Using a Videogame Intervention to Reduce Anxiety and Externalizing Problems among Youths in Residential Care: an Initial Randomized Controlled Trial

Abstract

Residential care is among the most intensive forms of treatment in youth care. It serves youths with severe behavioral problems and is primarily focused on targeting externalizing problems. Despite best efforts, effect sizes remain moderate, which may be due to the disregarding of internalizing symptoms – in particular anxiety - and to limitations regarding the delivery model of interventions. This initial randomized controlled trial (n = 37) aimed to examine the effectiveness of a biofeedback videogame intervention (Dojo) as an addition to treatment as usual for youths with and without intellectual disability (ID) in residential care with clinical levels of anxiety and externalizing problems. Dojo targets both anxiety and externalizing problems, and incorporates the principles of conventional treatment, while addressing its limitations. Youths were randomly assigned to play Dojo (eight 30-min gameplay sessions) or to treatment as usual (TAU). Measurements of anxiety and externalizing problems were conducted at baseline, posttreatment, and 4-months follow-up through youths’ self-report and mentor-report. Completers-only analyses revealed decreases in self-reported anxiety and externalizing problems, and mentor-reported anxiety at posttreatment for participants in the Dojo condition compared to the control condition. Only mentor-reported anxiety was maintained at follow-up. No effect was found for mentor-reported externalizing problems. These findings provided preliminary evidence that Dojo is a promising, innovative intervention that engages high-risk youths. Practical implications are discussed.

Online Videogames Use and Anxiety in Children during the COVID-19 Pandemic

“…The existing literature has focused on five aspects to be considered to assess the effect of videogames on children: the amount of time spent playing (especially if without pauses and with a complete immersion in the videogame), the content of the videogame, the game context, the game structure and the game mechanics [ 5 , 35 ]. Videogames can lead to unhealthy behaviors, including a sedentary lifestyle (with the consequent risk of developing over-weight), a reduction of time dedicated to academic learning (or a lack of concentration in performing school duties) and the substitution of all other forms of social relations with the videogame (favoring a state of isolation and a tendency towards introversion) [ 32 , 38 , 39 , 40 ].…”

How Do Parents Influence Child Disruptive Behavior After Acquired Brain Injury? Evidence From a Mediation Model and Path Analysis

“…To date, intervention programs focused on improving inhibition after ABI are lacking. Previous interventions applied directly to the child, such as biofeedback and using video games, have shown promising results in improving disinhibited behavior in other pediatric populations (O'Neil, Jamieson, & Goodwin, 2017;Schuurmans, Nijhof, Engels, & Granic, 2018); however, their effect on child inhibition after ABI requires further study.…”

Game-Based Meditation Therapy to Improve Posttraumatic Stress and Neurobiological Stress Systems in Traumatized Adolescents: Protocol for a Randomized Controlled Trial

“…To achieve a statistical power of at least .80, a sample size of 72 participants was required. We aim to include 80 participants in total to allow for 10% attrition, which was estimated from previous studies [ 44 , 45 , 47 ] on game-based interventions in this population.…”