It is no question that the video game industry is rapidly growing, with over 130 million Americans (40% of the population) having been reported to play commercial video games in 2017 [1]. A great degree of research has been conducted towards examining the issues associated with video gaming, ranging from sedentary screen time, exposure to violence, and excessive or problematic gaming [2]. The negative behaviour that is seemingly linked to video gaming is also a highly sensationalised topic in the news and media, mainly due to the controversial yet popular idea that the increased violence observed in teenagers and young adults in the current age is due to the popularity of video games in this age group. However, considerable attention has also been drawn to researching the benefits of video games, namely in enhancing cognitive function and intelligence. Investigation into the benefits of video games has also led to the suggestion of video games as a possible form of therapy.

Commercial video games and their association with benefits in mental and cognitive function has gained substantial attention due to their ever-increasing popularity and emerging research supports the notion that commercial, off-the-shelf video games hold potential applications in preventive and therapeutic medicine.

Examples of the positive benefits linked with playing video games is highlighted by the computer solitaire game FreeCell, which has been found to be useful in monitoring cognitive status in adults with mild cognitive impairment [3], while new augmented reality games such as Pokémon GO may be helpful in promoting physical activity in those who require it and are reluctant to do so [4]. For children undergoing surgery, a handheld game was found to be more helpful in relieving preoperative anxiety compared to a dose of midazolam [5]. Puzzle games such as Tetris and Bejeweled have also been proven to reduce depression, stress, and even prevent flashbacks following a traumatic event [6][7][8]. The structural characteristics of games may provide unique benefits that traditional therapies do not offer.

Video games may also act as a useful tool in psychotherapy for assessment, building rapport, and training social skills. For example, playing non-violent and non-competitive video games in a co-operative or multiplayer mode is a good way for parents to participate in a child-directed activity in Parent-Child Interaction Therapy [9]. Playing video games together as a family also fosters social connection between grandparents and grandchildren, which is highly beneficial towards the health of elderly adults [10].

Co-operative and multiplayer gaming, a popular feature in modern video games may also unite gaming communities in facing real-world issues in a therapeutic and philanthropic manner. By establishing an online gaming community with users becoming connected through online gaming forums and co-operative gaming sessions, gamers and gaming-related organisations can provide peer support, online clinician-delivered services, information about mental health conditions, and assistance finding in-person mental health treatment to community members and the gaming population at large. Examples of these non-profit gaming support organisations are Stack-Up and Anxiety Gaming, who provide safe spaces where gamers can learn about mental health problems, seek support and assistance, and interact socially either in person or online. This image of connected, socially engaged gamers challenges the stereotypical view of video games as an isolating and detrimental pastime that reinforces social withdrawal and isolation [11].

There is increasing evidence supporting the notion that online communities are, for specific types of players, socially liberating and contribute to improving self-esteem and mood control in real-world settings.

Although it may appear counterintuitive to suggest that socially anxious individuals or those who avoid face-to-face social interactions may benefit from interventions that do not involve exposure to “in vivo” therapy, online interactions allow individuals who face difficulties with social interactions in the real-world setting to receive much needed social support and a sense of inclusion or connectedness. These represent ideal interventions for those individuals facing suicidal ideation and behaviour [12].

Serious research into the therapeutic potential of commercial video games faces several challenges, including a lack of standard terminology, rapidly changing technology, negative societal attitudes toward video games, and understanding and accounting for complex interactions between individual, social, and cultural health determinants.

Much like other forms of entertainment, video games may be regarded as a double-edged sword as excessive video game activity may be detrimental to the player by causing them to become too immersed in virtual reality, which may lead them to neglecting aspects of their real life, such as health and social relationships.

Modern digital video games in the current age are far more advanced in comparison to their 8-bit predecessors of the 1980s. Although it may still be decades until sufficient research and breakthroughs into the potential therapeutic applications and benefits of video games has been conducted, the ever-increasing popularity of video games in young adults and the population in general has encouraged scientists to taking a step forward in investigating the potential benefits of gaming. Thus, video games may not be so detrimental to mental health as it is popularly perceived and video game therapy may not just be a far-fetched fantasy.

References

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