Annual Research Review: Immersive virtual reality and digital applied gaming interventions for the treatment of mental health problems in children and young people: the need for rigorous treatment development and clinical evaluation

Abstract

Background: Mental health problems in children and young people are common and can lead to poor long-term outcomes. Despite the availability of effective psychological interventions for mental health disorders, only a minority of affected children and young people access treatment. Digital interventions, such as applied games and virtual reality (VR), that target mental health problems in children and young people may hold a key to increasing access to, engagement with, and potentially the effectiveness of psychological treatments. To date, several applied games and VR interventions have been specifically developed for children and young people. This systematic review aims to identify and synthesize current data on the experience and effectiveness of applied games and VR for targeting mental health problems in children and young people (defined as average age of 18 years or below). Methods: Electronic systematic searches were conducted in Medline, PsycINFO, CINAHL, and Web of Science. Results: Nineteen studies were identified that examined nine applied games and two VR applications, and targeted symptoms of anxiety, depression, and phobias using both quantitative and qualitative methodologies. Existing evidence is at a very early stage and studies vary extensively in key methodological characteristics. For applied games, the most robust evidence is for adolescent depressive symptoms (medium clinical effect sizes). Insufficient research attention has been given to the efficacy of VR interventions in children and young people. Conclusions: The evidence to date is at a very early stage. Despite the enthusiasm for applied games and VR, existing interventions are limited in number and evidence of efficacy, and there is a clear need for further co-design, development, and evaluation of applied games and VR before they are routinely offered as treatments for children and young people with mental health problems.

A New Perspective on the Role of Self-Confidence and Confidence in the Evaluation and Rehabilitation of Children With Adverse Life Experience and Borderline Intellectual Functioning: A Preliminary Study

“…Specifically, VR/serious games have also been effectively used in complex and difficult relational and behavioral contexts such as autism spectrum disorders. Nevertheless, the use of new technologies does not replace the importance of personalized pathways that consider the specific characteristics of young patients and their environment, and this may explain the limited efficacy observed in some cases (Halldorsson et al, 2021 ; Karami et al, 2021 ). Our experience, for example, tells us that whatever the approach, the relational aspect remains crucial for the effectiveness of rehabilitation intervention.…”

“…Specifically, VR, allowing for an ecological setting that mimicks real social interaction, has been widely used to train social cognition in children with autism spectrum disorder (Strickland, 1997 ; Wass and Porayska-Pomsta, 2014 ; Karami et al, 2021 ). Moreover, VR, applied games, and serious games have been extensively used to help children with mental health problems such as anxiety and depression (Halldorsson et al, 2021 ). Efficacy results are encouraging, although more studies are necessary.…”

“…Efficacy results are encouraging, although more studies are necessary. Indeed, despite good acceptance and adherence, in most cases, the effects of VR/games intervention were comparable with the effects of non-therapeutic games (Halldorsson et al, 2021). Finally, the need for a user-centered and personalized design to ensure that the needs and specificities of patients are more effectively met is well-recognized (Parsons et al, 2017;Halldorsson et al, 2021;Karami et al, 2021).…”

Virtual reality among children with mental disorders: A mini-review

“…Mental disorders are a group of disorders that affect thinking and behavior by causing discomfort or disability to the person [1]. Mental disorders are very common among children and adolescents since almost one in eight aged 5 to 19 deals with it and it may have a significant impact on his or her growth [2]. Moreover, these kinds of disorders also affect children's performance in schools and their ability to interact with other children and adults.…”

Editorial: ‘In our time’: Has the pandemic changed the way we write and read mental health and neurodevelopmental disorder research reviews?

“…One potential benefit of the pandemic might be the widespread transition to telehealth, which has made traditional treatments more widely available to individuals who live in areas with few available high‐quality services or who find it challenging to access treatment for other reasons. Creswell et al (2021) explore the possibility that nontraditional treatments, such as gaming and virtual reality interventions, offer another opportunity to meet the need for mental health services, particularly for young people who are sophisticated users of technology. They review the evidence that gaming and virtual reality interventions are effective in treating depression, anxiety, and phobias in young people and the evidence that young people find these interventions relevant and engaging.…”