Video-game therapy

Domain VIII · Creative & expressive arts therapies · Robert Rice, Anthony M. Bean, Brian H. Moyer · 2014 · Williamsville, New York

What it is

Video-game therapy is not a separate, regulated therapy. It is the planned use of commercial (off-the-shelf) video games, gaming culture and game metaphors inside an existing psychotherapy, mostly with children, adolescents and young adults. Games can serve as:

Format

• No published source sets out a fixed phase model, session count or criteria for moving between phases. Rice's publisher and bookseller pages describe a "practical session-by-session framework" with example therapist questions, responses and activities, case examples, templates and worksheets, and a…
• Phase 0: Suitability and safety screening (session 1–2).

Who practises it, and how they are trained or regulated

• No regulated profession, protected title or required credential exists for "video-game therapy". A practitioner uses it within their existing licence as a psychologist, counsellor, social worker, psychotherapist or play therapist, and within that discipline's ethics.
• Specialist training exists. Bean founded Geek Therapy Training, which teaches what it calls "Leyline's Geek Therapy Techniques". He is described as executive director of The Telos Project, a non-profit mental-health clinic in Fort Worth, Texas, and as founder of Leyline Publishing; the Geek Therapeutics stand at PAX East 2023 sold his books. None of the sources cited names a formal certification, hours or curriculum.
• When games are used as a play-therapy medium with children, the play-therapy standards of your jurisdiction apply: for example APT (RPT) in the US, or BAPT or PTUK in the UK. Do not present yourself as a play therapist without that training.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• regression as the ending approaches. Plan booster sessions if needed.
• sessions that never move beyond game talk. Set a goal by session 3 (see section 5).
• the client dismissing their game skill as "just a game". Validate the effort as real.
• immersion that is used mainly to numb distress, which returns you to 4.2 and a risk review.
• do not use it where the child needs to watch or cooperate actively, and use it alongside medical pain management, not instead of it.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.