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G H 556 Global Mental Health

Published : 09-Sep,2021  |  Views : 10

Question:

Research paper about "Serious Games and Mental Health", from serious game perspective. To recall, serious games can include educational games, military games, rehabilitation games. The purpose of a serious game is to put entertainment 2nd, or 3rd, or even not at all.

Answer:

The present era is witnessing a rapid growth and development of technology that aims to train, inform and educate populations to address a wide range of challenges faced in daily lives. An integral element of the digital technology toolset, serious games are known to hold much potential for bringing changes in therapeutic approaches across domains. Serious games refer to those games that do not have entertainment, enjoyment or fun as the primary purpose. Instead, the main aim is related to training, education and human resource management apart from health improvement (Granic, Lobel and Engels 2014). The role of serious games in mental health has been widely discussed in the literature for better understanding its potential to bring a transformation in mental health services (Clark and Clark 2016). The present research paper is about serious games and mental health from the mental health perspective. The paper aims to draw inferences from a wide range of rich literary sources to explain the impact of serious games on mental health. Further, the effectiveness, accessibility and feasibility of such games for being applied in mental health treatment would also be discussed. The present status of application of serious games and gamification in mental health and the promising directions are an integral part of the paper.

According to Johnson et al. (2016), computer games and video games have wide spread use across communities that have enormous variation along dimensions like involved technology, interaction and goals. Research indicates that computer or video games that have high quality are useful for enhancing concentration, improving information retention and facilitating deep learning. Changes in human behaviour might also be brought about through such games under certain conditions. Over the past few years, game-based approaches, both ‘gamification’ and ‘serious games’ have been studies and developed for addressing ‘serious’ purposes, which is educating, motivating, and persuading users in health and educational settings alike. There lies a distinct difference between gamification and serious games. While serious games use gamming as the primary medium, gamification is the addition of elements of the game to non-game contexts. There is, however, adiscrepancy in how serious games has been viewed and researched on. The authors have to opine that in contexts where serious games have been studied, there is a poor description of interventions at certain stages. Moreover, diverse approaches have been treated as homogeneous.

Loh, Sheng and Ifenthaler (2015) highlight the reasons that justify the application of serious games in the mental health contexts. The prime reason is that serious games offer a very important ‘appealing potential’ as indicated by the high popularity of such games. At the core lies the ability to reach to populations through gaming approaches and instil mental health interventions which would otherwise have been impossible. It is to be noted that there remains a large section of the population of mental health patients suffering distress, giving treatment to whom is not an easy process. Secondly, serious games are known to have ‘enagaging potential’. Surveys have indicated that users view gaming approaches as highly pleasurable and enjoyable. It is an urge that comes from within to win such games and see what unfolds. On this basis, it has been argued that such suitable dynamics might contribute to the reduction of high attrition rates in interventions that are naturalistic. Thirdly, serious games have ‘effectivenees potential’. This is so because gaming provides users with an opportunity to learn and bring changes in personal behaviour through non-conventional as well as conventional approaches. For example, games can allow potential sensory environments that are significant for learning. In addition, social learning and behavioural modelling are also fostered. Users are thereby allowed to try skills in a reactive yet safe environment. This facilitates rehearsal of new behaviour.

Games take advantage of engagement processes. Reynolds et al. (2017) carried out a study for identifying main motivational orientations supporting engagement of mental health patients into gaming. The identified orientations were exploration, domination, sociability, achievement, and immersion. An individual might have one or more of these motivations for playing a game. in this context it is to be remembered that predominant motivations tend to show a discrepancy across demographic contexts, groups and game types. For those who are easily motivated through these processes might consider a few of gaming elements for enhancing engagement. For others, more extensive and more effective features of gaming would be critical that can motivate improvement in mental health.

The most eminent forms of applied games that are effective in mental health interventional approaches have been discussed by (Wattanasoontor et al. 2013). The authors have highlighted six different forms of games that can be considered for therapeutic changes. These are exergames, virtual reality games, Cognitive Behavior Therapy (CBT)-Based Serious Games, Entertainment Computer Games, Biofeedback-Based Games and Cognitive Training Games. Exergames are movement based games that address depressive symptoms. Virtual reality games offer interactivity in an augmented world presented with sensory, audio and visual stimuli that increase  engagement of users. Multilevel CBT-based programs utilise a fantasy environment that reduces anxiety as well as depressive symptoms. Entertainment Computer Games affect the mood of individuals through stress reduction, emotional directive, and social support pathways. A novice form of commercial games application for treating patients with mental health complications is marked by te utilisation of the puzzle games with the aim of therapeutic approaches. Biofeedback-Based Games lower depression and anxiety. Cognitive training games are effective against cognitive impairment.

At this juncture, it would be desirable to discuss the different mental health conditions addressed by video gaming approach and the respective games that have been used in practice. Serious games might have the training or psychoeducational purposes, both of which are of equal importance. The serious game SPARX aims at treating adolescents of age between 12 and 19 years suffering from depression. This game is basically a problem solving and goal oriented game utilised for relieving patients from symptoms of depression. The basis of the game is cognitive behavioural therapy. One version of the game can be played even when internet connection is not provided. While playing the game, the player is required to control a certain personalised character restoring the balance in a world of fantasy. This is to be done by solving eminent challenges and eliminating negative thoughts. It is to be noted that all these elements are a component of cognitive behaviour therapy (Kemppainen, Korhonen and Ravelin 2014).

The post-traumatic disorder can be addressed through games such as Tetris. The basis of the study is neurobiology of memory and cognitive science findings. It is to be assumed that visuospatial and sensory-perceptual mental images make up flashbacks suffered by individuals in relation to traumatic events. Carrying out visuospatial tasks post a trauma and within memory consolidation time frame leads to competition for resources. This leads to decrease in flashbacks. At present, the game is available on a different platform such as a tablet, mobile, and game consoles (Wu et al. 2017). The game Junior Detective Training Program (JDTP) has been used for addressing Autism Spectrum Disorder in patients. The game has the player playing the role of a junior detective living in the era 2030 and responsible for decoding the feelings and thoughts of the suspects. This decoding is to be done through understanding body postures, facial expressions, and deciphering nonverbal clues. The game Let’s Face It! That supports cognition training reduces ASD-related symptoms, one of which is poor facial recognition skills. The game can be played without internet connection (Lau et al. 2017).

Cortese et al. (2015) summarised the games used for addressing Attention Deficit Hyperactivity Disorder and Cognitive functioning. As per the authors, the game Braingame Brain provides cognitive training and addresses deficits presented by the patient in relation to executive functioning such as attention, hyperactivity and impulsivity. In this game, Brian is a young inventor is responsible for helping and befriending characters through the creation of inventions. The game is made of inhibition task, cognitive flexibility task and working memory task. Other games addressing cognitive functioning have the focus on speed of processing, working memory and control of cognitive functioning. Treatment of symptoms of Alcohol Use disorder has been the focus of games such as Guardian Angel. In this game. The player is given the role of a  “guardian angel” who is supposed to guide and help any certain character for making a recovery from AUD. Daily decisions for recovery process and continuous abstinence are to be taken by the player. In addition, they are to identify and eliminate relapse risk factors. The game has the key focus on methods for relapse prevention that encompass identifying stimulus control, drink-refusal skills, high-risk situations, and craving-management methods (Lau et al. 2017). 

Turner, Thomas and Casey (2016) pinpointed that though the potential for serious games to act as therapeutic interventions has been established along a wide range of literature, the challenges that come along must not be ignored. These mainly include speed of implementation, game development costs, challenges pertaining to face validity, and lastly preferences of users. The motivation level of users is a key concern. People might not be willing to use such important resources and perceive them to be inappropriate. Those not wanting therapeutic assistance might show displeasure that a game can hold important agendas for mental health.

Dillon et al. (2016) argue that serious games is still at the infant stage in relation to its application to the mental health services. There is still a limitation in the scope of evidences highlighting a positive influence of digital gaming on mental health well being. The authors stated that the cost and complexity involved in coming up with a new serious game and evaluating it for understanding it therapeutic value might not be the answer to an under-resourced service. It is imperative that a considerable amount of investment and time would be required for developing a completely evaluated and service user-led the serious game. Mandryk and Birk (2017) oppose this idea and state that corporations and health care bodies must recognise the potential of serious games so that they can be applied suitably in the near future. Organisational conglomerates are investing huge amounts in development of software that supports large and dedicated serious game divisions. Universities across the globe are to work in collaboration with industries to develop beneficial cognitive therapies through serious games.

Lau et al. (2017) in this regard highlight that industries must only be concerned about the benefits that are to be gained from serious games since the costs of developing such games at the initial level is to be borne by the respective software companies. It is significant that forward-looking and progressive software and clinical expertise would be available in this manner for that would give rise to realistic and effective gaming environments. Though serious games developers might be showing a tendency to consider the end-user as more important, developing games in a two-way partnership for reflecting scenarios that they dwell in would be a novel approach. A current trend revolves around considering entertainment games such as Tetris and Pokémon Go for therapy purposes. The cost of development of games is to be recovered. In addition, there is a need of on-going maintenance to be provided by profit-making organisations. Further, there must be a source of questions raised for understanding the ownership of data gathered through intelligent agents and analytic devices entrenched within such serious games (Clark and Clark 2016).

Birk and Mandryk (2016) opined that it is feasible and reasonable to translate conventional evidence-based interventions such as exposure therapies and cognitive behavioural therapy to video and computer gaming formats. It is also feasible to take advantage of characteristics of video games for therapeutic change that are guided by processes that are not customarily prominent in therapies based on psychological approaches. Moreover, further research must be directed towards understanding the chances of achieving positive mental health outcomes through casual video game playing. This is noteworthy since a large population can be included in this. In addition, there lies an absence of data highlighting whether approaches based on gaming techniques might prove to be more appealing when a comparison is done with the non-gaming mental health interventions in case of patients who do not show the requirement of accessing help at the time of distress. This forms a major question for research (Loton et al. 2016).

Fleming et al. (2017) recommended some strategies through which improved mental health benefits can be achieved. The first strategy is user-centred approaches that require exploring the motivational factors for engaging patients in playing video games. It has been continually illustrated that one engagement factor working for a particular individual might not be suitable for others. The second strategy is effective and engaging interventions. Ther is a demand for studies that provide details of dynamics used. The third strategy is international and intersectoral collaborations. Lastly, fast testing of games and their implementation is needed against the backdrop that expectations of users is highly evolving.

From the above analysis, it can be concluded that serious games hold immense potential to be applied within the context of serious games despite the debate around its application in practice at a wide scale. These games are valuable since they offer a proper arena for addressing psychological and social dimensions with the help of which healthcare professionals might explore and resolve complex issues. These games provide a friendly, accessible and desirable point of contact for users. The appropriate game would lead to meaningful and valid therapies that support mental health recovery. A rich pool of literature indicates that serious games promise to reinforce, augment and customise the therapies already into practice. Serious games are to be considered as tools that enhance the primary elements of the role of the mental health professional that is to utilise technology to the optimal extent for better patient outcomes. When used on an individualised basis, serious games might also serve as a portal for online communities that cross geographical boundaries, thereby facilitating novice models of care.

References

Birk, M.V. and Mandryk, R.L., 2016, May. The Benefits of Digital Games for the Assessment and Treatment of Mental Health. In CHI 2016 Workshop Computing in Mental Health.

Clark, A.M. and Clark, M.T., 2016. Pokémon Go and Research: Qualitative, Mixed Methods Research, and the Supercomplexity of Interventions. International Journal of Qualitative Methods. 15 (1) 1-3

Cortese, S., Ferrin, M., Brandeis, D., Buitelaar, J., Daley, D., Dittmann, R.W., Holtmann, M., Santosh, P., Stevenson, J., Stringaris, A. and Zuddas, A., 2015. Cognitive training for attention-deficit/hyperactivity disorder: meta-analysis of clinical and neuropsychological outcomes from randomized controlled trials. Journal of the American Academy of Child & Adolescent Psychiatry, 54(3), pp.164-174.

Dillon, A., Kelly, M., Robertson, I.H. and Robertson, D.A., 2016. Biofeedback and Gaming-Style Smartphone Applications as a Stress Reduction Intervention. In ACM Conf Human Factors in Computing Systems: Computing and Mental Health Workshop.

Fleming, T.M., Bavin, L., Stasiak, K., Hermansson-Webb, E., Merry, S.N., Cheek, C., Lucassen, M., Lau, H.M., Pollmuller, B. and Hetrick, S., 2017. Serious games and gamification for mental health: current status and promising directions. Frontiers in psychiatry, 7, p.215.

Granic, I., Lobel, A. and Engels, R.C., 2014. The benefits of playing video games. American Psychologist, 69(1), p.66.

Johnson, D., Deterding, S., Kuhn, K.A., Staneva, A., Stoyanov, S. and Hides, L., 2016. Gamification for health and wellbeing: A systematic review of the literature. Internet interventions, 6, pp.89-106.

Kemppainen, J., Korhonen, T. and Ravelin, T., 2014. Developing Health Games requires multidisciplinary expertise. Finnish Journal of eHealth and eWelfare, 6(4), pp.200-205.

Lau, H.M., Smit, J.H., Fleming, T.M. and Riper, H., 2017. Serious games for mental health: are they accessible, feasible, and effective? A systematic review and meta-analysis. Frontiers in psychiatry, 7, p.209.

Loh. C.S., Sheng, Y. and Ifenthaler, D. 2015. Serious Games Analytics, Methodologies for Performance Measurement, Assessment and Improvement. Springer International Publishing Switzerland.

Loton, D., Borkoles, E., Lubman, D. and Polman, R., 2016. Video game addiction, engagement and symptoms of stress, depression and anxiety: The mediating role of coping. International Journal of Mental Health and Addiction, 14(4), pp.565-578.

Mandryk, R.L. and Birk, M.V., 2017. Toward Game-Based Digital Mental Health Interventions: Player Habits and Preferences. Journal of medical Internet research, 19(4).

Reynolds, L.M., Davies, J.P., Mann, B., Tulloch, S., Nidsjo, A., Hodge, P., Maiden, N. and Simpson, A., 2017. StreetWise: developing a serious game to support forensic mental health service users' preparation for discharge: a feasibility study. Journal of psychiatric and mental health nursing, 24(4), pp.185-193.

Turner, W.A., Thomas, B. and Casey, L.M., 2016. Developing games for mental health: A primer. Professional Psychology: Research and Practice, 47(3), p.242.

Wattanasoontorn, V., Boada, I., García, R. and Sbert, M., 2013. Serious games for health. Entertainment Computing, 4(4), pp.231-247.

Wu, Y., Eisenegger, C., Zilioli, S., Watson, N.V. and Clark, L., 2017. Comparison of clear and narrow outcomes on testosterone levels in social competition. Hormones and behavior, 92, pp.51-56.

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