Mental Health Professionals Use Video Games to Enhance Therapy


For decades, mental health professionals have used toys and games to engage patients during psychotherapy. During the pandemic, it was much more difficult as therapy wore off. Thus, some therapists are abandoning analog games like Candy Land for world-building online games like Roblox or Minecraft.

Geek Therapy is a non-profit organization promoting the use of video games in therapy, and Josué Cardona is the group’s president. He said that since a lot of people gamble anyway, it makes sense for it to show up in therapy. The following is an edited transcript of our conversation.

Josué Cardona: I think the toys people play with are changing. Therefore the Association [for] Play therapy has these fundamentals, these therapeutic powers of gaming, and they apply to video games the same way. And video games are so popular that it makes sense that therapists are just starting to use them and clients are starting to ask to use them, too.

Kimberly Adams: So what types of mental health issues do you typically use this type of play therapy for?

Cardona: The usual. Depression, anxiety, these are things that come up often. And, it’s so unique for each customer, what they like to play, what they experience and how everything they deal with presents itself during the game. So there are games that are very open, so you have the flexibility to travel wherever you want and do what you want. And some customers struggle with that – they have a lot of anxiety about making decisions and playing such an open game. It’s an experience that’s contained and in a very safe space and environment that we can then, we can kind of control different variables and address those concerns.

Josué Cardona (courtesy Cardona)

Adams: Are there any other privacy concerns or [Health Insurance Portability and Accountability Act] considerations you need to worry about when introducing video games into therapy?

Cardona: It’s interesting. Many therapists are very concerned about this. And the truth is, the answer is usually just to use the tool you already use for remote therapy, like Zoom, or any other HIPAA compliant service, and then use that for communication.

Adams: I think a lot of us who grew up were told by our parents that if we played too many video games our brains would turn to mush. So how do you sell this idea of ​​using play as therapy to parents or even patients?

Cardona: Something that makes it a lot easier now is that a lot of us who had parents who told us they were parents now. And so we don’t necessarily tell our kids that, which makes it much, much easier to sell the idea of ​​play in therapy. But some parents resist. And so I like to refer to the nearly 227 million players in the USA

Adams: But I also imagine that some people may be reluctant to pay therapy rates for someone to play video games with their child or with themselves.

Cardona: Yeah, yeah, absolutely. I think we’re building a lot on what’s already happened in the world of play therapy, which for decades has used toys and games and a sandbox. [which uses figures and props to create a safe, imaginary world], and things like that. And so there is a part of the population that is willing and accepting and, and open to doing it. It is also interesting to note that many children are more willing to go to therapy, to work with a counselor, if it is on the table than if it is not. So I had parents say, “My son, I think it would be very helpful to them if they saw a therapist. They never want to go, or they go and they don’t want to continue. But with you they want to keep coming because you are ready not only to tell them about Minecraft but also to play the game in session. It has certainly opened a lot of doors for a lot of families to enter the mental health field.

Adams: Guess you must be pretty good at Minecraft so the kids don’t laugh at you during the session.

Cardona: Nope. Sometimes you just pretend you don’t know what you’re doing. Children want to teach you, it’s better that way. They love to teach you and think they know more than you do.

Adams: The American surgeon general has just published a 53 page review highlighting the crisis which is essentially the effects of the pandemic on youth mental health in the United States. What role do you think play therapy, or therapy that includes gambling, could play in solving this problem?

Cardona: The fact that we are drawing attention to youth mental health right now, in light of the pandemic, is so great. And I think anything that appeals to this age group is more willing and open to great opportunities for more therapy and more therapy services to embrace it. Ten years ago, when I started Geek Therapy, my supervisor told me, “Absolutely not, don’t use video games. And my point was, this is the language children speak, so it makes sense to use it and adopt it. And it is proven. So this age group, those who love video games, let’s talk to them about video games. Those who love Taylor Swift, let’s talk to them about Taylor Swift no matter what brings them in.

Adams: You mentioned Minecraft. What other games do you think are particularly good for therapy that people might not consider using as a therapy device?

Cardona: I think my favorite right now would probably be Fortnite. It’s a very popular game that a lot of people just assume to be – 100 people dropped onto an island and everyone kills each other. But the game isn’t – I mean, no one actually dies in the game. When someone loses their points, they’re taken by an alien ship and teleported, so it’s less violent. And in that sense, it’s very caricature in its violence, but it also has many modes. So you can go for example in party mode or in creative mode and simply create a space together. You can design different experiences for therapy or just to go out and walk, and [it’s] very similar to something like Minecraft.

Related Links: More information on Kimberly Adams

Wired has a detailed history on how the pandemic has helped push online gaming into mainstream therapy, and there is research showing that in some cases video games can be as or more effective than other mental health interventions. .

We also have a link to this opinion of the general surgeon we mentioned.

the Cardona group, Geek therapy, has been doing this job for quite a while. The association is celebrating its 10th anniversary this year. According to Cardona, geek therapy involves more than just play. It includes things like comics, dungeons and dragons, or my favorite anime.

Cardona is also a co-founder of the Let’s Play Therapy Institute, which trains mental health professionals to use some of these strategies in play therapy. The institute also free training open to the general public, including how to use Animal Crossing, Roblox, Minecraft, or Fortnite in play therapy.

But don’t forget to turn to a professional therapist if you or a loved one needs support.


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