Last year, a review and meta-analysis by Turner and Casey found 30 eligible studies with their criteria and an overall moderate effect size for intervention in a random-effect meta-analysis of VR-based therapeutics.1 They found an overall large effect size against non-intervention waitlists and overall moderate effect size against active interventions. There were no correlations between treatment outcomes and methodological rigor. The interventions included mostly exposure therapy, some skills training, some occupational therapy and physical therapy, and some cognitive-behavioral therapy.
As far as games are concerned, a lot has been published the past seven years. A 2014 review of video games found that they are associated with enhanced cognitive performance, with regular gamers being able to allocate attentional resources more efficiently and filter out irrelevant information more effectively.2 This review also found that a causal relationship has been established between playing preferred video games and improved mood or increases in positive emotion. They also found that violent video games played cooperatively seem to decrease players’ access to aggressive cognitions.
With regard to youth-based mental health interventions, we need to work a lot harder. A 2014 systematic review of online youth mental promotion and prevention interventions by Clarke, Kuosmanen and Barry,3 most of which did not include high quality interactive entertainment, found that despite the wide number of interventions tested, studies suffer from numerous methodological issues. They noted high levels of dropout and non-completion as a significant issue for online interventions, a significant gender imbalance, which limits generalization of findings to young men, and lastly, that existing interventions may not generalize to low- and middle-income countries.
ACP meeting participants noted there is still a great deal of stigma within the psychiatric community with games. Indeed, even in 2010, Ceranoglu explained that “these concerns about their effects on youth might prevent video games from being included in our offices.”4
The second problem that is harder to address is lack of media literacy within the psychiatric community. Newer generations of psychiatrists and other health professionals who grew up with interactive entertainment have greater comfort with trying new things, but they still don’t have time to know everything that is out there available to use. Continuing medical education courses in the future could address this problem.