Therapeutic Gaming: Literature Review

Feedback from my ‘Video Games and Violence’ popup showcase highlighted the need to broaden my project’s scope. While initially focused on dispelling the misconception that video games incite violence, probing questions about societal benefits and potential for an impactful change made me reconsider. These feedbacks led me to explore the therapeutic uses of video games. This new direction promises greater impact by supporting neurodivergent individuals, while also challenging longstanding prejudices by showcasing the constructive potential of video games.

Video Games and Therapeutic Potentials

At the start of this research journey, I discovered an intersection between the joy of video games and the serious potential for therapeutic intervention for neurodivergent individuals. It was a study by Colder Carras et al. (2020) that helped ground me in my direction. “Emerging research suggests that commercial off-the-shelf video games have potential applications in preventive and therapeutic medicine.” This statement became the starting point, prompting me to look deeper into how video games could genuinely contribute to society besides being an entertainment.

From Theory to Tangible Experience

The literature illuminated the tangible impact video games could have on understanding and empathy. Meinen (2021) brought to life the excitement around simulation games, noting that they have the “theoretical potential to show not only what a psychiatric condition looks like from the outside but also what’s going on in someone’s mind.” This perspective on games opened up the idea that they could be more than entertainment, they could be a medium for understanding more complex experiences.

Prescription Video Game

The evolution of video games in therapeutic contexts marks a significant milestone in healthcare. Meinen (2023) captures this transformative moment: “In 2020 the FDA approved the first video game on prescription… some going as far as enthusiastically describing prescription video games as ‘the future of medicine’.” This approval shows a shift towards recognizing video games not just as entertainment, but as active participants in medical treatment, offering a promising platform for enhancing neurodivergent individuals’ engagement and understanding of their own experiences in a more immersive and interactive way.

Play for Social Engagement

Franco (2016) sheds light on the potential of video games for therapeutic purposes, significantly enhancing our understanding of their value. He notes, “A group of researchers conducted weekly 1 h video game-based group therapy once a week for 6 months. They found that video game integrative video game-based group therapy are a motivating and effective treatment approach to improving self-awareness, social skills, and behaviors in people with TBI.” This evidence challenges societal misconceptions and highlights video games as viable tools for rehabilitation, aligning with my goal to shift the narrative around video games towards a more positive and therapeutic perspective.

Expanding the Therapeutic Toolbox

Every piece of paper I’ve read here adds a new layer of understanding. I came across a paper discussing the effectiveness of serious games in therapy, a game category I have never heard of before. Unlike traditional video games designed primarily for entertainment, serious games have a primary focus on education, training, health improvement, or therapeutic support. They are crafted with the intention of solving problems, enhancing learning experiences, or aiding in therapy. Vacca et al. (2023) expanded upon this by suggesting that “SG-based [Serious Games] therapeutic interventions have been well accepted by children with cognitive disabilities such as ASD, ADHD, DS [Down Syndrome], and FXS [Fragile X Syndrome], showing to be effective in improving cognitive areas, social interaction, and motor skill function.” These findings adds to the narrative of video games as tools that can cater to a spectrum of therapeutic needs.

Integrating Gaming into Therapeutic Practices

Among the sources the informed my exploration was the review of practices by Griffiths et al. (2012), which catalogues the various ways video games have been utilized for therapeutic purposes. They highlight how video games have evolved beyond mere entertainment to become valuable tools in physiotherapy, occupational therapy, and cognitive rehabilitation. This insight not only validates the therapeutic benefits of video games but also showcases their versatility in addressing a wide range of health and psychological conditions. It lays a foundational perspective on video games as multifaceted therapeutic instruments, further motivating my exploration into gaming’s application for neurodivergent individuals.

A New Frontier (?)

Throughout this exploration, I’ve noticed a recurring theme: a lot of the research surrounding the use of video games in therapy are published very recently, pointing towards this being a relatively new field of study. This realization is exciting, it highlights the potential for impactful work in an area ripe for exploration. The recency of much of this research suggests that there’s much we don’t yet understand about the therapeutic possibilities of video games, especially for neurodivergent individuals. This gap presents a unique opportunity not only to contribute to a developing field but also to help in the process of exacting real societal impact.

References

Colder Carras, M., et al., (2020). ‘Commercial Video Games As Therapy: A New Research Agenda to Unlock the Potential of a Global Pastime’. Frontiers in Psychiatry, 8(300).

Franco, G.E., (2016). ‘Video Games and Therapy: A Narrative Review of Recent Publication and Application to Treatment’. Frontiers in Psychology, 7:1085. DOI: 10.3389/fpsyg.2016.01085.

Griffiths, M.D., Kuss, D.J., and Ortiz de Gortari, A.B., (2012). ‘Video Games as Therapy: A Review of the Medical and Psychological Literature’. In: Cruz-Cunha, M.M., Miranda, I.M., and Gonçalves, P., eds., Handbook of Research on ICTs for Healthcare and Social Services: Developments and Applications, IGI Global, pp.43-68.

Meinen, L., (2021). ‘Experiences of Neurodivergent People When Playing an Educational Video Game About Their Own Diagnosis’. Journal of Autism and Developmental Disorders.

Meinen, L., (2023). ‘Share the Experience, Don’t Take it: Toward Attunement With Neurodiversity in Video Games’. Games and Culture, 18(2). DOI:10.1177/15554120221149538.

Vacca, R.A., et al., (2023). ‘Serious Games in the New Era of Digital-Health Interventions: A Narrative Review of Their Therapeutic Applications to Manage Neurobehavior in Neurodevelopmental Disorders’. Neuroscience and Biobehavioral Reviews.



Future of Work: Week 5 – Closing

Time flies, and here we are at week 5, the final week of our “Future of Work” project. This Monday’s tutorial was about wrapping up and reflecting on our learning outcomes. As we were discussing and reflecting on the “Happy Company” narrative, XQ brought up the quote “Happiness is a Lie” by Derren Brown, it really hit the nail on the head. This quote captured the essence of the “Happy Company” – designed to exploit human “resources” in our speculative future.

In the next days, as we transitioned to crafting our final presentation, I felt a moment of flashback. Yet, this time, we had the experience of collaborating with each other already, so we were able to reach a consensus on structuring and delegating the slides swiftly. There were no hiccups like before. My role in this part involves presenting our survey results, which is something I am interested in doing.

The survey is limited in scope with just 36 respondents, primarily from CSM’s MAAI and MACCC courses, provided a small glimpse into anxieties concerning technological displacement. The first graph painted a bell curve of concern, suggesting that there are some noticeable worry, but not to a point of hopelessness, it shows that people are aware.

How anxious are you about the potential for technology to replace you in your current or future job?
(Click to see full image)

We also inquired about the likelihood of seeking employment at the hypothetical “Happy Company” in a future dominated by automation. The mixed responses were interesting. A segment displayed firm reluctance, citing doubts about the company’s ethics and a desire to preserve their humanity, showing a clear preference for work environment with purpose and authenticity. On the other hand, other’s seemed more resigned, willing to adapt passively to the narrative that has been laid out.

If you lost your job to automation, how likely would you apply for a job at Happy Company? Please briefly explain your reason.
(Click to see full image)

With the presentation ready for tomorrow, I sit back and reflect on these past weeks. It’s been quite a ride, full of challenges, growth, and insight. I’m grateful to Team Strawberry for the lessons and to David for guiding us through this experience.

Last but not least – From left to right, XQ, David, Jim, Louason, Nina, Khyathi
Link to Reflective Report:

https://docs.google.com/document/d/1WdLniLhjVab71ThheYZgBeHRyJpMSCwsxGFiYXHn4UI/edit?usp=sharing


Future of Work: Week 4 Entry 2 – Incubator Feedback

Looking back at yesterday’s incubator, it’s clear that our project quite a few dents that will need to be addressed. The incubator helped us validate our ideas, but also pointed out gaps that will require deeper exploration and refinement.

Strawberry group Incubator setup
Incubator Feedback

The feedback that we had gotten yesterday highlighted an important oversight: we hadn’t fully explored the socio-economic effects of automation. We were too focused, to a point of having a tunnel vision, on building out the “HAPPY ORGANIZATION” as this sinister capitalistic plot and missed having a deeper look at the ramifications this kind of dystopian future will have on the society and individuals. There was also feedback around the lack of detail in the “Happy” company’s operation, things like how it’s run, what do people do, and what the company is trying to achieve. Originally, in my mind, I thought keeping it vague would help make the company look more mysterious and sinister, but I now also realized that this lack of context could break the immersion within our content.

The feedback around the potential for despair and revolutionary responses to oppressive system were particularly striking, I was reminded by a tutor from MACCC, Elliot, of the Luddite rebellion, where humans rose against industrialization because it has displaced their way of life. I don’t think the background scenario for the Luddite rebellion is too different from ours, and we should definitely use this as a reference to refine our project. We need to do more investigation and include the social consequences of our speculative future into our narrative.

Moreover, the interaction with our audience, through both direct feedback and engagement with our project’s website was incredibly informative. Despite receiving fewer survey responses than anticipated (only 36, I hoped for at least 40), the insights we gained was invaluable.

Website Engagement

One of the most interesting outcomes for me was our website(click here to visit) heatmap, which offers a tangible measure of interest and interaction with the website. The most engaged with content throughout our page was the “About Happy Company” section, which is positioned directly after our introductory video, suggesting a genuine interest in understanding the scenario we proposed, leading them to seek more in-depth information about the concept of our speculative world. The second most engaged with section was the Research section. Initially I was concerned that people wouldn’t be interested in reading about the research behind our speculative scenario, but I guess I worried too much. Analytics has dispelled this worry for me, revealing that the audience were not only interested in the narrative but also keen on understanding the research and foundations that underpinned our scenario. This made me really happy, as it indicates a deeper level of interest among our audience, suggesting that they were not just passively consuming our content but also actively and mentally engaging with the ideas and questions it presented.

Heatmap of the “ABOUT” section showing engagement intensity, the redder, the more interaction. Note: Empty spaces represent graphics not captured by the heatmap tool, but present on the page.
Heatmap of the “RESEARCH” section showing engagement intensity, the redder, the more interaction. Note: Empty spaces represent graphics not captured by the heatmap tool, but present on the page.


Next Steps & Personal Reflection

Moving forward, our task is to evaluate the received feedback, and integrate these insights to present a more comprehensive vision of the future we speculate!

I wrote in my previous entry that I didn’t fully grasp what caused our team to just “click” together into this cohesive “hive mind.” However, a moment of clarity struck while having a drink with another member of our cohort today, it was the willingness to compromise. Initially, we were all deeply attached to our own ideas, but as soon as one of us made a compromise, it was as if we started tossing out our egos. This started a chain reaction within the group, with each member gradually taking steps back, and this shaped the team dynamic that we have today.

EDIT – 8/3/2024 9:49PM

While riding on the tube today, I came across an article on reddit titled “What’s going to happen when lower tier jobs no longer pay enough to live on?” It’s not research material, but it was a good read because of all the perspectives in the comment.

Future of Work: Week 4 Entry 1 – Before the Incubator

Reflecting on week 4 of our “Future of Work” project, I find myself really immersed in this project, we were challenged and we made significant breakthroughs in our collaborative process, leading us into this “flow state.” This week’s tutorial with David served as a mirror, allowing us to look back on and examine our group dynamics and individual learning curves. The evolution of our team’s cohesion from initial friction to seamless collaboration really speaks volume.

Monday’s Reflective Tutorial:

Discussing our experiences, I realized how much I’ve learned, especially from Louason. In previous group projects, especially in a school environment, I often felt compelled to lead authoritatively, driven by a fear of losing control over time management and being able to deliver results. This tendency was mitigated in our group by clear deadlines and shared objectives negotiated by Louason.

Louason’s approach to steering our project, balancing and listening to everyone, seems like basic common sense, but it was really an eye-opener for me. I didn’t think that would work previously. His ability to manage timelines and scope without exerting additional pressure to others was both effective and respectful. This is something that I’m keen to incorporate into my own practice in the future.

The initial weeks were marked by divergent views and heated debates. Yet, this phase was crucial; it ensured that each and every one of our ideas were considered, we cultivated a group culture of mutual respect and comprehensive evaluation. The turning point came towards the end of the third week, something just “clicked” and all of a sudden our interactions transitioned from strenuous to enjoyable. I still can’t quite understand what caused that “click.” Perhaps it’s the workshop from Elizabeth, or maybe it’s something else, I can’t quite place it.

On Track with Project Deliverables

Our project is shaping up well, with a clear direction, research, and the resources to realize our vision. A recent review of our AI-generated video revealed areas for improvement, leading to my assignment to refine the script and visuals (with AI of course!), it’s a really interesting process, curating AI content.

Leveraging Expertise for Engagement

Drawing on my marketing background, I set up the integration of analytics and interactive elements into our website. Working closely with Nina and XQ, we ensured that the technical side and the aesthetic side flowed smoothly together. We will be incorporating Google Analytics, heatmap tracking, user recording, and on-site surveys to gather actionable insights. As we approach the upcoming Thursday incubator, I’m really excited about the feedback and data that we’ll be able to collect, witnessing people’s reactions and gathering insights to further inform our research

Example of data/heatmap we’ll be able to collect

For our onsite survey, I designed it to trigger at the 50% scroll mark of the webpage, right after a video section that provides an overview of our speculative scenario. This will ensure participants have sufficient context before encountering our survey. After completing the survey, a message will be presented to provoke thought and reaction, which we hope to capture on camera.

Message after the survey
(CLICK TO ENLARGE)
Edit: 6/3/2024 11:47PM

As I’m packing the essentials for tomorrow’s incubator, things like my Insta360 camera, printed flyers and the like, I spotted this mannequin head in my closet left over from another project. I suddenly had an idea: it would be really cool if we can fit the camera into the head and convert its eyes into the camera lenses. It would look like a cyborg and we will be able to record interactions with this cyborg head! I’m planning to bring this tomorrow and figure out with the team how to jam the camera in there!

Soon to be cyborg head

Future of Work: Week 3 – Expanding Scope, Execution!

While I loved documenting every single discussing last week, I realized that my enthusiasm made for too many journal entries! This week, I’m aiming for a more focused and concise approach.

Expanding Scope & Project Deliverables

This week, our team broadened the project scope to address the widespread impact of automation of various work sectors. This decision was made as we touched on how tech-driven displacement is not only isolated in the hospitality sector.

We’ve decided a multi-pronged approached for our speculative project:

– Website: Our core platform, integrate Google Analytics to track engagement across the site.
– AI-Generated Video: Using AI tools to highlight AI’s impact on work. Oh the irony!
– “Future Canteen” Social Media: Posts from 2035 depicting the normalized integration of machines in the workspace (e.g., “John the Auto Fryer”).
– Physical Elements: 2.5D kitchen visualization, mock job flyers for roles like “Food Engineer,” adding interactive elements to our scenario.

Primary Research: Expert Interview

The interview process adhered to the Code of Practice principle of informed consent, ensuring the participant was fully aware of the project’s purpose and the use of their insights (University of the Arts London, 2020).

My interview with Ian Yang, Senior Design Manager at ASUS, provided valuable perspectives on AI’s influence in the design sector. Key takeaways include:

– Efficiency vs. Control: AI significantly speeds up execution but designers remain crucial. As Ian stated, “At best it (AI) gets the job done at 60%, the rest of the 40% I will require another designer to fine tune it.”
– Priority on Upskilling: According to Ian, parts of the industry are starting to expect designers to be proficient in AI tools, potentially creating a divide between those who adapt and those who don’t.
– The Human Edge: Ian pointed out that industry knowledge and creative thinking are irreplaceable: “The most important factor to cause me to think this is probably work experience, industry experience, you need to know the ins and outs…”

Reflection & Next Steps

Ian’s insights confirm that the concerns we’re exploring extends beyond hospitality. His emphasis on proactive upskilling raises ethical questions: How can we ensure this technological transition is inclusive, and that no worker is left behind? (This could be a great topic for our Unit 4 project!). Currently, I think our team is well-positioned with a division of tasks based on our different expertise. Now, we focus on our primary website and AI-generated video deliverables.

References

University of the Arts London. (2020). Code of Practice on Research Ethics. https://www.arts.ac.uk/__data/assets/pdf_file/0020/43328/UAL-Code-of-Practice-on-Research-Ethics-October-2020.pdf [Accessed: February 27, 2024]