological health, well-being, and treatment of various mental disorders and problems. The benefits and uses and role of computer games in addressing some of the limitations of traditional psychological therapies and the limitations of computer games in the field of psychotherapy have also been addressed. In addition, guidelines and suggestions for developing computer games for mental health interventions are provided.
We explore novel game mechanics and techniques in the domain of gamified and game-based mobile mental health applications. By combining modern game design elements with techniques applied by practitioners (e.g., therapists) and known mechanics used in relevant games, we developed an integrated mobile game. Playtesting with a group of individuals showed a positive response towards the study's claims and a promising direction for further research.
Despite increasing scientific interest in explaining how gamification supports positive affect and motivation, behavior change and learning, there is still a lack of an overview of the current theoretical understanding of the psychological mechanisms of gamification. Previous research has adopted several different angles and remains fragmented. Taking both an observational and explanatory perspective, we examined the theoretical foundations used in research on gamification, serious games and game-based learning through a systematic literature review and then discussed the commonalities of their core assumptions. The overview shows that scientists have used a variety of 118 different theories. Most of them share explicitly formulated or conceptual connections. From their interrelations, we derived basic principles that help explain how gamification works: Gamification can illustrate goals and their relevance, nudge users through guided paths, give users immediate feedback, reinforce good performance and simplify content to manageable tasks. Gamification mechanics can allow users to pursue individual goals and choose between different progress paths, while the system can adapt complexity to the user's abilities. Social gamification elements may enable social comparison and connect users to support each other and work towards a common goal.
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