One of the biggest challenges to recovery is non-compliance with therapies. Doing what is good for us isn’t always fun or convenient. Doctors do not enjoy nagging and harassing us. They aren’t going to tell us twice a day that it is time to put down that engaging book and do our exercises, so our injury will heal. Physical, drug, and talk therapies can all be incredibly boring and are often more difficult to follow consistently for those who struggle with the very goals of the program. Making therapy fun and use of skinner boxes makes it easier to obtain compliance that programs are seen through to their conclusion.

There are efforts by researchers and developers to produce games specifically geared toward mental health and recovery. I have investigated several of these apps and games myself. Unfortunately, I have had limited success with those I care for utilizing these games to manage their mental health. This is not because gamification doesn’t work, but rather because the researchers are not game developers, and lack of motivation or attention are among the symptoms of those I care for. They don’t quite hit the mark on fun, or theme, some are quite restricted in tasks and activities available, although they do manage to make therapies and managing your health more fun and easier to achieve, than without the tools.

The challenges are discussed by ICT in their post “The Ultimate Skinner Box: Clinical Virtual Reality 1990-2016” which provides a brief history of the incorporation of these technologies and gamification into therapies over time.  Some challenges being the practicality of the equipment, others being related to rendering and processing power; struggling to achieve the desired immersion. While gamification was slow to be incorporated into therapies it wasn’t for a lack of trying or failing to see the potential; the largest challenges have been the technology not quite being a level needed yet.

Some examples of such games and applications are;

VR being used to treat PTSD for combat veterans by ICT

https://www.youtube.com/watch?v=nrgUPVFY44o

and

Wii Based Movement therapy for stroke victims

conducted by Neuroscience Research Australia.

https://www.youtube.com/watch?v=Sk53cBpZ_Ik

If you feel like experiencing one of these games first hand Reach Out Orb is available for the public to play free. Reach Out Orb is a game that teaches students skills to live a positive life.

Reach Out Orb Produced by Reach Out Australia

https://www.youtube.com/watch?v=uShypgTJSuI

Their approach is much like my own; look at a product and think of productive applications for it. The format or technology used in each application has more to do with accessibility than the principle behind what is being done with it. Some technologies will be more effective for certain purposes, but for the most part the process can be replicated across media, from tabletop and video games to augmented and virtual reality. It has more to do with suitability for purpose than any one medium being better than another.

MMORPGs and other computer games do in fact use the principles behind skinner boxes to drag you in and keep you playing; which many perceive as an evil genius abuse of power. Skinner Boxes aren’t entirely a bad thing and have noble applications in relation to therapies and recovery. We want to hook people into what’s good for them. What is good for them is participating fully in their treatment. Skinner boxes increase participation, adherence and effectiveness, they also reinforce good coping skills as a stronger influence when an individual begins to struggle.

Therapies can be more successful when incorporated with quests, goals, levels and dings. Breaking goals up into levels and of course the rewards; Recovery can be FUN!

Reward charts and reminder lists, which aren’t installed on phones, but rather strategically placed on walls with magnets or stickers to mark progress, regularly sighted throughout the day due to placement, reminding of progress, has been far more effective to date as far as gamifying their routines.

In this series, I will go through several specific games formats, styles, or series of games, and outline how we apply them to our needs, along with what makes them fit for purpose. This isn’t to say they are the only applications either, these are just the ones which fit us, for everyone, needs and applications will vary according to an individual’s specific challenges.

The way we incorporate our gaming into how we manage mental illness isn’t about prescribing this game for that use. It is a process of exploring what is available and finding ways to apply it to our needs to make the most of the resources available to us.