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Should Video Games Be Used in Therapy? (VG Series Part 7/10)

2010 October 22
by Richard N. Landers

Neo-Academic coverage of the Journal of General Psychology special issue on the psychology of video games:

ResearchBlogging.orgThere are few topics so hotly debated on the Internet as the value of video games. Are they the next generation’s artistic advance, as film was for the last, or are they a blight that makes children overly aggressive and dangerous? In this 10-part series, I’m reviewing a recent special issue of the Journal of General Psychology on video games. For more background information, see the first post in the series.

In the seventh article in this series, Ceranoglu (2010)1 discusses the use of video games within the context of psychotherapy. Much like the discussion of video games in relation to autism, there is not much of an established research literature in this area, though there is much potential in many of the same areas – patient compliance and understanding of their condition, for example.  We also see the same flaws: a lack of randomized controlled trials and small sample sizes.

What did surprise me is that games (generally) have been used in therapy for some time.  One citation put the use of board games in psychotherapy as early as 1957.  This implies to me a more receptive scientific community associated with general therapy than is associated with autism research.  Some of the earliest video games examined in the context of therapy were conversions of board games to computer-based versions.  This is a common theme we see in all computerization research: conversion of an already generally accepted technique to a new technology and comparison of outcomes.

The evidence that video games can be used to increase patient outcomes, though sparse, is intriguing.  In one study, kids in juvenile detention were exposed to a commercial available video game (though they do not reveal which one) in order to decrease their impulsiveness and improve their self-esteem, which was successful.  In another study, patient compliance (i.e. actually attending sessions and engaging with the therapist) was improved in a group of teenagers after a text-based adventure game was introduced in the session.

There are caveats, of course.  Ceranoglu lists three major areas where problems might arise: 1) the content and interactivity of the game itself, 2) both patient and parent attitudes toward video games, and 3) the availability and cost associated with many games.  For example, it is known that games can be engaging and distracting.  This is generally a positive, but in therapy, might turn against the therapist.  For example, someone engaged in a video game during therapy might pay less attention to the therapist, which would ultimately slow the building of rapport between them.  Though this is certainly avoidable, it is up to the therapist to monitor for such withdrawal.

Probably the most amusing part of this article for me personally is the discussion of “cheating.”  Anyone who has played more than handful of video games is probably aware of the concept of “cheat codes.”  The purpose of cheat codes is to “cheat” the game in that trials and struggles early in the game can often be bypassed.  For example, an invincibility cheat code would likely prevent the player character from dying despite game conditions where that player should have died (IDDQD!).  Other cheat codes give unlimited resources or skip the player ahead in the game.  Ceranoglu devote a good quarter-page to explaining that cheating in a video game is not the same as cheating in a board game, where the patient might be trying to take advantage of the therapist in order to “win.”  Ceranoglu makes this point by saying, “evaluation of possible meanings of cheating for a child during video game play should include this normative view.”  In other words, just because a kid cheats in a video game doesn’t mean there’s something wrong with them.

In any case, this article is, like the piece on autism, an excellent exploration of the potential of video games for therapy with relatively little background research to work from.  Once again, the answer to our title question – should video games be used in therapy? – is, “There’s no reason to think they shouldn’t, so go for it.” Just make sure to collect useful data and let the rest of the world know how it went.

  1. Ceranoglu, T. (2010). Video games in psychotherapy. Review of General Psychology, 14 (2), 141-146 DOI: 10.1037/a0019439 []

Call for Participants in NSF Proposal to Integrate Social Media in Undergraduate Education

2010 October 14
by Richard N. Landers

My mission:  I want to develop and research a freely available, NSF-funded, open source online social networking platform customized to the needs of university faculty and students. And I’ve already got pilot data.

I’ve been hunting around for universities to get involved in this project, and given the high level of enthusiasm so far from those I’ve explained it to, I figured it was time to make a larger-scale announcement. Since non-regular readers might come across this, this will be a little more introductory than usual:

Hello!  My name is Richard Landers, and I’m an industrial/organizational psychologist at Old Dominion University.  My research interests primarily center around the potential of the Internet to create community and ultimately provide better adult education and training.

In Summer 2010, I received a seed grant (thanks ODU!) to investigate the value of social media in online education, intended to provide a stepping stone to acquiring a larger grant.  So for that project, I wrote (by myself) an online social network centered around undergraduate education.  This online social network was deployed to 20 courses in the Summer 2010 semester, and was thus available to roughly 600 students.  Of those 600 students, about 400 set up profiles and actually tried to use it, some of which were required to do so for course participation, but many of which were not.

Of those roughly 400 students, uptake of our online social network for Psychology (which we named socialPsych) was tremendous.  Over just a few months, about 500 status updates were made, alongside roughly 4,500 posts in course discussion areas.

I implemented two experimental features to this social network that I am quite proud of and am to my knowledge the first to use such technologies.

First, I created a Certification Center.  In this area, students could take quizzes on course material from any course.  Quizzes were always 10 questions and drawn randomly from a much larger database of questions specific to each course.  For example, a student enrolled in social psychology could complete quizzes in social psych, quantitative methods, etc – any course currently being offered in the department.  But students were only allowed to take a quiz in any particular subject area once every 4 days.   We took advantage of many principles of casual gaming (sometimes called the gameification movement) to create a reward system for completing these quizzes.  Several levels of “mastery” were created, with increasingly difficult bars to reach in order to achieve them.  But when a student achieved a new rank (which they could never lose), a badge would appear next to their name in class discussion areas to provide a social reward for doing well.  For example, if the aforementioned student completed the social psychology quiz enough times to reach Mastery Level 3, a little blue ribbon would appear next to their name when they chatted in that classroom.  This system was ridiculously well-received.  Across those approximately 400 students, 113 (28%!) willingly chose to take optional multiple choice quizzes.  If you’re an educator like I am, you are probably shaking your head in disbelief right now – 28% of students willingly completed optional multiple choice quizzes that would never have an effect on their grades.  That’s absolutely amazing to me every time I think about it.  Especially fantastic is that simply spending time completing the quizzes exposes them to course material more than they otherwise would have been exposed – meaning they were more likely to learn something!

Second, I created a Mentoring System.  After achieving ranks, students could flag themselves as available to be mentors to students who wanted help.  16 students (about 4%) signed up to be mentors and 19 students (about 5%) signed up to be mentees.  And although those numbers seem relatively small, remember that these are students struggling who I would hypothesize would be unlikely to seek out help from their instructors – or possibly even their classmates, in person.  What a fantastic resource such a system would make – especially one that vets expertise automatically through the certification system!

I think this quote from one of our students on the post-test exam is what give me the most hope:

I beleive [sic] the best thing about social psych was the interaction you have with your classmates. ODU is a big university and everyone is always on the go it was nice to have a moment to ask people questions and hear encouraging words from other people.

Totally unsolicited positive virtual interactions between students.  Just what I was hoping for!  We even found a positive correlation between GPA and online social network usage.  And consider this one on community building:

i [sic] am a commuter student and only attend classes. Normally, I don’t socialize with other students. Social Psych Net [sic] provided the opportunity to speak with other students during the course, which I do not typically do. It also provided an area for students to ask each other questions. I think this site should continue.

Now having said all that, things are never quite as simple as they appear.  I’ll be trying to publish at least a couple of papers based upon the psychological theory that led to the creation of this system and an evaluation of its outcomes, and if you want more than that, you’ll just have to join our grant team.  That’s right – I want to use our pilot data from socialPsych to apply to one of two NSF grants, depending on who we get to join the team.  The deadlines are in January, so we’ve got some time, and I want to do it right.

My current goal is to get multiple sets of people involved:

  1. Universities, colleges or even individual departments that want to deploy the social network we develop and let us take some metrics to see how people use it and what can be further improved.   The more students that are involved, the more useful and valuable everyone will find it.  One of the negatives to socialPsych that students commented on was that they wished it was available year-round and to more students!
  2. Experts in areas outside of my own expertise (I/O psychology) that can contribute to the theoretical development of this system.  We’ll need (at least) gaming experts, sociologists, computer scientists, human-computer interaction specialists and so on to make this the best cross-disciplinary team we can, to make the very best system possible.  And if you think your expertise is needed but I didn’t list it here, feel free to contact me.

If you are a policy-maker in education, all you need to do is volunteer your university, college or even your department as a testing ground.  We’ll build into the grant all that is needed to run the technology and support it.  And in 3 years, if you still want to use it, we’ll be designing the technology to be as easily adaptable as possible, so that the transition from NSF-funded severs to your own will be as seamless as possible.  And if you want to run it on your own school’s equipment from the start, so that you have complete control over your students’ experiences – all the better.

So if you want to create community, improve learning, and take advantage of social technology that is here to stay (i.e. the Internet!), let me know ASAP to get in at the ground floor!


Have a look at the introductory video that we used to introduce students to the idea of socialPsych.

If you want to be a part of this innovative project, e-mail me at rnlanders@odu.edu or call me at 757-683-4212.  Collaborators and institutions from anywhere in the world are welcome.

Edit: We are no longer taking new institutions onto this project, but we may do so again in the future. Please contact me if you might wish to participate in the future.

Should Children with Autism Play Video Games? (VG Series Part 6/10)

2010 October 7
by Richard N. Landers

Neo-Academic coverage of the Journal of General Psychology special issue on the psychology of video games:

ResearchBlogging.orgThere are few topics so hotly debated on the Internet as the value of video games. Are they the next generation’s artistic advance, as film was for the last, or are they a blight that makes children overly aggressive and dangerous? In this 10-part series, I’m reviewing a recent special issue of the Journal of General Psychology on video games. For more background information, see the first post in the series.

In the sixth article in this issue, Durkin (2010)1 discusses the use of video games by children with developmental disorders, including those on the autism spectrum, ADHD, and language impairments.  For the most part, this is what I’d call a literature review by proxy.  In other words, the research literature on video game use by people with developmental disabilities is spotty, so the only solution to this is to review more general literatures (such as overall research on ADHD) and discuss how that might apply in this more specific context.

There’s nothing wrong with this approach.  It simply means that the research literature in the focal area of interest is very new.  It’s a problem I myself face when trying to find research to support my work on online social networking for adult training and education.

Durkin reveals that most of the evidence for the intense popularity of video games among those with developmental disorders is from case study research – a number of observational studies, interviews, and clinical reports have mentioned it.  Three “laboratory and survey studies” are also cited to reveal that children on the autism spectrum are “strongly attracted to screen-based entertainment.”  In comparison to what exactly is not revealed.

Interestingly, there do not seem to be differences in video game play between children with and without ADHD, in terms of the types of games played, the length of time they played them, or how often they played them.  I suspect the researchers’ original hypotheses involved increased fixation on action-oriented video games from children with ADHD (bright colors and action hold one’s attention a little more firmly), but this does not appear to be the case.

Durkin continues by examining what forces might drive children on the autism spectrum to video games but does not find any research or even any theory revealing that such children would be driven any more than any other child.  Children with ADHD, on the other hand, should find video games extremely satisfying because of the constant stream of psychological rewards, but no work seems to have been done in this area.

Several cognitive concepts are highlighted that are likely to be relevant to video game play: sensory stimulation, reward/dopamine release, executive functioning, and visual perspective taking.  Children with autism might use video games as an object of obsession, but any activity could be the focus – nothing special about gaming in this context.  There is a suggestion that the dopamine release associated with pleasure from success in video games might be used as an alternative treatment for ADHD, but the research does not yet reveal this either way.  One study examined executive functioning for children with autism through something similar to a video game and concluded there was no specific deficit to be measured.

Overall, Durkin summarizes the issues quite well here:

Although many authors have noted, and some have explored, the uses of videogames by young people with developmental disorders, we lack systematic quantitative data on frequency and duration of use and on game preferences.

And that’s the heart of it.  While this article does provide an excellent review of the ways that researchers might investigate the relationships between disorders and video game use, the actual research literature is sparse.  What is available does not reveal that there are any systematic differences between the way children with and without developmental disorders  approach or play games.

So should children with autism play video games?  Sure.  There’s no scientific evidence thus far to think that they shouldn’t.

  1. Durkin, K. (2010). Videogames and young people with developmental disorders. Review of General Psychology, 14 (2), 122-140 DOI: 10.1037/a0019438 []