Clinicians Band Together with Game Designers
To Create a Mobile Game to Relieve Symptoms of Depression and Anxiety
Hedonia™ packs clinician-designed activities to relieve symptoms of depression and anxiety inside an entertaining game that keeps players coming back.
Research suggests that commercial video games relieve symptoms of some mental health conditions, particularly depression and anxiety.1 The Hedonia team is reaching deeper and aiming higher with mobile games that treat the causes of mood disorders and offer symptoms relief.
Hedonia’s mobile games are based on a novel therapy called FTP - Facilitating Thought Progression™ that delivers an integrated therapeutic experience by combining therapy with adapted popular games' mechanics.
The team, composed of distinguished clinicians and researchers, together with veteran game designers and developers, is now launching Mood Bloom, the first game to bring this integrated therapeutic experience. For FTP to be effective, patients need to adhere to a period of time in which they do the activities regularly. But as clinicians know too well, adherence is a hurdle in mental health treatment.
The integrated experience engages patients with the frequency and intensity necessary to induce adherence and help patients feel better.
FTP and engagement lead to symptom relief
The song says, “A spoonful of sugar helps the medicine go down.” In Mood Bloom:
The “medicine” is a set of activities, rooted in FTP, that disrupt cycles of ruminative, narrow, and slow thinking that mire down people with mood disorders.
The “sugar” is a captivating and entertaining game, so players come back for their dose of fun often enough to experience significant improvement in their symptoms.
The effectiveness of FTP relies on people with depression and anxiety consistently “taking their medicine” by playing Mood Bloom at their leisure at least four days a week for eight weeks or longer – as long as they like.
Prof. Moshe Bar, the neuroscientist who is co-founder of Hedonia, notes that people with depression, in particular, often lack intrinsic motivation, they are stuck, and often unable to perform activities known to improve mood, such as exercise and exposure to the outdoors.
That’s why it was important for Hedonia’s developers and designers to reach into their toolkits of techniques proven to engage and retain users, explained Ohad Barzilay, who heads product development at Hedonia.
A twist on the familiar
Mood Bloom has some traits in common with top-rated games such as The SimsTM, Hay Day, and Township, namely:
It's simple, and it’s fun. Players can pick up and play at any time.
Players gather resources to build personalized spaces - in Mood Bloom, villages populated with human and animal characters.
And they progress by achieving higher levels and winning more rewards in the form of features to fill their villages.
Mood Bloom players progress by playing therapeutic games based on FTP. The games use word chains, associations, speed reading, seeing the “big picture”, and even sky-gazing to expand thinking, tease out imagination, and make thoughts travel more rapidly.
“We give (players) a logical reason to come back, which is, ‘I want to feel better.’ But we also give them an emotional reason to come back because ‘I want my village to be more beautiful. I want to advance’,” Barzilay said. “And of course, we make it fun, so players return for entertainment or to take a break when they need one.”
Mood Bloom™ is designed to appeal to everyone, regardless of characteristics such as race or cultural or gender identity. People often associate gaming with men more than women, but mobile games attract a large audience of women2. That is important, since women are about twice as likely to be diagnosed with depression or experience an anxiety disorder.3,4
A unique alliance at the heart of Hedonia™
The ability to design an integrated therapeutic experience is the result of the unique nature of the Hedonia team, bringing together clinicians, researchers and game developers.
But it took time for them to coalesce as a team, Barzilay said. They come from different worlds.
Game development is fast and furious. Clinical research is deliberate and cautious. In game development, if something doesn’t work, developers abandon it and move on to something different. If a treatment isn’t effective, clinicians patiently hunt for alternatives.
“In a way, it was like going back to university,” Barzilay spoke about the time his game developers spent learning about mood disorders. They realized that some tools needed to stay under lock and key, such as any typical game elements that would:
Create FOMO (fear of missing out).
Pit players against each other.
Manipulate players’ emotions.
Shoehorn players into loops or cycles.
Every single aspect of design and game action needed to point players toward the FTP activities and encourage frequent playing to achieve symptom relief.
Cracking retention rates in mental health apps
Hedonia’s No. 1 challenge is keeping Mood Bloom players coming back to its FTP-based games for weeks. It’s a challenge shared by other apps and games.
Wellness and mental health apps have high download rates, but their use tends to drop off rapidly. A meta-analysis of mental health apps showed a median 30-day retention rate of only 3.3%.
By contrast, Barzilay said, casual games label success as having 10% to 15% of players who download a game still playing after 30 days. Mood Bloom’s creators are aiming for results that approach those metrics.
Mood Bloom’s palette is colorful and bright to make every visit a pleasure. Puckish characters inhabit the game. Mood Bloom pushes new content continuously to reflect the seasons, holidays, and other events encouraging players to return out of curiosity to see what’s new.
“As game designers, we usually measure our success in numbers of players and how much money a game generates. With Mood Bloom, our focus shifts to evaluating how many people with depression and anxiety who play our game, start feeling better. We strive to give people a game that they enjoy and, more importantly, make it so captivating that they want to make playing the game a long-term habit.”
Samuel Keret, chief executive officer, says Hedonia’s “magic” stems from the unusual collaboration of scientists and game developers. “We created a language that combines these two worlds. Our mission -- to bring real relief from symptoms of depression and anxiety to as many people as possible -- is rooted in science and brought to life through play.”
1. Baumel, A., Muench, F., Edan, S., & Kane, J. M. (2019). Objective User Engagement With Mental Health Apps: Systematic Search and Panel-Based Usage Analysis. Journal of Medical Internet Research, 21(9), e14567. https://doi.org/10.2196/14567
2. 74% of women play mobile games daily. (n.d.-c). pocketgamer.biz. https://www.pocketgamer.biz/news/81150/74-of-women-play-mobile-games-daily/
3. Depression in women: Understanding the gender gap. (2019, January 29). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression/art-20047725
4. Anxiety disorders | Office on Women’s Health. (n.d.). https://www.womenshealth.gov/mental-health/mental-health-conditions/anxiety-disorders