Does Video Game Therapy Work?
Video Games are the new American pastime.
As of July 2020, 64 percent of North American adults regularly play video games, nearly matching the 70 percent of those under the age of 18 who regularly play. In the US, this works out to about 214 million gamers nationwide, 46 million of them are people with disabilities (ESA, 2020).
Globally, the Video Game Industry was valued at $159.3 billion in 2020, which is quadruple the value of the global Music Industry ($19.1 billion) and triple that of the global Movie Industry ($41.7 billion). (source)
The field of Mental Healthcare has taken notice of these trends, and a rapidly growing body of research indicates that in addition to its general value for purposes like entertainment, friendship and relaxation, Video Games have numerous beneficial applications when integrated into psychotherapy for individuals and groups seeking support across a wide range of issues.
The Risks
While gamers are statistically likely to tout the many benefits that gaming has on their lives, some of their loved ones, be they parents, partners, friends or community members, may harbor doubts.
For caregivers, concerns about topics like screen time, physical inactivity, balancing indoor and outdoor time, and privacy in any type of online setting are very valid concerns. While the right balance may vary from person to person, Video Game Therapy can support individuals in being more intentional with their screen time. The therapist may also emphasize the necessity of balancing gaming with other activities and responsibilities, and provide tangible tools and build skills to support a healthy relationship with gaming.
While Video Game Addiction is very real, and impacts some people to the degree that they need support reducing their play time and finding balance, it is important to remember that this applies to a minority of people who play video games. For most gamers, play is a life-affirming hobby that provides vast opportunity for enjoyment, connection, stimulation, and improved mental health.
The Benefits
The rising popularity of gaming as a hobby is due to certain inherent benefits of gameplay as an activity. It offers entertainment, pleasure, relaxation, engrossing challenges, problem solving, rewards for hard work and persistence, cooperation with others and in some cases, redemptive narrative experience. For players experiencing stress, including stress related to mental health conditions, neurodivergence and trauma, gaming may help manage symptoms, provide regulation, self-soothing stimuli, and focus. 80 percent of gamers say gaming provides mental stimulation, and 79 percent say gaming grants relaxation (ESA, 2020). In recent years, some therapists have begun integrating games into therapy sessions to support clients with a wide variety of goals.
But, does it work?
The short answer: Yes.
Research appears to indicate that Video Games may be an effective addition to psychotherapy for a wide variety of presenting concerns.
Benefits to Therapy Overall
Recent research highlights how video games can play a powerful role in therapy when integrated into traditional approaches. Studies show that gaming not only engages clients but also helps therapists better understand and support them.
For example, Ceranoglu et al. (2014) found that observing a client’s gameplay provided insights into their thought processes, temperament, impulsivity, and decision-making. It also strengthened the therapist-client relationship and even helped anchor the therapy itself in the gaming experience.
Franco (2016a) emphasized that video games, like other creative tools such as art or film, can help clients and therapists connect, especially in treating conditions like trauma, traumatic brain injury (TBI), and eating disorders. Playing games together during sessions can break the ice, boost motivation, and encourage engagement in clients who might otherwise resist therapy (Coyle et al., 2009).
In group therapy, video games have also proven effective. Llorens et al. (2015) showed that using games in sessions improved self-awareness, social skills, and behavior in TBI survivors. Because games are inherently motivating and accessible, they also helped participants stick to their treatment plans.
As games become ever more immersive, beautiful, relatable and compelling, the modern therapist is given an opportunity to collaborate with the gaming client in a rapport-building context (Fleming et al., 2016; Turner et al., 2016; Wilkinson et al., 2008). These findings echo Gardner’s (1991) early observations of how Nintendo games helped build rapport with children in therapy, proving that video games can be a versatile, impactful tool for therapists across various settings.
By meeting clients where they are—whether on a virtual battlefield or in a creative simulation—therapists can foster trust, deepen understanding, and make therapy more engaging and effective.
Social Skills
Positive research outcomes have been shown for inclusion of video games in social skills training for participants with autism spectrum disorders (Blum-Dimaya et al., 2010; Gaylord-Ross et al., 1984).
Trauma
First-person shooter (FPS) games have been repeatedly shown to aid in symptom management for military veterans experiencing PTSD, offering distraction or stimulation that mitigates hypervigilance (Colder Carras et al., 2018a, 2018b; Elliott et al., 2015; Rizzo & Shilling, 2018). Tetris, a classic puzzle game, has been proven to reduce or eliminate the occurrence of intrusive memories following experiential trauma when played for 25 minutes after exposure to a memory trigger (Iyadurai et al., 2018; James et al., 2015; Kessler et al., 2018).
Anxiety
Studies have also shown gaming reduces anxiety in children before an upcoming operation, with similar effects to medication (Bruggers et al., 2018; Patel et al., 2006), and for children battling cancer, provides distraction from nausea and anxiety associated with chemotherapy treatments (Redd et al., 1987).
Depression
Casual games, defined by their simplicity and often centered around puzzle and pattern mechanics, have been shown to significantly reduce symptoms of clinical depression when played regularly (Russoniello et al., 2013). Further study of clinical depression by Kühn and colleagues (2018) suggest positive effects of action video game play on executive function, decreasing rumination, and subjective cognition.
ADHD
Video games have been shown to support neurological rehabilitation for attention deficit disorder (Pope & Palsson, 2001). Gaming with neurofeedback, when available, can also be a wonderful tool for improving executive function and decreasing adverse effects of symptoms for people with ADHD. Because of ADHD’s effect on dopaminergic activity, games are likely to hold an ADHDers focus more easily, gamify the learning of skills, and support sticking to treatment by making the experience more pleasant and compelling.
Cognitive Decline
Jimison et al (2004) documented the usefulness of monitored puzzle gameplay in assessing executive functioning and cognitive status in elderly patients.
TBI & Stroke
Video games can aid in recovery from TBI with minimal brain damage and attention problems (Larose et al., 1989), and recovery from stroke (Yong Joo et al., 2010).
Llorens et al. (2015) examined the role of video games in group therapy contexts for treatment of traumatic brain injury (TBI). It was found that an integrative therapeutic approach utilizing video games improved self-awareness, social skills, and behaviors in TBI survivors.
Schizophrenia
Additionally, research has demonstrated improvements in schizophrenia symptoms, as well as extrapyramidal symptoms related to antipsychotic medications, when participants played video games regularly (Han et al., 2008).
Pain Management
For purposes of cognitive distraction, studies have suggested gaming is an effective pain management tool for women with fibromyalgia (Mortensen et al., 2015). In a study focused on mitigating discomfort for children battling cancer, researchers found that tablet-based games provided distraction from nausea and anxiety associated with chemotherapy treatments (Redd et al., 1987).
Video Game Therapy: An Arena for Healing
Video Games, just like Tabletop RPGs, board games, and activity-based games, can be very effective when included in therapy in ways that are relevant to your goals. Video Game Therapy can bridge the benefits of gaming for stimulation, engagement and task-based communication with peers, with the opportunities for reflection, interpersonal skill building, and formation of supportive relationships afforded by a group therapy space.
Additionally, in group settings, the group structure is designed to support participants' development of strategies to maintain healthy gaming habits through mindful closings and transitional activities. For some gamers, ending a regular play session can be uncomfortable, not only because they may not want to stop having fun, but also because to end the game session means to disconnect from friends and their gaming community. By structuring closings with a community-building exercise, we offer an alternative experience in which endings are a time of forward-looking closeness, rather than an experience of loss and loneliness.
Interested in learning more? Contact us to arrange a free, no-commitment call, and learn more about upcoming groups offered at Golden Gate Counseling Services.
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References
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