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The benefits of Gamification for mental health

The uses of gamifying counselling and mental health therapy

With the pandemic crisis of Covid-19, the world has been forced to embrace the various possibilities of 21st-century technology in its totality. If the numerous technological options weren’t a part of every aspect of daily life before the crisis, then they are most certainly now.

And with the new ‘working from home’ culture now being the norm, there has also risen the likely need for providing aid to those who cannot cope with it as well as others can. As many may feel disconnected, isolated and possibly suffer from a form of cabin fever after being in lockdown for an extended period of time.

Before the crisis, technology and its obsessive features were seen as negatives, but now there is an acknowledgement of their ability to distract and support those who feel isolated. I’ve always felt that a little bit of gaming can improve your mood, and am glad that others are discovering this as well.

Here on æStranger we’ve covered the benefits that gaming and gamification have in other posts before. But those have usually been focused on specific aspects of therapy and how gamification can be used to aid those aspects. In this piece, I would like to take a somewhat broader look at the overall idea of using gaming and gamification as a counselling tool.

A word of advice before we continue, when using gamification to better engage those that need help and support, do be careful in its use and make sure it is moving towards an objective that benefits those in need.

The TL;DR of what we will look at in this piece is:

  • Role of gamification in counselling – the research done around gaming and gamification as therapeutic tools,
  • Possibilities of gaming in mental health – how gaming can benefit those with mental health issues,
  • And examples of gamification in counselling – using the two examples of SPARX and SuperBetter to show the varying use of gaming and gamification in counselling.

The role of gamification in counselling

Using gaming as a tool in counselling isn’t a new concept. The idea of using games to help with your emotional and mental state has been around for quite some time. One of the first studies of note was one published by Crocker and Wroblewski in 1975, which looked at how recreational games could be used within a group counselling session.

Other area’s where gaming has been of use as a therapeutic tool is with play therapy in child counselling. The activity of playing allows children to express themselves more freely and take away barriers that may be there due to external pressures.

Gaming, and by extension gamification, in these settings are so powerful because they can engage and immerse players. As players lose themselves in the game, they no longer ‘consciously’ think about they are doing, they enter a state of Flow. When they are in this state, therapists can observe their behaviours in various contexts and how they react to these.

Since games and gamification have structures, rules, objectives, win and fail states, these can be used to observe and analyse the interactions and reactions in a person and use the conclusions taken from them to develop a more effective therapy.

Examples of this could be when individuals are tasked with an objective and seeing how they go about completing it. This is illustrated with such things as when LEGO or something similar is used and the person must create something and explain what it is and why they created it. This process can give valuable insights to therapists.

Gaming and the possibilities in mental health

When considering gaming and gamification with mental health, it has always been a tense relationship between the two. In 2018 the WHO listed that gaming and gaming obsession is a mental health disorder.

However, with the crisis and the need for everyone to stay safe and at home, the WHO has come to the realisation that gaming can in fact help. With an initiative that they named #PlayApartTogether, they teamed up with various companies in the video game industry, to help those that feel isolated at home during the lockdown.

Some of the more recent studies that have been done into the potential of video games and mental health have started to explore their effectiveness counselling tools when dealing with depression, a possible outcome of remaining isolated for too long.

One such research study is the paper “Serious Games and Gamification for Mental Health: Current Status and Promising Directions”. The paper discusses and looks at how immersive activities that players engage with in games, with particular note for VR and AR games, and how these can enhance overall engagement for patients and improve therapeutic effects.

There are other earlier studies, such as one from the University in Nijmegen, in the Netherlands, where the researchers analysed the benefits of video games and determined that they could promote the well-being of patients and improve the treatment of mental health issues.

What all these studies have shown is that possibilities of gaming in mental health can be quite extensive. Specifically, they’ve discovered that entertainment video games have shown the most effective when there is the requirement to improve mood and act as a stress/emotional relief valve. This can be seen in particular with the aforementioned WHO initiative: #PlayApartTogether.

The overarching theme of all these studies is that they certainly show that the elements within games that make them engaging, are incredibly useful in treating mental health issues and offering methods to better observe and analyse individuals in need of help.


Examples of gamification in counselling

There are quite a few examples of gaming and gamification in counselling and as therapeutic tools, or as examples of what mental health issues are like. Hellblade: Senua’s Sacrifice is a good example of what trauma may be like for some.

But the most prominent example currently of a game that is used as a counselling tool is a game called SPARX, which is designed to help reduce depression in those that play it. The game takes place in a fantasy world and has several levels that the player goes through, solving puzzles, completing quests and learning methods to better manage their mental health. Using such game elements as customisation, purpose and mastery, the game helps teach the player various skills that can better ‘shield’ them from depression.

When the game first came out, the BMJ looked at the game and determined that people who played it had a marked reduction in levels of depression, than those who did not play the game and only received traditional therapy. The paper does state that the game should not replace therapy, but simply augment it. And this is the correct statement of usage in my opinion, games and gamification should not be replacements for traditional therapy, but rather additions to it.

Another example is SuperBetter from Jane McGonigal, which engage its users by allowing them to personally aid and work on their own recovery and helping them manage stress and depression. As it engages it’s users in an activity that lowers the barriers for discussing mental health issues that they are struggling with. In essence, it helps make CBT (Cognitive Behavioural Therapy) less ‘boring’ for those that use the application.

Final Thoughts

Some final thoughts of when considering games and gamification for counselling and treating mental health issues. Some caution should be taken when looking into them and in specifically two points of note need to be remembered.

Firstly, presenting a gamified therapy session to a patient should be properly contextualised. Those who are vulnerable will not benefit from a badly presented option that has the possibility of coming across to them as a trivialisation of their issues.

And secondly, when using gaming or gamification tools, be sure to use ones that have been properly tested by professionals in the correct fields, such as game design and psychology. You do not want to use a low-quality tool, as this will be of no benefit to anyone. In addition to checking the quality of the tool, make sure that the gamified experience’s objective aid’s the counselling intention, and it is not simply entertainment with the purpose of only being entertaining.

Gamification is slowly coming into the limelight, showing the benefits it can offer in a variety of areas. More research still needs to be done on it, but the growing evidence of its potential in the commercial industry and now the health industry should provide some insight into the benefits it can offer everyone. Hopefully, there is a future where activities can be both enjoyable, beneficial and aid in improving our lives in every way.


I hope that this piece has given you some food for thought and helped improve your own methods or at least offered a different viewpoint to consider.

Do check out the other posts on æ, and do leave a comment or contact us if you have some ideas of your own that you wish to discuss or if you would like to see other topics discussed.

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