title: Maximizing the Impact of e-Therapy and Serious Gaming: Time for a Paradigm Shift.
abstract: Internet interventions for mental health, including serious games, online programs, and apps, hold promise for increasing access to evidence-based treatments and prevention. Many such interventions have been shown to be effective and acceptable in trials; however, uptake and adherence outside of trials is seldom reported, and where it is, adherence at least, generally appears to be underwhelming. In response, an international Collaboration On Maximizing the impact of E-Therapy and Serious Gaming (COMETS) was formed. In this perspectives' paper, we call for a paradigm shift to increase the impact of internet interventions toward the ultimate goal of improved population mental health. We propose four pillars for change: (1) increased focus on user-centered approaches, including both user-centered design of programs and greater individualization within programs, with the latter perhaps utilizing increased modularization; (2) Increased emphasis on engagement utilizing processes such as gaming, gamification, telepresence, and persuasive technology; (3) Increased collaboration in program development, testing, and data sharing, across both sectors and regions, in order to achieve higher quality, more sustainable outcomes with greater reach; and (4) Rapid testing and implementation, including the measurement of reach, engagement, and effectiveness, and timely implementation. We suggest it is time for researchers, clinicians, developers, and end-users to collaborate on these aspects in order to maximize the impact of e-therapies and serious gaming.
authors.affiliation: Department of Psychological Medicine, University of Auckland, Auckland, New Zealand; Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand.
authors.forename: Theresa M
authors.initials: TM
authors.lastname: Fleming
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL) , Utrecht , Netherlands.
authors.forename: Derek
authors.initials: D
authors.lastname: de Beurs
authors.affiliation: Department of Psychiatry, University of Geneva , Geneva , Switzerland.
authors.forename: Yasser
authors.initials: Y
authors.lastname: Khazaal
authors.affiliation: Department of Psychology, Catholic University of Sacred Heart, Milan, Italy; Applied Technology for NeuroPsychology Laboratory, Istituto Auxologico Italiano, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Gaggioli
authors.affiliation: Department of Psychology, Catholic University of Sacred Heart, Milan, Italy; Applied Technology for NeuroPsychology Laboratory, Istituto Auxologico Italiano, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Riva
authors.affiliation: Department of Psicología Básica, Clínica y Psicobiología, Castellón, Spain; Department of Personalidad, Evaluación y Tratamiento Psicológicos, Valencia, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERon), Instituto Salud Carlos III, Valencia, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Botella
authors.affiliation: Department of Personalidad, Evaluación y Tratamiento Psicológicos, Valencia, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERon), Instituto Salud Carlos III, Valencia, Spain.
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Baños
authors.affiliation: Department of Psychology, Catholic University of Sacred Heart , Milan , Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Aschieri
authors.affiliation: Department of Psychological Medicine, University of Auckland , Auckland , New Zealand.
authors.forename: Lynda M
authors.initials: LM
authors.lastname: Bavin
authors.affiliation: Department of Clinical Psychology, Faculty of Behaviour and Movement Science, Vrije Universiteit Amsterdam , Amsterdam , Netherlands.
authors.forename: Annet
authors.initials: A
authors.lastname: Kleiboer
authors.affiliation: Department of Psychological Medicine, University of Auckland , Auckland , New Zealand.
authors.forename: Sally
authors.initials: S
authors.lastname: Merry
authors.affiliation: Department of Psychiatry, VU University Medical Center , Amsterdam , Netherlands.
authors.forename: Ho Ming
authors.initials: HM
authors.lastname: Lau
authors.affiliation: Department of Clinical Psychology, Faculty of Behaviour and Movement Science, Vrije Universiteit Amsterdam , Amsterdam , Netherlands.
authors.forename: Heleen
authors.initials: H
authors.lastname: Riper
keywords: cCBT; computerized therapy; implementation; serious games