Video Game Assisted Therapy (VGAT) is a form of therapy that makes use of video games. We use video games as the medium to address areas of concern that led a client to seek counselling in the first place. It enables the client and the therapist to quickly form a bond, without the added pressure of sitting face to face, and having to come up with something to say.
VGAT is essentially a non-traditional approach that uses video games to build rapport with clients, in conjunction with evidence-based interventions (CBT, SE, Narrative, & DBT). It includes the creative use of “gaming” as a common language within the structure of therapy sessions. Using gaming language to get to the root of the “problem” as well as the solution.
So, you are just playing Video Games?
Yes, we are playing video games, but we are doing more than that. For many people the idea of sitting across from a stranger (aka therapist), and divulging their deepest darkest secrets, is about the last thing they want to do.
During VGAT like other therapies, it can be difficult to share what you are thinking and feeling with someone new. One of the nice things about VGAT is it allows us to quickly get comfortable with each other, to relax, and not have the pressures of needing to fill an awkward silence. It provides the opportunity to let our thoughts and words flow without over thinking.
In VGAT you are getting the opportunity to share what you are thinking and feeling in an environment where you don’t have to worry about what to say, with a clinician (who at the same time is beating you at Mario Kart), and who will listen empathetically to whatever you choose to share.
This is particularly effective for children, teenagers and young adults who can find it particularly hard to vocalize what they are feeling and thinking.
So, who would benefit from doing VGAT?
Research has shown that VGAT has proven to be effective in helping clients with a variety of common problems such as anxiety, depression, navigating social situations, problem solving, and self-esteem to name a few. VGAT also appears to be especially helpful with neurodivergent folks, those with ADHD and autism.
So, what are the benefits to VGAT?
VGAT brings in multiple elements to therapy. One is the client winning against the therapist. The client can assume a more powerful role in the relationship. For example, consoling the therapist in their loss or in allowing them a chance to redeem themselves. Oftentimes a client takes on the idea that the therapist is the expert. But by winning they have the bonus of boosting their self-esteem and believing in their own capabilities.
A surprising benefit is that playing video games can allow a therapist to learn more about the client’s cognitive processing style (how they process things and events). It gives the therapist the opportunity to observe how they play the game and provides insight into their memory, visuospatial abilities, motor, planning and academic skills, and frustration tolerance to mention a few.
For many, going to therapy can be as stressful as going to the dentist. However, in this case you get to think about “therapy” in a different way. You are not going to “therapy” per se, you’re just going to play video games with an empathetic person who happens to be a therapist. Sitting in front of a screen can feel like a safer place for a client’s conflicts to emerge.
So, why does it work?
VGAT works by quickly creating a relaxed and trusting atmosphere. It works by allowing the therapist to teach a client a method of relaxing, grounding, or taking back control. A quick pause, a quick review, and some practical strategies can be used when you are playing a game. Since the client is back in control, they start to play better, and potentially beat the therapist, which acts as a positive reinforcement for using the technique.
Research has shown that actively practicing a therapeutic technique, allows a person to remember the technique longer. A positive outcome can be that outside of the therapy office they will use the technique instead of reverting to learned habits (such as screaming, punching a wall, and ripping apart an innocent book). Perhaps they will take a calming breath, stretch, or do some grounding techniques as they practiced in video game assisted therapy.
VGAT has the feature of allowing the client to avert their gaze and not looking directly at the therapist. Being side by side supports a warm and hospitable space to talk about “stuff”. This may result in the client taking a risk, such as starting a conversation about a difficult experience. This conversation may be related to game play at hand, real-life stress, or both.
So, what can I expect when doing VGAT?
As with all therapies when you start, you start with an intake form and the initial appointment where you get to share your concerns and why you are reaching out for therapy. With those goals in mind, you will join the therapist in a special video game assisted therapy room. There you will pick from a library of games that you are interested in playing. If you are decent at games, you will beat the therapist. If you are new to video games the therapist will likely win (but do not worry, you will get another chance). As time goes on, the therapist will work with you to figure out ways of approaching your goal.
For example, if your goal is to deal with anger, the therapist will work with you to figure out a technique that might help you when you feel angry or are about to lose control. Then throughout the video game session whenever you start to get angry (because the therapist keeps winning) the games are paused. The technique is practiced until you are calm. Then the game restarts. Often the client who is calm easily wins (*important notice: the therapist will never “let you win”). Winning will be something that you earn. This sequence of playing, pausing, resetting, reinforce the importance of staying in control and the benefits of using the technique. In this way VGAT uses immediate body sensations and emotional expression as feedback to help a client achieve their goals.
Andre Stam
RP, CCC