Exploring the Intersection of Video Games and Mental Health

By iThrive Games
March 4, 2019

MAGFest 2019 - A Compilation of Panels, Playtesting, and so much more!

Kelli Dunlap, PsyD, director of Mental Health Research and Design at iThrive Games, playing our Critical Strengths Engine (CSE) as she helps a new playtester facilitate the game for the rest of the group.

With over 20,000 people in attendance, iThrive Games was beyond excited and thankful for the opportunity to be a part of MAGFest for the third year in a row. This annual event celebrates music and games while attracting attendees, speakers, musicians, and cosplayers from all over the world. MAGFest enables us to be surrounded by like-minded individuals who believe in promoting prosocial outcomes.   

Showcasing iThrive's Critical Strengths Engine

MAGFest Indie Tabletop Showcase featured iThrive's Critical Strengths Engine (CSE), a pen and paper role-playing game ruleset for exploring and supporting social and emotional skill development.

In 2017, Ian McDonald posed this question to us at one of our game jams,

"What if there were a system for tabletop role-playing games (TTRPGs) based around social and emotional attributes like emotional integrity, instead of strength and dexterity?"

To say this piqued our curiosity is an understatement. It launched the idea for the CSE and we've been working on it ever since!  

We designed the CSE to be accessible and enjoyable for all players, and were especially mindful in our development that it meet the needs of mental health professionals working with teens.

At the MAGFest panel, The Making of a Therapeutic RPG, iThrive's Kelli Dunlap, PsyD, director of mental health research and design, and Sean Weiland, producer, talked about the collaborative design process for the CSE and shared lessons learned in development and during playtesting. Also on the panel were our CSE collaborators, mental health provider and executive director of the Bodhana Group, Jack Berkenstock, and game designer, Max Raabe. We shared with the audience the unique rewards and challenges of designing with a truly interdisciplinary group, and how we strove to balance fun, a strengths-based focus, engaging stories, and therapeutic relevance.

Jack Berkenstock, mental health provider and executive director of the Bodhana Group, playtesting with a group of eager participants.

During development, our design team at iThrive went through 10 versions of the CSE character sheet. This game structurally lets players bring characters to life by engaging with their strengths and deficits via the "Whys" or circle of character motivation. Therapy often necessitates interacting with difficult issues. We consciously observed and allowed for the CSE to be an analogue where players can use characters to engage with issues that are difficult for them.

Following the panel discussion, 20 people joined us to playtest the CSE. Not only did this playtest extend past midnight, but it was also the largest concurrent playtest of the CSE to date! Playtesters thoroughly enjoyed taking part in the CSE playtest and it was delightful to watch both teams work together within the system of the CSE to solve problems and overcome obstacles that were thrown in their way. Some of the feedback we received from participants included the following,

"Positive! Refreshing! Great to think of solving solutions with emotional strengths rather than physical ones."

"I had a lot of fun! It was neat to focus on motivation."

"Very positive, lots of fun. Far more [than] we would have in another system with no combat. I liked how this focuses on other aspects of traveling/adventuring."

The CSE officially launches this Fall and includes four unique adventures: an official Pugmire story by Eddy Webb; Alteris, a contemporary science fantasy story by Toiya Finley; Dust, a post-apocalyptic survival game by James Portnow; and a fourth untitled story by Bodhanna Group founder, Jack Berkenstock.

Max Raabe, game designer, leading a playtest just after the panel on creating a therapeutic RPG.

Toward A New Vision of Mental Health Representation in Games

Kelli Dunlap spoke on a panel with Tanya DePass, and its organizer Meg Eden on the Mental Health Representation in Games. With standing room only attendance, this panel discussed important issues surrounding the representation, diversity, and accessibility of mental health in games. In addition to sharing their favorite examples of the representation of mental health in games, and tropes and ideas to be avoided, panelists expressed their hopes for what mental health representation could look like in future games.  

Tanya said,

"I'd like to see people and characters have mental health as just a matter of course for their character and not have it be the be-all end-all. If a character needs meds or something like that just like everyday life for those that take medication it's not big deal, it's not like 'oh woe is me I have to take meds everyday to regulate my brain, therefore, I'm a garbage human' that a lot of us fall into.... This is something that is part of me and move on with it."

Kelli responded with,

"I would love for there to never be another horror game that uses an asylum ever… We see asylums or mental health institutions or psychiatric hospitals as a shorthand we use in media for 'Be afraid. Be very afraid. Bad things are going to  happen.' Has anybody ever played a video game where you woke up in an insane asylum and something good happened to you immediately after? No. The trope is dead. Kill it."

The panelists also answered questions about respectful and ethical ways of dealing with difficult mental health topics within the game design process,

"Give players the chance to opt out of something. You don't know anyone's experience when you're programming a game or what's happening… Things like warnings or give me the chance to opt out or fade to black or something like that because I was not ready to deal with that scene at all." - Tanya DePass

"Games are such a creative medium that you can [do that] in creative ways that can actually benefit the design of the game. Allowing for those options can actually branch into a unique gameplay experience. It doesn't have to limit you." - Meg Eden

After the panel, one of the attendees shared his appreciation and excitement with Kelli saying, "I didn't think a game about ADHD is possible, but after your panel, I think it is and I'm excited to get started."

Keep The Conversation Flowing

At MAGFest, the fun never ceases and the conversations are always flowing. We are so grateful for the opportunity to meet with more people who aim to work to benefit teens at the intersection of game development, education, and mental health. We especially appreciated being part of the Music and Games Education Symposium (MAGES), of MAGFest, where we presented on topics related to the personal and social impact of mental health representation in games, strategies around self-care and confronting impostor syndrome, and designing for cooperation. If these topics interest you and you want to keep up-to-date with all of the happenings and projects here at iThrive, please sign up for our newsletter.

Game designer Max Raabe and Sean Weiland producer at iThrive Games (top left), the tabletop role-playing game (TTRPG) panel (top center), Kelli Dunlap, PsyD, director of Mental Health Research and Design at iThrive (top right), Jack Berkenstock executive director of the Bodhana Group, Max Raabe game designer, Sean, and Kelli (Bottom)