Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ASCO Annual Meeting 2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

2024 ASCO Annual Meeting

Keep up to date with all the top stories and latest evidence with our hub page, including official congress videos and expert takeaways.
ADVANCED SEARCH
Log in
Top
Current Psychiatry Reports
Published in: Current Psychiatry Reports 12/2014

Open Access 01-12-2014 | Psychiatry in the Digital Age (JS Luo, Section Editor)

The Use of Electronic Games in Therapy: a Review with Clinical Implications

Authors: H. Lynn Horne-Moyer, Brian H. Moyer, Drew C. Messer, Elizabeth S. Messer

Published in: Current Psychiatry Reports | Issue 12/2014

Login to get access

Abstract

Therapists and patients enjoy and benefit from interventions that use electronic games (EG) in health care and mental health settings, with a variety of diagnoses and therapeutic goals. We reviewed the use of electronic games designed specifically for a therapeutic purpose, electronic games for psychotherapy (EGP), also called serious games, and commercially produced games used as an adjunct to psychotherapy, electronic games for entertainment (EGE). Recent research on the benefits of EG in rehabilitation settings, EGP, and EGE indicates that electronic methods are often equivalent to more traditional treatments and may be more enjoyable or acceptable, at least to some consumers. Methodological concerns include the lack of randomized controlled trials (RCT) for many applications. Suggestions are offered for using EG in therapeutic practice.
Literature
1.
Salonius-Pasternak DF, Gelfond HS. The next level of research on electronic play: potential benefits and contextual influences for children and adolescents. Human Technology. 2005;1(1):5–22.
2.
Allen DH. The use of computer fantasy games in child therapy. In: Schwartz MD, editor. Using computers in clinical practice: psychotherapy and mental health applications. New York: The Hawthorne Press, Inc.; 1984. p. 329–34.
3.
Clark B, Schoech D. A computer-assisted therapeutic game for adolescents: initial development and comments. In: Schwartz MD, editor. Using computers in clinical practice: psychotherapy and mental health applications. New York: The Hawthorne Press, Inc.; 1984. p. 335–53.
4.
5.
6.
Baranowski T, Buday R, Thompson DI, Baranowski J. Playing for real: vido games and stories for health-related behavior change. American Journal of Preventive Medicine. 2008;34(1):74–82.CrossRefPubMedCentralPubMed
7.••
Kato PM. Video games in health care: closing the gap. Review of General Psychology. 2010;14(2):113–23. This review describes the use and mechanisms of action of both commercially available and serious video games to enhance health and treat illness and in training medical practitioners. CrossRef
8.
Proffitt RM, Alankus G, Kelleher CL, Engsberg JR. Use of computer games as an intervention for stroke. Topics in Stroke Rehabilitation. 2011;18(4):417–27.CrossRefPubMed
9.••
Sajjad S, Abdullah AH, Sharif M, Mohsin S. Psychotherapy through video game to target illness related problematic behaviors of children with brain tumor. Current Medical Imaging Reviews. 2014;10:62–72. Using an imagery-based game in which the immune system’s destruction of tumors is represented, depression, anger, anxiety, and problem behaviors were found to be decreased post-intervention and significantly different from controls who received only medical treatment. CrossRef
10.•
Parisod H, Pakarinin A, Kauhanen L, Aromaa M, Leppanen V, Liukkonen T, et al. Promoting children’s health with digital games: a review of reviews. Games for Health Journal: Research, Development, and Clinical Applications. 2014;3(3):145–53. Authors advocate for systematic reviews of the use of video games for health promotion using AMSTAR guidelines. Evidence to date supports the benefits of sedentary games in health knowledge and active games in physical activity. CrossRef
11.
Griffiths MD. The therapeutic use of videogames in childhood and adolescence. Clinical Child Psychology and Psychiatry. 2003;8:547–54.CrossRef
12.
Tatla SK, Radomski A, Cheung J, Maron M, Jarus T. Wii-habilitation as balance therapy for children with acquired brain injury. Developmental Neurorehabilitation. 2014;17(1):1–15.CrossRefPubMed
13.
Szturm T, Betker AL, Moussavi AD, Goodman V. Effects of an interactive computer game exercise regimen on balance impairment in frail community-dwelling older adults: a randomized clinical trial. Physical Therapy. 2011;91(10):1449–62.CrossRefPubMed
14.
Hsu JK, Thibodeau R, Wong SJ, Zukiwsky D, Cecile S, Walton DM. A “Wii” bit of fun: the effects of adding Nintendo Wii bowling to a standard exercise regimen for residents of long-term care with upper extremity dysfunction. Psychotherapy Theory and Practice. 2011;27(3):185–93.CrossRef
15.•
Douris PC, McDonald B, Vespi F, Kelley NC, Herman L. Comparison between Nintendo Wii Fit aerobics and traditional aerobic exercise in sedentary young adults. Journal of Strength and Conditioning. 2012;26(4):1052–7. A randomized double-crossover study to compare Wii Fit Aerobics free run and brisk walking on a treadmill showed higher perceived and measured intensities with the Wii, but lower levels of positive well-being.CrossRef
16.•
Cuthbert JP, Staniszewski K, Hays K, Gerber D, Natale A, O’Dell D. Virtual reality-based therapy for the treatment of balance deficits in patients receiving inpatient rehabilitation for traumatic brain injury. Brain Injury. 2014;28(2):181–8. Randomized controlled trial comparing balance therapy using the Wii to TAU, physical therapy, which found significant improvements and equivalence of the two methods in physical improvement. Enjoyment was better for the Wii group. CrossRefPubMed
17.•
Kloos AD, Fritz NE, Kostyk SA, Young GS, Kegelmeyer DA. Video game play (Dance Dance Revolution) as a potential exercise therapy in Huntington’s disease: a controlled clinical trial. Clinical Rehabilitation. 2013;27(11):972–82. Using a crossover, controlled, single-blind design, Dance Dance Revolution was compared with a handheld video game, with improvement noted in many physical outcome measures for ambulatory individuals with Huntington’s disease. CrossRefPubMed
18.
Stuifbergen AK, Becker H, Perez F, Morison J, Kullberg V, Todd A. A randomized controlled trial of a cognitive rehabilitation intervention for persons with multiple sclerosis. Clinical Rehabilitation. 2010;26(10):882–93.CrossRef
19.
Bessell A, Clarke A, Harcourt D, Moss TP, Rumsey N. Incorporating user perspectives in the design of an online intervention tool for people with visible differences: face IT. Behavioural and Cognitive Psychotherapy. 2010;38:577–96.CrossRefPubMed
20.
Brown JL, Vanable PA, Carey MP, Elin L. The development of a computer-administered cognitive-behavioral intervention to promote stress management among HIV+ women. Journal of Cognitive Psychotherapy: An International Quarterly. 2010;24(4):265–80.CrossRef
21.•
Lii WHC, Chung JOK, Ho KY. The effectiveness of therapeutic play, using virtual reality computer games, in promoting the psychological well-being of children hospitalized with cancer. Journal of Clinical Nursing. 2011;20:2135–43. In this study with children receiving inpatient treatment for cancer in Hong Kong, playing a therapeutic immersive VR game, using the PlayMotion system, in a group format showed significantly fewer depressive symptoms compared to the control group receiving nursing care. No differences were found in anxiety. CrossRef
22.••
Janssen J, Verschuren O, Levac D, Ermers J, Ketelaar M. Structured game-related group therapy for an adolescent with acquired brain injury: a case report. Journal of Pediatric Rehabilitation Medicine: An Interdisciplinary Approach. 2012;5:125–32. This article describes the use of the Nintendo Wii in a group format, with systematic tailoring of game determine children’s roles during game play based on individual goals for children with acquired brain injury.
23.•
Bell CS, Fain E, Daub J, Warren SH, Howell SH, Southard KS, et al. Effects of Nintendo Wii on quality of life, social relationships, and confidence to prevent falls. Physical and Occupational Therapy in Geriatrics. 2011;29(3):213–21. This pilot study failed to demonstrate consistent treatment effects relative to controls on psychosocial variables, such as confidence, socialization, and quality of life using a pre-post design using the Wii. CrossRef
24.
Hind D, O’Cathain A, Cooper CL, Parry GD, Isaac CL, Rose A, et al. The acceptability of computerized cognitive behavioural therapy for the treatment of depression in people with chronic physical disease: a qualitative study of people with multiple sclerosis. Psychology and Health. 2010;25(6):699–712.CrossRefPubMed
25.••
Bisoglio J, Michaels TI, Mervis JE, Ashinoff BK. Cognitive enhancement through action video game training: great expectations require greater evidence. Frontiers in Psychology. 2014;5(136):1–9. The authors review some indications that action video game training can improve cognition, but concluded that evidence for mechanisms of change, causation, and specific areas of improvement are lacking, as well as transfer of skills.
26.
Berger T, Boettcher J, Caspar F. Internet-based guided self-help for several anxiety disorders: a randomized controlled trial comparing a tailored with a standardized disorder-specific approach. Psychotherapy. 2014;51(2):207–19.CrossRefPubMed
27.
Newman MG, Consoli AJ, Przeworski A, Taylor CB. A randomized controlled trial of ecological momentary intervention plus brief group therapy for generalized anxiety disorder. Psychotherapy. 2014;51(2):198–206.CrossRefPubMed
28.
Newman MG, Szkodny LE, Llera SJ, Przeworski A. A review of technology-assisted self-help and minimal contact therapies for anxiety and depression: is human contact necessary for therapeutic efficacy? Clinical Psychology Review. 2011;31(1):89–103.CrossRefPubMed
29.
Mohr DC, Burns MN, Schueller SM, Clarke G, Klinkman M. Behavioral intervention technologies: evidence review and recommendations for future research in mental health. General Hospital Psychiatry. 2013;35:332–8.CrossRefPubMedCentralPubMed
30.
31.
Eells TD, Wright JH, Barrett MS, Thase M. Computer-assisted cognitive—behavior therapy for depression. Psychotherapy. 2014;51:191–7.CrossRefPubMed
32.
Merry SN, Stasiak K, Shepherd M, Frampton C, Fleming T, Lucassen MFG. The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: randomised controlled non-inferiority trial. BMJ. 2012;344:e2598. doi:10.​1136/​bmj.​e2598.CrossRefPubMedCentralPubMed
33.
Crawford EA, Salloum A, Lewin AB, Andel R, Murphy TK, Storch EA. A pilot study of computer-assisted cognitive behavioral therapy for childhood anxiety in community mental health centers. Journal of Cognitive Psychotherapy: An International Quarterly. 2013;27(3):221–34.CrossRef
34.
Santamaria JJ, Soto A, Fernandez-Aranda F, Krug I, Forcano L, Gunnard K, et al. Serious games as additional psychological support: a review of the literature. Journal of Cyber Therapy and Rehabilitation. 2011;4(4):469–76.
35.•
Fernandez-Aranda F, Jiménez-Murcia S, Santamaria JJ, Gunnard K, Soto A, Kalapanidas E, et al. Video games as a complementary therapy tool in mental disorders: PlayMancer, a European multicentre study. Journal of Mental Health. 2012;21:364–74. Authors explore the use of a video game designed for individual with impulse-related disorders which uses an analysis speech, face, and physiological responses to assess emotional reactions. CrossRefPubMedCentralPubMed
36.
Opris D, Pintea S, Garcia-Palacios A, Botella C, Szamosközi S, David D. Virtual reality exposure therapy in anxiety disorders: a quantitative meta-analysis. Depression and Anxiety. 2012;29:85–93.CrossRefPubMed
37.
Goncalves R, Pedrozol AL, Coutinho ESF, Figueira I, Ventura P. Efficacy of virtual reality exposure therapy in the treatment of PTSD: a systematic review. PLoS ONE. 2012;7(12):e48469.CrossRefPubMedCentralPubMed
38.•
Motraghi TE, Seim RW, Meyer EC, Morissette SB. Virtual reality exposure therapy for the treatment of posttraumatic stress disorder: a methodological review using CONSORT guidelines. Journal of Clinical Psychology. 2014;70(3):97–208. Authors explored the idea of cCBT for clients with depression by reviewing three different EGPs. CrossRef
39.•
Trost ZA, Parsons TD. Beyond distraction: virtual reality graded exposure therapy as treatment for pain-related fear and disability in chronic pain. Journal of Applied Biobehavioral Research. 2014;19(2):106–26. The authors explore the use of an EGE hardware apparatus (Xbox Kinect) to incorporate the client’s movement in a virtual reality, allowing VR functionality in a more cost-effective manner. CrossRef
40.
Tanaka, J.W., Wolf, J.M., Klaiman, C., Koenig, K., Cockburn, J., Herlihy, L., Brown, C., Stahl, S., Kaiser, M.D., and Schultz, R.T. Using computerized games to teach face recognition skills to children with autism spectrum disorder: the Let’s Face It! Program. Journal of Child Psychology and Psychiatry. 2010; Pp. 1–10. Doi:10.​1111/​j.​1469-7610.​2010.​02258.​x.​
41.•
Orvalho V, Jain S, Tamersoy B, Zhang Y, Aggarwal JK. An interactive game teaching facial expressions to children with autism spectrum disorders. Proceeding of the IEEE international symposium on control. Rome: Communications and Signal Processing – ISCCSP; 2012. This publication of a presentation offers a game that uses facial recognition technology as a source of feedback/interaction from the client to allow the game to respond to the behavior of the client beyond the typical keyboard type or mouse click. The game can observe, analyze, and respond to the clients’ change in facial features, directly.
42.•
Leff J, Williams G, Huckvale M, Arbuthnot M, Leff AP. This article explores an innovative use of a virtual creation of a character (avatar) to be able to externalize hallucination for more effective processing of the negative experiences of the psychosis. Social and Integrative Approaches. 2014;6(2):166–76. doi:10.​1080/​17522439.​2013.​773457. Avatar therapy for persecutory auditory hallucinations: what is it and how does it work? Psychosis: psychological.
43.
Goh DH, Ang RP, Tan HC. Strategies for designing effective psychotherapeutic gaming interventions for children and adolescents. Computers in Human Behavior. 2008;24:2217–35.CrossRef
44.
Kappes BM, Thompson DL. Biofeedback vs. video games: effects on impulsivity, locus of control and self-concept with incarcerated juveniles. Journal of Clinical Psychology. 1984;41(5):698–706.CrossRef
45.••
Granic I, Lobel A, Engels RCME. The benefits of playing video games. American Psychologist. 2014;69(1):66–78. doi:10.​1037/​a0034857. This article reviews previous research on the benefits of playing EGE, grouping studies according to cognitive, motivational, emotional and social benefits. CrossRefPubMed
46.
47.
Blum-Dimaya A, Reeve SA, Reeve KF, Hoch H. Teaching children with autism to play a video game using activity schedules and game-embedded simultaneous video modeling. Education and Treatment of Children. 2010;33(3):351–70.CrossRef
48.
49.
50.•
Friedberg RD, Hoyman LC, Behar S, Tabbarah S, Pacholec NM, Keller M, et al. We’ve come a long way, baby! Evolution and revolution in CBT with youth. Journal of Rational-Emotive Cognitive-Behavior Therapy. 2014;32:4–14. This review article focused on the history of CBT and the latest trend of incorporating technology, including EGE, into CBT. CrossRef
51.
Springer C, Misurell JR. Game-based cognitive-behavioral therapy (GB-CBT): an innovative group treatment program for children who have been sexually abused. Journal of Child and Adolescent Trauma. 2010;3:163–80.CrossRef
52.
Misurell JR, Springer C, Tryon WW. Game-based cognitive-behavioral therapy (GB-CBT) group program for children who have experienced sexual abuse: a preliminary investigation. Journal of Child Sexual Abuse. 2011;20(1):14–36.CrossRefPubMed
53.
54.••
Ferguson BR, Gillis JM, Sevlever M. A brief group intervention using video games to teach sportsmanship skills to children with autism spectrum disorders. Child and Family Behavior Therapy. 2014;35(4):293–306. A pre-post design demonstrated efficacy of group intervention with EGE. CrossRef
55.•
Barrett MS, Gershkovich M. Computers and psychotherapy: are we out of a job? Psychotherapy. 2014;51(2):220–3. This article explores the potential role of the therapist in the use of computer-assisted therapy. CrossRefPubMed
56.
57.
58.
Elson M, Ferguson CJ. Twenty-five years of research on violence in digital games and aggression: empirical evidence, perspectives, and a debate gone astray. European Psychologist. 2014;19(1):33–46.CrossRef
Metadata
Title
The Use of Electronic Games in Therapy: a Review with Clinical Implications
Authors
H. Lynn Horne-Moyer
Brian H. Moyer
Drew C. Messer
Elizabeth S. Messer
Publication date
01-12-2014
Publisher
Springer US
Published in
Current Psychiatry Reports / Issue 12/2014
Print ISSN: 1523-3812
Electronic ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-014-0520-6

Other articles of this Issue 12/2014

Current Psychiatry Reports 12/2014 Go to the issue

Mood Disorders (JF Greden, Section Editor)

Population-Based Initiatives in College Mental Health: Students Helping Students to Overcome Obstacles

Genetic Disorders (W Berrettini, Section Editor)

Genetics of Alcoholism

Women’s Mental Health (D Rubinow, Section Editor)

Hormone Replacement Therapy in the Treatment of Perimenopausal Depression

Psychiatry in the Digital Age (JS Luo, Section Editor)

Internet Interventions for Mental Health and Addictions: Current Findings and Future Directions

Mood Disorders (JF Greden, Section Editor)

Proceed with Caution: Off-label Ketamine Treatment for Major Depressive Disorder

Sleep Disorders (P Gehrman, Section Editor)

Wake-Promoting Pharmacotherapy for Psychiatric Disorders