Currently, ROC gamers encounter situations designed to help them make new friends and handle peer pressure, stress, and anxiety in healthy ways. They learn about self-confidence and anger management as well as strategies to apply in situations that encourage drug use.

While researchers are still administering online surveys to collect more information, data from the Swinburne University eTherapy Unit’s evaluation is available for review. This evaluation is presented and analyzed by Kerrie Shandley and two other faculty members from the Swinburne University of Technology.

Purpose of ROC

The designers of ROC intended to use cognitive-behavioral principles to assist young people in the identification and development of practical coping skills for dealing with life stressors that might otherwise contribute to the development of mental health problems.

The game also has a mood component that must be increased to promote easier progress, so ROC is both preventative and therapeutic in terms of mental health.

Role-play encourages gamers to both learn life skills for good mental health and apply them offline. Skills like problem-solving, challenging negative beliefs, and negotiating relationships are emphasized in the game.

Gamer Responses to ROC

A qualitative survey was administered to ROC participants four weeks after a trial version of the game was released. The survey consisted of only two questions and encouraged gamers to select at least one pre-scripted response to each question, but also included a text box for open comments. 154 ROC players were asked to identify what they liked most about the game and what they liked least about it.

• Game play, which was described on the survey as including interactivity, response options, choices, storyline, characters, and fun, was identified by 44.8% of players as the best part of ROC. Other top aspects of ROC included informative and educational components (31.2%); game design components like interface, music, and graphics (26%); and the realistic and relatable nature of the game (19.5%).
• The characteristic of ROC that players identified as being the least satisfactory was its usability at 36.4%.  58.9% of gamers who wanted to see improved usability cited technical issues (such as navigation, bugs, screen resolution, accessing the website, and logging in) as the worst problems, while the remaining 41.1% experienced difficulty with instructions, directions, and objectives.
• Interestingly, the runner-up for least favorite aspect of ROC was game play, which was selected as the best thing about the game. 27.9% of players found game play to be deficient in terms of storyline, length of the game (too short), response options, pace (too slow), and number of locations and scenarios (too limited).

Recommendations for Future Mental Health Games

Based on the responses collected thus far from ROC gamers, Shandley and her team have developed a list of considerations for future mental health game designers who want to focus on preventative and therapeutic components.

• Keep uploads and downloads to a minimum and limit updates as much as possible.
• Allow gamers to customize their experiences as much as possible in order to give them a heightened sense of control and increased identification with characters.
• Make sure that directions and objectives are clear. One specific way to do this is to ensure that players know when an objective has been completed, leaving no doubts about what to do next. This also gives players a sense of accomplishment.
• Debug the game as much as possible prior to its release. With serious games, the stakes are higher, and bugs can influence players to quit without giving it a second thought. To make sure that everyone who wants to learn from the game can enjoy it, debugging is an essential priority.

About the Author

Alexis Bonari is a freelance writer and blog junkie. She is currently a resident blogger at First in Education performing research surrounding online universities and their various program offerings. In her spare time, she enjoys square-foot gardening, swimming, and avoiding her laptop.

Helping children recognize emotions with games.

MyFriendQuest is an interactive animated computer game created to teach children to recognize emotions and respond to them appropriately.  This is important, as difficulty with these skills often stands in the way of children reaching their capacity to communicate and develop empathy. Although initially created specifically for children with autism, MyFriendQuest has also achieved great results in testing with children with ADD, ADHD, dyspraxia, learning difficulties, social anxiety and severe shyness.

The interview.

I had the pleasure of interviewing Fraser Hurrell, CEO and Co-Founder of BrightMind LABS who created the game with the leadership of Clinical Psychologist Dr. Yvette Ahmad.

HG: I have often heard that video games are a great way to teach Autistic children.  What was the inspiration behind MyFriendQuest?

FH: The inspiration for MyFriendQuest – and the future games which we are planning under the BrightMind LABS banner – came from the fact that in no country is the need for child mental health services fully met. It seems unlikely that the planet will ever produce – or fund – enough mental health professionals to provide one-on-one therapy for all children who need it.  Gaming is a means of providing more  widespread delivery of cognitive behavioural therapy to those who need it, but are unable to access one-on-one therapy.

HG: Your site says “clinically designed.” Was an effectiveness study done? If so, can you share any results?

FH: A large amount of clinical testing has been done in trials working with kids on the autistic spectrum during development of MyFriendQuest.  However a proper clinical effectiveness study has only just been started – and we anticipate results before Christmas. We’ll post these on the web site once available.

HG: What kind of results should people who purchase this game expect to see in the player?  For example, are better social interactions an expectation or simply better skills at identifying facial expressions?

FH: Skills at identifying facial expressions are a prerequisite for better social interactions.  The expected outcome is for the child to increase their ability to interact socially, reduce anxiety and build
self-esteem.

HG: Describe the “package” that people who purchase your game will receive.

FH: The package will be a downloadable Flash file which has been designed to run on either a PC or a MAC – although only the PC version will be released initially.  To accompany the download will be a detailed user guide which is downloadable in .pdf format free of charge.

HG: What was your funding mechanism for production?

FH: The production has been funded so far by private investment.  Once we have proven the delivery model with the first game, we will be looking for further investment to develop future games.

HG: Was art and programming done in-house?

FH: We developed the clinical aspects of MyFriendQuest in-house, and also the storyboarding and scripting.  Once we had a good idea of what we wanted, we brought Flux Animation Studios in Auckland into the mix –and they took care of the Flash animations.  Local company Guerrilla managed the programming.

HG: Who is your target market? Should we expect to see this inphysicians’ offices or is it an at-home purchase for parents and their children?

FH: Initially the target market is direct to parents of children on the higher functioning end of the autistic spectrum.  However, we have had a lot of interest from institutions to bulk purchase as a therapeutic intervention they can provide to parents while on the waiting list for one-on-one therapy.  When we release, the game will  initially be marketed just to parents through one-off sales, but we  will work quickly on developing a mechanism for making bulk sales to health institutions.

HG: You mention future games on the horizon.  Will they all be related to autism and childhood mental health?

FH: Future games will be targeted to mental health conditions for children up to 12 years of age.  We do have more ideas for kids on the autistic spectrum – and also some great ideas in the pipeline for other conditions.

About BrightMind LABS.

Winner of the 2009 Global Social Impact Assessment competition at Berkeley, BrightMind LABS exists to improve the lives of children with mental health issues. Their goal is to deliver Cognitive Behavioral Therapy by computer (CCBT) to children using an immersive gaming wrapper. They have coined the term psytainment to define this exciting new space. Their first release, MyFriendQuest, is now available for download at the low price of $39.95 USD.

Brain Coach and More Brain Exercise have been adapted for mobile and allow players to test and refine their mental agility by stimulating different parts of their brain.  Dr. Kawashima accompanies the player throughout the experience and explains each of 36 minigame puzzles.  The player’s performance is ranked after gameplay, and statistics can be uploaded to the official website or Facebook. You can challenge up to 3 friends too.

Both games are officially approved by Dr. Kawashima of Tohoku University, the mastermind of the brain training games, and are scientifically proven at the Kawashima Lab to stimulate certain regions of the brain.  You can try the games online now at the More Brain Exercise website.

Brain fitness business 101.

HG: For those unfamiliar with your business, what is HAPPYneuron?

Laura: HAPPYneuron is a pioneer in brain training solutions which offers a broad range of scientifically validated multimedia, personalized cross-training programs for children, adults and seniors. The programs minimize brain decline by maximizing the brain’s capacity to learn and its ability to adapt to new information. Program effectiveness is optimized through the availability of thousands of hours of fun and challenging brain games, guided by a virtual personal coach. The goal of the site is to defer the onset of age-related brain decline.

HG: Why did you choose to get into brain fitness?

Laura: In 1998, the founding Product Team (Bernard Croisile, MD Neurology, Ph.D Neurosciences and Neuropsychology; Franck Tarpin-Bernard, Ph.D Computer Science, Human-Computer Interaction; and Michel Noir, Ph.D Cognitive & Educational Sciences) conducted collaborative research at University of Lyon, France. The goal of the trio was to bring cognitive science to everyday people through the use of interactive computer methods. After 2 years of university research together, the trio founded the company. Brain stimulation for healthy, aging and impaired individuals was the goal from the beginning.  Today, HAPPYneuron is a majority owned subsidiary of Scientific Brain Training (NYSE Euronext: MLSBT) with product distribution in France, Germany, USA, Japan, and Holland.

HG: What has been your biggest challenge in the brain fitness business?

Laura: Brain fitness education. As an industry we have a long way to go in terms of people understanding the reasons for it and the methods and basic principles. The lack of understanding often causes individuals to make in appropriate product choices for themselves. Additionally, while the general body of science has progressed tremendously, there is more to be done to validate the category. That said, these can be viewed as less of challenges and more opportunities to grow the category overall and recognize that it’s a marathon not a sprint to a point in time when brain fitness is as well understood as physical fitness. I look forward to the journey.

HG: Who is your target audience?  Do you see more older, dedicated players visiting your site or younger, casual players?

Laura: HAPPYneuron’s users can be represented by an age bell curve, where the majority are 45-65 years old.  Overall abut 70% are women. We have a good number of older people (65+) participating in the online program with about 1M page views and 250K unique visitors a month.

HG: What is the benefit of becoming a member versus just playing for free?

Laura: With HAPPYneuron you get to experience 5 exercises, one from each of the major cognitive functions, as a non paying guest. As a paying member, you get access to the current set of 35 exercises, the online virtual coach that designs your personalized workout based on your cognitive strengths and weaknesses and you available time during the sessions. Monitoring and tracking tools enable you to track your cognitive performance over time in all areas. See this page for membership details.

HG: Has this subscription model proven an effective monetization strategy for you?

Laura: Yes it is, but we’ve also seen consumers challenged by the current economic environment. With the current recession we are seeing more people curtail non-essential expenses, and brain fitness as a category, is not yet mainstream enough to be view as essential by everyone.

Scientific validity.

HG: Your site states that your games are scientifically validated and developed.  Can you explain this further?

Laura: The software has been used in a number of scientific studies that are at varying degrees of progress. A partial list of activities can be found on our brain science research page.

HG: There has been a great deal of controversy surrounding the Brain Age game and its initial subtle claims of a health benefit. Does this differ from HAPPYneuron’s “use it or lose it” philosophy?

Laura: Nintendo’s Brain Age has had a lot of positive benefit for the brain fitness market. By the sheer marketing power of Nintendo, a spotlight has been placed on the space. Since the rising tide lifts all boats, this has helped those with more scientifically grounded products. However, Nintendo’s Brain Age has no efficacy in terms of scientific validation. Nintendo is very up front about that.

HG: How are your games different from other brain training sites (ex. Luminosity)? What makes your games special?

Laura: All the brain game site have some similarities and differences. Without going in to a line by line detailed comparison, HAPPYneuron’s differentiation can be found in a number of areas, including more games and challenge levels than others. Also HAPPYneuron has the largest online results database in the industry, with over 30M cognitive results data points, each calibrated by age, gender and education level. These are three of the essential influencers of brain reserve. No other vendor has as large of a database or normalizes the data with these three variables. Doing so gives HAPPYneuron the ability to give users real feedback relative to their peer group, so I not only know how I am doing, but I know it relative to how I might be expected to do for my age, gender and level of education.

On the Games For Health Conference.

HG: Two of our Playnormous health games were added to the HG4H site after we met Humana Games 4 Health at the Games For Health Conference last year.  How did HAPPYneuron start working with HG4H? Why did you decide to put some HAPPYneuron games on their site?

Laura: Humana gets it when it comes to the benefits of cognitive training. They also are very supportive of the therapeutic and educational qualities of healthy gaming. We actually started talking initially at the GFHC last year and the relationship progressed form there. Humana wanted to add brain games to the Humana games site, and we were pleased that they were excited to be working with HAPPYneuron. We have also launched a brain fitness online store for Humana. The store offers discounts on brain fitness products to Humana members.

HG: You are going to be speaking the the Games for Health Conference this week. Is this your first appearance at GFHC?

Laura: We were present at GFHC conference in Baltimore last year, as an invited guest of the Robert Wood Johnson foundation. HAPPYneuron was a finalist in their world wide competition, Games for Health: a prescription for health care. There were 74 entries from 13 countries. We are delighted to be back again this year.

HG: Can you give our readers a little spoiler on what your talk will include on Thursday?

Laura: I will be bringing stories from the field about the use of brain games, like HAPPYneuron’s in the effective remediation and rehabilitation of individuals with a variety of cognitive impairments, specifically related to depression, schizophrenia and MCI. I’ll talk about how cognitive remediation programs across the country are adapting to the use of games in their therapies and the related issues in doing so.

Don’t miss Laura!

To learn more about Laura Fay and the brain fitness industry, don’t miss her presentation at the Games for Health Conference Thursday afternoon, June 11, 2009!

Brain games have been the subject of much controversy due to their unclear effectiveness in maintaining mental fitness among users.  Many are asking, “Do these games really make people smarter?”  I say that the real question is “Are these games better than traditional methods?”  For example, the Alzheimer’s Association recommends games like Brain Age, but they also recommend general puzzle therapy to patients.  Some researchers have taken notice, including cognitive psychologist Alain Lieruy of the University of Rennes in Brittany, France.  His recent study of 10-year-olds concluded that Nintendo’s brain games aren’t what they claim to be.  Yes, kids use their brains while playing Big Brain Academy and Brain Training on Nintendo DS, but not any more than doing homework, reading, or playing paper-and-pencil games like sudoku.

Lieruy’s study.

Professor Lieruy chose to test 10-year-olds for his study because “That’s the age where you have the best chance of improvement.  If it doesn’t work on children, it won’t work on adults.”  Sixty-seven 10-year-olds were split into four groups:

• Groups 1 and 2 – A 7-week course on Nintendo DS game console
• Group 3 – Puzzles with pencil and paper (ex: Scrabble and sudoku)
• Group 4 – Typical school work

Each group was tested on three skills before and after their assigned seven week courses:

• Mathematics
• Memorization
• Logic

Here were the results:

• Nintendo DS Groups – 19% better in math, 17% worse in memorization, 10% better in logic
• Pencil/Paper – 19% better in math, 33% better in memorization, no change in logic
• School – 18% better in math, no change in memorization, 20% better in logic

What does this study really tell us?

Most of the press interpreted the results of this study as negative.  I actually think this is a positive thing for brain games as far as math skills are concerned.  Brain games are just as good as doing math homework.  Awesome!  However, most brain games take pride on sharpening brains, “rejuvenating gray cells.”  That means improving memory.  Too bad kids who played on the DS had worse memory than when they started.  In reality, this study tells us that more research needs to be done on the effectiveness of brain games.  Do brain games really make people smarter?  More data is needed to really answer this question.

Recommended readings.

• Jan 26, 2009 – The Times – Nintendo brain-trainer ‘no better than pencil and paper’
• Sept 6, 2007 – BBC News – Mind Games
• Jan 17, 2006 – USA Today – Exercise your option to keep your brain cells active