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Cited by 81Digital Mental Health InterventionsEducational Games and GamificationMobile Health and mHealth Applications

Gamifying CBT to deliver emotional health treatment to young people on smartphones

Open access
Christie, Grant I., Shepherd, Matthew, Merry, Sally N., Hopkins, Sarah, Knightly, Stephen, Stasiak, Karolina·2019·Internet Interventions
DOI 10.1016/j.invent.2019.100286PMC PMC6926322
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Abstract

mHealth interventions promise the economic delivery of evidence-based mental health treatments like cognitive behavioural therapy (CBT) to populations that struggle to access health services, such as adolescents and in New Zealand, Māori and Pasifika youth. Unfortunately engagement with digital therapies is poor; modularisation and gamification have potential to increase their appeal. Gamifying CBT involves selecting suitable interventions, adapting them to a digital format while applying gamification principles. We describe the design and development of Quest - Te Whitianga, an app that encourages the user to learn CBT skills via a series of activities and games. A variety of approaches including consultation with clinicians, reference to best-practice literature, focus groups and interactive workshops with youth were used to inform the co-design process. Clinicians worked iteratively with experienced game designers to co-create a youth CBT digital intervention. The Quest modular app is set on an ocean and the user travels between islands to learn six evidence-based skills. These include a relaxation/mindfulness activity, activity planning, a gratitude journal plus problem solving and communication skills training. We describe the theoretical and design aspects of each module detailing the gamified features that aim to increase user engagement. In the near future we will be testing the app and the principles discussed in this paper via a randomised-controlled trial.

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  • Gamification can increase motivation to engage with mental health apps.

    “Previous research shows that gamification can increase motivation to engage with mental health apps [42-44], improve mood [45], and activate the ventral striatum, which can enhance individuals’ general reward responsiveness to positive stimuli [21].”

    From Examining the effectiveness of gamification in mental health apps for depression: Systematic review and meta-analysis (2021) · cites this paper as [44]

    The Conclusions (page unavailable) report that one comparison found greater use and time spent on a gamified mental health app, supporting the possibility of increased engagement. But they also say that a positive effect on engagement is not yet established, and they do not report a measured increase in motivation. The citing sentence presents the evidence more firmly than this source does. (LLM, conf=0.85)

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Research works printed but not linked: 2

  1. D’zurilla T.J. Nezu A.M. Problem-solving Therapy: A Positive Approach 2007 Springer New York
  2. Sardi L. Idri A. Fernández-Alemán J.L. A systematic review of gamification in e-Health J. Biomed. Inform. 71 2017 31 48 28536062

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Related

Authors
Christie, G. I., Shepherd, M., Merry, S. N., Hopkins, S., Knightly, S., & Stasiak, K.
Affiliations
University of Auckland (NZ)
Corresponding author
Christie, Grant I.
ORCID
Venue
Internet Interventions
Publisher
Elsevier BV
Published
2019-12
Volume
18
Pages
100286
ISSN
2214-7829 (ISSN-L)
DOI
10.1016/j.invent.2019.100286
PMC
PMC6926322
OpenAlex
W2980334302
Cited by
81
References
66
Citations by year
2026: 10 · 2025: 10 · 2024: 14 · 2023: 11 · 2022: 18 · 2021: 8 · 2020: 10
FWCI
10.17
Type
journal article
Language
en
Open access
Licence
Locations
  • Internet Interventions (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • ResearchSpace (University of Auckland) (submittedVersion, cc-by-nc-nd)
Funders
Ministry for Business Innovation and Employment
Topics
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Social Sciences › Psychology › Developmental and Educational Psychology › Educational Games and Gamification
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords
gamification, cognitive behavioral therapy, youth mental health, mobile health apps, digital mental health interventions, co-design, user engagement, Māori youth, gratitude journal, problem-solving skills, communication skills training

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