Marianne Webb, ReachOut.com Interactive Manager, Inspire
Foundation and Michelle Blanchard, Senior Research Officer, Inspire
Foundation and PhD Candidate Orygen Youth Health Research
Centre
Innovation in clinical practice
An exciting development in the area of utilising technology to
promote wellbeing is the advent of serious games.
So what are serious games?
Serious games refer to software or hardware applications
developed with game technology and game design principles for a
primary purpose of learning rather than pure entertainment. In
simple terms, it refers to technology-mediated learning.
Serious games are designed with the intention of improving some
specific aspect of learning and players come to serious games with
that expectation. Serious games can be used in emergency services
training, in military training, in corporate education, in health
care and in many other sectors of society.
There is some blurring or convergence in the definition of a
serious game with some extending the definition to include console
games like Wii. For example, Egenfeldt-Nielsen, Smith, & Tosca
(2008) define them as computer or video games that are 'produced,
marketed or used for purposes other than pure entertainment.'
Serious games measure success through learning outcomes such as
reproduction of knowledge and self efficacy. In the mental
health context this could include gains in mental health literacy,
resilience, coping skills and optimism.
Current trends and evidence for the use of serious
games
Serious games intended for health aim to prevent illness,
promote healthy behaviours or provide early intervention. It is
still a new and emerging area in research and practice and it is
only within the last decade that game development has taken off and
effectiveness evaluations conducted. However, there is
growing evidence that serious games can lead to positive outcomes
for health and wellbeing by providing opportunities for engagement,
skill building and motivation for behavioural change.
One of the first serious games developed to promote health and
wellbeing was Remission, a well designed psycho-educational action
game, comparable in quality to a commercially successful game such
as Halo. The game aims to educate players about cancer and
improve self care skills. A randomised controlled trial of 375
young people found that Re-Mission demonstrated significant
increases in knowledge about cancer for participants who used
Re-Mission as compared to those in the control group, who played a
non-therapeutic commercial entertainment video game. It also found
these outcomes present in 1 month and 3 month follow-ups (Beale,
Kato, Marin-Bowling, Guthrie, & Cole, 2007), suggesting that
serious games have much potential in health promotion and
prevention.
Reach Out
Central (aka ROC) is a serious game developed to improve the
mental health and wellbeing of young people, particularly young
men, by increasing their problem solving, help-seeking and
communication skills. It allows young people to explore how their
thinking, behaviour and choices influence their mental health. It
is unique in being the only mental health serious game in Australia
available online.
ROC has been developed in consultation with psychologists, young
people, gaming experts and with the support of beyondblue: the
national depression initiative and the Sony Foundation. It combines
cutting-edge technology with the established principles of
cognitive behavioural therapy (CBT) to provide a series of modules
that help young people aged 14-25 develop life skills to manage
mental health difficulties and build resilience.
An external evaluation of ROC, conducted by Swinburne University
of Technology in 2008 found that ROC reduced psychological
distress, alcohol use and avoidance behaviour. It also found that
ROC improved life satisfaction, resilience, problem solving and
help seeking. The study concluded that ROC appears to have the
capacity to be a useful primary and early intervention tool,
enhancing protective factors in young people.
How can serious games be used in clinical
practice?
There are numerous opportunities to use serious games to
influence clinical outcomes for young people. These can
include:
- Making serious games such as ROC available to young people in
waiting rooms or prior to their first session can help to reduce
anxiety and makes for a great conversation starter.
- For young people who are on a waiting list to see a clinician,
using a serious game such as ROC during that time can improve
wellbeing, reducing the intensity and frequency of intervention
required face to face.
- During a consultation, a serious game can be used to break the
ice, promote engagement and facilitate conversation. Working
side by side on a game can be less confronting for some young
people and can provide an opportunity for them to discuss sensitive
issues by externalising them temporarily to the characters in the
game.
- Following a consultation, setting tasks in serious games as
homework can provide an opportunity for young people to practice
the skills and strategies explored during the sessions in a safe
and anonymous environment
- Finally for those young people leaving clinical care, serious
games can be used to assist in the maintenance of wellbeing.
For example, games like ROC allow you to track progress and
improvement over time. This may signal to a young person when
they need to reconnect with face to face support or clinical
care.
- You may have found serious games helpful in other ways.
We'd love to hear your stories below.
Further reading
Serious Games is an emerging area. Below are some links you
might find useful:
Health Games
Research
eLearning
Reach Out Central: A Player's Perspective
An
Evaluation of Reach Out Central