2024
Gómez-Cambronero, Águeda; Mann, Anna-Lisa; Mira, Adriana; Doherty, Gavin; Casteleyn, Sven
Smartphone-based serious games for mental health: a scoping review Journal Article
In: Multimedia Tools and Applications, vol. 83, pp. 84047–84094, 2024, ISSN: 1573-7721.
Abstract | Links | BibTeX | Tags: mental health, serious games, symptoms, Systematic mapping
@article{GomezCambronero2024a,
title = {Smartphone-based serious games for mental health: a scoping review},
author = {Águeda Gómez-Cambronero and Anna-Lisa Mann and Adriana Mira and Gavin Doherty and Sven Casteleyn},
doi = {https://doi.org/10.1007/s11042-024-18971-w},
issn = {1573-7721},
year = {2024},
date = {2024-04-01},
urldate = {2024-04-01},
journal = {Multimedia Tools and Applications},
volume = {83},
pages = {84047–84094},
abstract = {The use of smartphone-based Serious Games in mental health care is an emerging and promising research field. Combining the intrinsic characteristics of games (e.g., interactiveness, immersiveness, playfulness, user-tailoring and engaging nature) with the capabilities of smartphones (e.g., versatility, ubiquitous connectivity, built-in sensors and anywhere–anytime nature) yields great potential to deliver innovative psychological treatments, which are engaging, effective, fun and always available. This article presents a scoping review, based on the PRISMA (scoping review extension) guidelines, of the field of smartphone-based serious games for mental health care. The review combines an analysis of the technical characteristics, including game design, smartphone and game-specific features, with psychological dimensions, including type and purpose of use, underlying psychological frameworks and strategies. It also explores the integration of psychological features into Serious Games and summarizes the findings of evaluations performed. A systematic search identified 40 smartphone-based Serious Games for mental health care. The majority consist of standalone and self-administrable interventions, applying a myriad of psychological strategies to address a wide range of psychological symptoms and disorders. The findings explore the potential of Serious Games as treatments and for enhancing patient engagement; we conclude by proposing several avenues for future research in order to identify best practices and success factors.},
keywords = {mental health, serious games, symptoms, Systematic mapping},
pubstate = {published},
tppubtype = {article}
}
The use of smartphone-based Serious Games in mental health care is an emerging and promising research field. Combining the intrinsic characteristics of games (e.g., interactiveness, immersiveness, playfulness, user-tailoring and engaging nature) with the capabilities of smartphones (e.g., versatility, ubiquitous connectivity, built-in sensors and anywhere–anytime nature) yields great potential to deliver innovative psychological treatments, which are engaging, effective, fun and always available. This article presents a scoping review, based on the PRISMA (scoping review extension) guidelines, of the field of smartphone-based serious games for mental health care. The review combines an analysis of the technical characteristics, including game design, smartphone and game-specific features, with psychological dimensions, including type and purpose of use, underlying psychological frameworks and strategies. It also explores the integration of psychological features into Serious Games and summarizes the findings of evaluations performed. A systematic search identified 40 smartphone-based Serious Games for mental health care. The majority consist of standalone and self-administrable interventions, applying a myriad of psychological strategies to address a wide range of psychological symptoms and disorders. The findings explore the potential of Serious Games as treatments and for enhancing patient engagement; we conclude by proposing several avenues for future research in order to identify best practices and success factors.
2023
Gómez-Cambronero, Águeda
"Horizon: Resilience": A Smartphone-based Serious Game Intervention for Depressive Symptoms PhD Thesis
Universitat Jaume I. INIT, 2023.
Abstract | Links | BibTeX | Tags: mental health, Mobile apps, mobile computing, serious games, symptoms
@phdthesis{GomezCambronero2023b,
title = {"Horizon: Resilience": A Smartphone-based Serious Game Intervention for Depressive Symptoms},
author = {Águeda Gómez-Cambronero},
url = {http://hdl.handle.net/10803/689528},
doi = {http://dx.doi.org/10.6035/14101.2023.544418},
year = {2023},
date = {2023-12-11},
school = {Universitat Jaume I. INIT},
abstract = {Depression is the most prevalent mental issue in our society, leading to disability and suicide deaths. The COVID-19 pandemic has intensified the need for depression treatment and prevention. While effective, evidence-based psychological treatments for depression exists, only a small percentage of those in need actually receive them. Technology, particularly smartphone-based interventions, can help maximize the reach of these treatments while ensuring their effectiveness, although it comes with challenges, such as high dropout rates. Despite the potential
of this therapy, this is a field that requires considerably more research to fully explore the benefits that smartphones have to offer. Specifically, serious games, designed with a purpose beyond entertainment, have emerged as a promising treatment tool, leveraging advance smartphone capabilities, aligning with psychological treatment principles, and enhancing user engagement.
This dissertation introduces “Horizon: Resilience”, a smartphone-based Serious Game for depressive symptoms. It is a city builder game with a decision making narrative, in which the player (patient) manages a town. The objective is to make the town progress, ensuring the steady inflow of resources and fostering the psychological resilience of its inhabitants. The game is based on the Cognitive Behavioral Therapy (CBT) framework and includes Positive Psychology (PP) techniques. These psychological techniques are woven into the game’s gameplay, feedback, economy system, quests, graphics, and story. Noteworthy is the integration of promoting Physical Activity, detected using the phone’s motion sensors, as part of gameplay. The game draws on the findings of a scoping review on smartphone-based serious games in mental health, and was informed by consultations with therapists as part of a user-centered design. Therapists and patients furthermore provided a qualitative and quantitative evaluation of a Minimum Viable Product (MVP) of the game. Their positive impressions indicate high acceptance and positive expectation regarding the use of the game as an
intervention. Lastly, a pilot randomized controlled trial protocol is outlined to assess its preliminary effectiveness-},
keywords = {mental health, Mobile apps, mobile computing, serious games, symptoms},
pubstate = {published},
tppubtype = {phdthesis}
}
Depression is the most prevalent mental issue in our society, leading to disability and suicide deaths. The COVID-19 pandemic has intensified the need for depression treatment and prevention. While effective, evidence-based psychological treatments for depression exists, only a small percentage of those in need actually receive them. Technology, particularly smartphone-based interventions, can help maximize the reach of these treatments while ensuring their effectiveness, although it comes with challenges, such as high dropout rates. Despite the potential
of this therapy, this is a field that requires considerably more research to fully explore the benefits that smartphones have to offer. Specifically, serious games, designed with a purpose beyond entertainment, have emerged as a promising treatment tool, leveraging advance smartphone capabilities, aligning with psychological treatment principles, and enhancing user engagement.
This dissertation introduces “Horizon: Resilience”, a smartphone-based Serious Game for depressive symptoms. It is a city builder game with a decision making narrative, in which the player (patient) manages a town. The objective is to make the town progress, ensuring the steady inflow of resources and fostering the psychological resilience of its inhabitants. The game is based on the Cognitive Behavioral Therapy (CBT) framework and includes Positive Psychology (PP) techniques. These psychological techniques are woven into the game’s gameplay, feedback, economy system, quests, graphics, and story. Noteworthy is the integration of promoting Physical Activity, detected using the phone’s motion sensors, as part of gameplay. The game draws on the findings of a scoping review on smartphone-based serious games in mental health, and was informed by consultations with therapists as part of a user-centered design. Therapists and patients furthermore provided a qualitative and quantitative evaluation of a Minimum Viable Product (MVP) of the game. Their positive impressions indicate high acceptance and positive expectation regarding the use of the game as an
intervention. Lastly, a pilot randomized controlled trial protocol is outlined to assess its preliminary effectiveness-
of this therapy, this is a field that requires considerably more research to fully explore the benefits that smartphones have to offer. Specifically, serious games, designed with a purpose beyond entertainment, have emerged as a promising treatment tool, leveraging advance smartphone capabilities, aligning with psychological treatment principles, and enhancing user engagement.
This dissertation introduces “Horizon: Resilience”, a smartphone-based Serious Game for depressive symptoms. It is a city builder game with a decision making narrative, in which the player (patient) manages a town. The objective is to make the town progress, ensuring the steady inflow of resources and fostering the psychological resilience of its inhabitants. The game is based on the Cognitive Behavioral Therapy (CBT) framework and includes Positive Psychology (PP) techniques. These psychological techniques are woven into the game’s gameplay, feedback, economy system, quests, graphics, and story. Noteworthy is the integration of promoting Physical Activity, detected using the phone’s motion sensors, as part of gameplay. The game draws on the findings of a scoping review on smartphone-based serious games in mental health, and was informed by consultations with therapists as part of a user-centered design. Therapists and patients furthermore provided a qualitative and quantitative evaluation of a Minimum Viable Product (MVP) of the game. Their positive impressions indicate high acceptance and positive expectation regarding the use of the game as an
intervention. Lastly, a pilot randomized controlled trial protocol is outlined to assess its preliminary effectiveness-
Gómez-Cambronero, Águeda; Casteleyn, Sven; Bretón-López, Juana; García-Palacios, Azucena; Mira, Adriana
A smartphone-based serious game for depressive symptoms: Protocol for a pilot randomized controlled trial Journal Article
In: Internet Interventions, vol. 32, pp. 100624, 2023, ISSN: 2214-7829.
Abstract | Links | BibTeX | Tags: depression, serious games, smartphone app, symptoms
@article{GomezCambronero2023a,
title = {A smartphone-based serious game for depressive symptoms: Protocol for a pilot randomized controlled trial},
author = {Águeda Gómez-Cambronero and Sven Casteleyn and Juana Bretón-López and Azucena García-Palacios and Adriana Mira},
doi = {https://doi.org/10.1016/j.invent.2023.100624},
issn = {2214-7829},
year = {2023},
date = {2023-04-28},
journal = {Internet Interventions},
volume = {32},
pages = {100624},
abstract = {Background
Depression is the most prevalent mental disorder, with detrimental effects on the patient's well-being, high disability, and a huge associated societal and economic cost. There are evidence-based treatments, but it is difficult to reach all people in need. Internet-based interventions, and more recently smartphone-based interventions, were explored to overcome barriers to access. Evidence shows them to be effective alternatives to traditional treatments. This paper presents the protocol of a pilot study whose primary aim is to investigate the efficacy of a smartphone-based serious game intervention for patients with mild to moderate depressive symptoms.
Methods
This randomized controlled pilot trial protocol foresees two arms design: 1/ smartphone- based serious game intervention (based on Cognitive Behavior Therapy with particular emphasis on Behavioral Activation and Physical Activity), 2/ waiting list control group. The study is expected to recruit 40 participants (18+), which will be randomly assigned to one of the experimental conditions. The duration of the intervention is two months. The primary outcome measure will be depressive symptomatology. Secondary outcomes will include other variables such as physical activity, resilience, anxiety, depression impairment, and positive and negative affect. Treatment expectation, satisfaction, usability, and game playability will also be measured. The data will be analyzed based on the intention-to-treat and per protocol analyses.
Discussion
The study aims to establish initial evidence for the efficacy of a smartphone-based serious game intervention, to serve as input for a larger-scale randomized control trial. The intervention exploits advanced smartphone capabilities, such as the use of a serious game as delivery mode, with the potential benefit of engagement and treatment adherence, and motion sensors to monitor and stimulate physical activity. As a secondary objective, the study aims to gather initial evidence on the user's expectations, satisfaction, usability and playability of the serious game as a treatment.},
keywords = {depression, serious games, smartphone app, symptoms},
pubstate = {published},
tppubtype = {article}
}
Background
Depression is the most prevalent mental disorder, with detrimental effects on the patient's well-being, high disability, and a huge associated societal and economic cost. There are evidence-based treatments, but it is difficult to reach all people in need. Internet-based interventions, and more recently smartphone-based interventions, were explored to overcome barriers to access. Evidence shows them to be effective alternatives to traditional treatments. This paper presents the protocol of a pilot study whose primary aim is to investigate the efficacy of a smartphone-based serious game intervention for patients with mild to moderate depressive symptoms.
Methods
This randomized controlled pilot trial protocol foresees two arms design: 1/ smartphone- based serious game intervention (based on Cognitive Behavior Therapy with particular emphasis on Behavioral Activation and Physical Activity), 2/ waiting list control group. The study is expected to recruit 40 participants (18+), which will be randomly assigned to one of the experimental conditions. The duration of the intervention is two months. The primary outcome measure will be depressive symptomatology. Secondary outcomes will include other variables such as physical activity, resilience, anxiety, depression impairment, and positive and negative affect. Treatment expectation, satisfaction, usability, and game playability will also be measured. The data will be analyzed based on the intention-to-treat and per protocol analyses.
Discussion
The study aims to establish initial evidence for the efficacy of a smartphone-based serious game intervention, to serve as input for a larger-scale randomized control trial. The intervention exploits advanced smartphone capabilities, such as the use of a serious game as delivery mode, with the potential benefit of engagement and treatment adherence, and motion sensors to monitor and stimulate physical activity. As a secondary objective, the study aims to gather initial evidence on the user's expectations, satisfaction, usability and playability of the serious game as a treatment.
Depression is the most prevalent mental disorder, with detrimental effects on the patient's well-being, high disability, and a huge associated societal and economic cost. There are evidence-based treatments, but it is difficult to reach all people in need. Internet-based interventions, and more recently smartphone-based interventions, were explored to overcome barriers to access. Evidence shows them to be effective alternatives to traditional treatments. This paper presents the protocol of a pilot study whose primary aim is to investigate the efficacy of a smartphone-based serious game intervention for patients with mild to moderate depressive symptoms.
Methods
This randomized controlled pilot trial protocol foresees two arms design: 1/ smartphone- based serious game intervention (based on Cognitive Behavior Therapy with particular emphasis on Behavioral Activation and Physical Activity), 2/ waiting list control group. The study is expected to recruit 40 participants (18+), which will be randomly assigned to one of the experimental conditions. The duration of the intervention is two months. The primary outcome measure will be depressive symptomatology. Secondary outcomes will include other variables such as physical activity, resilience, anxiety, depression impairment, and positive and negative affect. Treatment expectation, satisfaction, usability, and game playability will also be measured. The data will be analyzed based on the intention-to-treat and per protocol analyses.
Discussion
The study aims to establish initial evidence for the efficacy of a smartphone-based serious game intervention, to serve as input for a larger-scale randomized control trial. The intervention exploits advanced smartphone capabilities, such as the use of a serious game as delivery mode, with the potential benefit of engagement and treatment adherence, and motion sensors to monitor and stimulate physical activity. As a secondary objective, the study aims to gather initial evidence on the user's expectations, satisfaction, usability and playability of the serious game as a treatment.
2021
Gómez-Cambronero, Águeda
A Serious Game to Battle Depression Proceedings Article
In: Extended Abstracts of the 2021 Annual Symposium on Computer-Human Interaction in Play (CHI PLAY '21), pp. 401-402, ACM, 2021, ISBN: 9781450383561.
Abstract | Links | BibTeX | Tags: depression, mental health, serious games, symptoms
@inproceedings{GomezCambronero2021b,
title = {A Serious Game to Battle Depression},
author = {Águeda Gómez-Cambronero},
doi = {https://doi.org/10.1145/3450337.3483520},
isbn = {9781450383561},
year = {2021},
date = {2021-10-01},
booktitle = {Extended Abstracts of the 2021 Annual Symposium on Computer-Human Interaction in Play (CHI PLAY '21)},
pages = {401-402},
publisher = {ACM},
abstract = {This multidisciplinary project aims to develop a mobile serious game – Horizon: Resilience – as an intervention for patient suffering from depression, the most common mental disorder globally. The game is based on Cognitive Behavioral Therapy (CBT), and intends to map therapeutic principles – such as Behavioral Activation (BA), motivation for change and cognitive flexibility – to game mechanics and gameplay. As such, as players progress in the game, they undergo an ecological momentary intervention in a playful way, which teaches them coping strategies, stimulates behavioral change and an active lifestyle. Once the game is fully developed, a validation with real patients under guidance of a therapist is foreseen.},
keywords = {depression, mental health, serious games, symptoms},
pubstate = {published},
tppubtype = {inproceedings}
}
This multidisciplinary project aims to develop a mobile serious game – Horizon: Resilience – as an intervention for patient suffering from depression, the most common mental disorder globally. The game is based on Cognitive Behavioral Therapy (CBT), and intends to map therapeutic principles – such as Behavioral Activation (BA), motivation for change and cognitive flexibility – to game mechanics and gameplay. As such, as players progress in the game, they undergo an ecological momentary intervention in a playful way, which teaches them coping strategies, stimulates behavioral change and an active lifestyle. Once the game is fully developed, a validation with real patients under guidance of a therapist is foreseen.
Gómez-Cambronero, Águeda; Casteleyn, Sven; Mira, Adriana
Horizon: Resilience – Design of a Serious Game for Ecological Momentary Intervention for Depression Proceedings Article
In: Extended Abstracts of the 2021 Annual Symposium on Computer-Human Interaction in Play (CHI PLAY '21), pp. 236–241, ACM, 2021, ISBN: 9781450383561.
Abstract | Links | BibTeX | Tags: depression, mental health, serious games, symptoms
@inproceedings{GomezCambronero2021a,
title = {Horizon: Resilience – Design of a Serious Game for Ecological Momentary Intervention for Depression},
author = {Águeda Gómez-Cambronero and Sven Casteleyn and Adriana Mira},
doi = {https://doi.org/10.1145/3450337.3483500},
isbn = {9781450383561},
year = {2021},
date = {2021-10-01},
booktitle = {Extended Abstracts of the 2021 Annual Symposium on Computer-Human Interaction in Play (CHI PLAY '21)},
pages = {236–241},
publisher = {ACM},
abstract = {Depression is the world’s most prevalent mental disorder and the primary source of disability adjusted life years (DALY). While traditional face-to-face therapies have been shown to be effective, alternative delivery methods, e.g. internet-based therapies, have been investigated to overcome barriers to access, such as lack of availability of therapists and infrastructure. This article presents the design of a mobile serious game as a novel psychological momentary ecological intervention for depressive symptoms. We discuss how selected principles and techniques of common psychological frameworks used to tackle depression, namely Cognitive Behavioral Therapy (including Behavioral Activation) and Positive Psychotherapy, were integrated in the game concept, gameplay and game mechanics of ”Horizon: Resilience”, a City Building and Decision Making serious game. The selected techniques are put central in the game design by introducing ”the Power R(esilience)”, which groups the psychological principles of motivation for change, cognitive flexibility, activation and positivity. While identifying with game characters and maintaining high levels of the Power R, the players are introduced to and learn to use Cognitive Behavioral Therapy and Positive Psychotherapy strategies, which they can ultimately apply in their real-life depressive symptomatology},
keywords = {depression, mental health, serious games, symptoms},
pubstate = {published},
tppubtype = {inproceedings}
}
Depression is the world’s most prevalent mental disorder and the primary source of disability adjusted life years (DALY). While traditional face-to-face therapies have been shown to be effective, alternative delivery methods, e.g. internet-based therapies, have been investigated to overcome barriers to access, such as lack of availability of therapists and infrastructure. This article presents the design of a mobile serious game as a novel psychological momentary ecological intervention for depressive symptoms. We discuss how selected principles and techniques of common psychological frameworks used to tackle depression, namely Cognitive Behavioral Therapy (including Behavioral Activation) and Positive Psychotherapy, were integrated in the game concept, gameplay and game mechanics of ”Horizon: Resilience”, a City Building and Decision Making serious game. The selected techniques are put central in the game design by introducing ”the Power R(esilience)”, which groups the psychological principles of motivation for change, cognitive flexibility, activation and positivity. While identifying with game characters and maintaining high levels of the Power R, the players are introduced to and learn to use Cognitive Behavioral Therapy and Positive Psychotherapy strategies, which they can ultimately apply in their real-life depressive symptomatology