Social anxiety disorder is characterized by sentiments of fear and anxiety in social interactions. This study's aim was to design and evaluate a serious game to raise awareness of cognitive behavioral therapy (CBT) skills associated with social anxiety disorder. The target group was university students, as 10-25% within this group have impaired functioning due to social anxiety. This study was based on three different iterations (study 1, study 2, and study 3), all included within a formative evaluation framework. In total, this study involved 71 university students, all within the 18-31 age range. The game was designed in Unity with the implementation of different CBT skills within different scenarios. The scenarios were designed based on psychophysiological pilot testing in study 1, and external psychiatrist and psychologist expertise. The evaluation in study 2 and 3 was based on self-reports (questionnaires and interviews), and a recall knowledge check. The findings revealed that the designed serious game was successful in terms of focused attention, perceived usability, aesthetic appeal, being worthwhile, and narrative understanding. However, the designed elements could be improved by allowing more in-game personalization with the inclusion of the users' own life experiences.
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