Video games as therapeutic tools? How gamification might help you cope

Gamifying therapy could change the country’s approach towards addressing mental health concerns

Not all of psychologist Arijita Sen’s clients spend their sessions talking their feelings out; some play games to process their emotions. “I’ve used calm picture puzzles for individuals with sleep difficulties, or general puzzles for people working on their self-esteem and for those with depression.” Sen, who lives and works in Mumbai, says a gamified approach helps in building an interest-based engagement and triggering insights in a client. “Sometimes when they learn something through a game, the effect [on them] is deeper.”

Understanding gamification in therapy

Gamifying therapy involves using elements of gaming such as rules, rewards, points, and characters in the context of therapy. This process makes therapy more engaging, interactive, and motivating for people. “If someone lacks social skills, or is grappling with Alzheimer’s disease, elements of gamification, assisted with artificial intelligence (AI) can be used to bypass the learning deficit,” says Dr Debanjan Banerjee, a psychiatrist based in Kolkata.

In India, there is a 86 per cent gap in treatment for mental health disorders, according to the National Mental Health Survey 2015-16. The survey reveals that over 150 million Indians need mental healthcare, but less than 30 million are seeking treatment. Another study found that there are only 0.75 psychologists and psychiatrists for every 100,000 patients in the country. These abysmally low numbers point to inaccessibility of mental health services due to high costs as well as the social and cultural stigma around it. 

Banerjee had worked on a study which examined the link between using digital gamified interventions and psychiatry in India. Published in the International Review of Psychiatry, the study notes that there is room for digital gamified interventions, including using Artificial Intelligence (AI) and Virtual Reality (VR). It also notes that research and implementation on gamification of therapy exists primarily in developed countries, and not in developing countries like India. “Factors such as socio-cultural aspects, cost, digital literacy, and lack of infrastructure and research are some of the limitations impeding the exploration of gamification of therapy in India,” he explains.

Video games might be good for you

Studies have shown that gamified approaches can help in the treatment of attention deficit hyperactivity disorder (ADHD),  post traumatic stress disorder (PTSD), autism, Alzheimer’s, depression, anxiety, eating disorders, and addiction. A 2017 study by the University of Oxford revealed that playing Tetris could interrupt visual memory processing after a traumatic experience. The research—conducted in collaboration with researchers from Sweden and Germany—also suggests similar studies can be carried out in a larger sample group of patients with PTSD, such as refugees. “Anyone can experience trauma,” says Professor Emily Holmes who led the study. “It would make a huge difference to a great many people if we could create simple behavioural psychological interventions using computer games to prevent post-traumatic suffering and spare them these gruelling intrusive memories. This is early days and more research is needed.”

Contrary to the myth, video games aren’t all that bad for you. Another study from 2020 reveals that people who played Nintendo’s Animal Crossing and EA’s shooter Plants vs. Zombies: Battle for Neighborville reported greater wellbeing. Additionally, a study from 2015 found that playing Tetris helps in reducing cravings for drugs, food, sex, alcohol, gaming, and nicotine.

For applied games, Banerjee highly recommends Lumosity, Big Brain, Tetris, and Super Mario. Indian apps like MindPeers offer a range of games for mental fitness. “There are games like Sparx designed for people with depression, stress, and anxiety. These games include emotive play which helps in generating emotions,,” he says. The targets of applied games are abstract, with overlapping benefits. “This isn’t the same as going to a psychiatrist and expecting an answer for one specific problem.”

Questions of access and privacy

India’s low digital literacy and Internet penetration levels make up a chunk of challenges in implementing digital gaming interventions. For instance, only 38 per cent of the country is digitally literate. Urban India, with 71 per cent of Internet penetration, is growing more steadily compared to rural India. By 2025, it’s estimated that India will have 900 million active Internet users. There are also legal, ethical, and policy challenges involved in the use of video games as therapy tools in India. Currently, there’s only one game approved by the US Food and Drug Administration—called EndeavorRx, it is used for the treatment of ADHD. 

Critics have raised alarm over mental health apps using the user’s data in the past, and the privacy risks. A country like India which has a high treatment gap for mental illnesses, provides room for more research on the link between gamified interventions and the larger population. “There should be more research on the use of these games for not just treatment of mental illness, but also for overall mental well-being. This can be done as a preventative tool against developing mental illnesses,” says Banerjee. India still deals with deep-rooted stigma around mental health. People seeking help would not only have to deal with a sense of othering and abuse, but also view and experience Western narratives and perspectives in video games, which may not sit well with everyone.

There is a need for a pilot module on gamified interventions, suggests Banerjee. “It can be replicated for disorders such as Alzheimer’s , ADHD, autism, and learning disabilities. This will allow us to go through subject feedback in order to understand what is needed to help people. Gamified interventions will make up an important part of the future in mental healthcare,” he says.

Also Read: Can an anti-therapy partner be a red flag?

Also Read: Discussing therapy on your first date is the beige flag we all need

Also Read: Why does retail therapy make you feel happier?