Videogame Assisted Emotional Regulation Training: An ACT with RAGE-Control Case Illustration

Abstract

This paper describes the treatment of an adolescent girl (age 16) who received the ACT with RAGEControl intervention during her treatment in an urban inpatient psychiatry unit. ACT with RAGE-Control utilizes five traditional Cognitive Behavioral techniques combined with an active biofeedback videogame designed to strengthen a patient's self-regulatory capacities while facing simulated stress in a virtual environment. The treatment is delivered as daily individual psychotherapy sessions over five consecutive days of an inpatient psychiatric admission. The following case illustrates the theory and techniques of the ACT with RAGE-Control intervention.

Videogames as Therapy

“…Lawrence (1986) advocates that videogames can be used in the treatment of psychological problemsduringtherapy.Inanoverview,hereportedthattherehadbeenapproximatelytwodozen effortsinthepublishedliteraturetodelivercounselingorotherpsychologicalinterventionservicesby computer.Althoughnotconcentratingonvideogamesspecifically,hedidrefertogames,computeraidedinstruction,biofeedback,andbehaviortherapy.Heconcludedthatcomputers(includinggames) couldmakemeaningfulcontributionstothetreatmentofpsychologicalproblems. Gardner (1991) claimed that the use of videogames in his psychotherapy sessions provided commongroundbetweenhimselfandhischildclients,andprovidedexcellentbehavioralobservation opportunities.AccordingtoGardnersuchobservationsallowedhimtoobserve: More recent research (Ducharme et al, 2012) reported the case of a 16-year-old girl who underwentAcceptanceandCommitmentTherapy(ACT)usingaRAGE-Controlinterventiondesigned toincreaseemotioncontrolabilitiesbymonitoringandcontrollingphysiologicalarousalwhilstfaced withstressinavirtualrealityenvironment.ThistreatmentusedfiveCBTtechniquestogetherwith avideogameusingactivebiofeedback.Theaimwastoimprovetheindividual'sself-regulation,and wasimplementedonadailybasisoverfiveconsecutivedays.Theresultsofthisstudyshowedthat thepatient'sstateandtraitangerscoresdecreasedsignificantlyfollowingtreatment,suggestingboth herangerandaggressionlevelsbenefittedfromthisvideogametherapyelement.Additionalbenefits included increased control over physiological arousal (i.e., heart rate). Although this study only providesevidencefromoneperson,theresultsshowedpromiseregardingreductionsofbothanger andaggressionandincreasesinself-control,andshouldbereplicatedinlargersamples.…”

Using neurofeedback to teach self-regulation to children living in poverty

“…electroencephalography (EEG)), to teach selfregulation of brain function. Therapy oriented computer games that utilize NF and/or biofeedback have also been effective with child and youth populations [2,7]. Our main research questions were: (R1) Can children living in poverty quickly learn to use neurofeedback-based tablet games?…”

Biofeedback and Anger Management: A Literature Review

“…Hence, it is impossible for the authors of this article to arrive at their own conclusions about whether the treatment was, in fact, efficacious. Ducharme et al (2012) described the treatment of a 16-year-old girl who received anger control therapy (ACT) with an active biofeedback video game "RAGE-Control" intervention. The intervention was delivered as daily counseling sessions and ended with playing RAGE-Control over 5 consecutive days.…”