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A New Frontier For Young People and Young Adults' Mental Health

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Gaming as part of Therapy: A New Frontier for Children’s Mental Health

Children’s mental health services in the UK are under unprecedented strain. Waiting lists are long, thresholds are high, and many young people struggle for months—or even years—before receiving support. The cost of a young person struggling with their mental health can exceed £4,000 a year.*

The digital context

The Digital Context

The deterioration in young people’s mental health has accelerated since Covid*, but the trend started earlier. Over the same period, technology and gaming use has surged. Around 38.5 million people in the UK now play video games, including 93% of young people. Gaming offers both opportunities and risks for development, yet parents and professionals often lack guidance on how to manage these new digital tools effectively.*

38.5
people in the UK now play video games
5.5
worth of the UK gaming industry alone.
4000
is the annual cost of mental health support for one young person.
93
of young people in the UK play video games, making gaming a highly accessible wellbeing tool.
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Why gaming matters

Gaming has transformed leisure time and offers a unique vehicle for therapeutic intervention. Traditional therapies often fail to engage young people who struggle emotionally, socially, or behaviourally in “real life,” yet thrive digitally. Their parents and mentors frequently feel judged and unprepared to harness the benefits of gaming to support wellbeing.* Society paradoxically values technological and gaming skills for future employment but continues to stigmatise young people for developing these competencies early.

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Atrium Clinic’s Approach

Atrium Clinic set out to make gaming part of the solution. Our goal is to reconnect young people struggling in school, community, or the justice system, improve their wellbeing, and support the professionals who work with them. We developed a structured protocol for integrating gaming into therapeutic work, refining best practice through evidence-based methods.

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A supplementary approach

Traditional talking therapies are not always developmentally appropriate, especially for those who struggle with emotional literacy, attention, or verbal expression. Digital game-based therapy builds on principles of person-centred approaches and play therapy, meeting young people in a medium that feels familiar, safe, and motivating. Rather than replacing the therapeutic relationship, digital play becomes a shared space where connection, regulation, and meaning-making can occur.

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The intervention

The Intervention

We delivered a supervised, digital game-based therapy program to children and young people aged 7–21 across schools and community settings. Participants often struggled to remain in the classroom, had experienced exclusions, bereavements, trauma, neurodivergence, or other difficulties unresponsive to traditional therapy. Some were involved with the criminal justice system.

What we found

Participants showed meaningful improvements in emotional wellbeing, with reductions in psychological distress. Gains were especially notable among males, a group less likely to engage in traditional therapy. Parents, teachers, and youth workers reported improvements in social functioning and overall mental health, indicating that therapeutic benefits transferred beyond the sessions.

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Clinical Reflections

Key themes emerged:

Engagement first

Digital play lowered barriers for anxious, avoidant, or resistant participants.

Safety through distance

The digital environment allowed exploration of difficult themes indirectly.

Therapeutic presence matters

Outcomes were strongest when therapists were actively attuned and purposeful.

Not a replacement, but a tool

Game-based therapy works best alongside traditional therapeutic models such as CBT, relational therapy, and trauma-informed approaches

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Implications for counsellors

Digital approaches are not a panacea, nor suitable for every child or young adult. When used ethically and intentionally, however, they can expand the therapeutic toolkit.

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Looking Ahead

Atrium Clinic has been pioneering gaming-mediated therapy since 2014, from Tetris for trauma management to Minecraft for supporting troubled young people.

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References

Alanko D. (2023) The Health Effects of Video Games in Children and Adolescents. Pediatr Rev. Jan 1;44(1):23-32. doi: 10.1542/pir.2022-005666. PMID: 36587018.

Childrens commissioner Report on gaming (2019) https://assets.childrenscommissioner.gov.uk/wpuploads/2019/10/CCO-Gaming-the-System-2019.pdf Gonzalez-Bueso V, Santamaria JJ, Fernandez D, Merino L, Montero E, Ribas J.

Association between internet gaming disorder or pathological video-game use and comorbid psychopathology: A comprehensive review. Int J Environ Res Public Health. (2018)

Government publication 2019 Science and technology committee Impact of social media, screen and gaming https://publications.parliament.uk/pa/cm201719/cmselect/cmsctech/822/822.pdf Digital survey childrens wellbeing https://www.internetmatters.org/resources/childrens-wellbeing-in-a-digitalworld-index-report-2022/#

Monica S. Wu1 , Shih-Yin Chen, Robert E. Wickham, Yan Leykin , Alethea Varra , Connie Chen and Anita Lungu1 (2022) Predicting non-initiation of care and dropout in a blended care CBT intervention: Impact of early digital engagement, sociodemographic, and clinical factors  Digital health ,volume 81-16

Montero-Marin J, Hinze V, Mansfield K, Slaghekke Y, Blakemore SJ, Byford S, Dalgleish T, Greenberg MT, Viner RM, Ukoumunne OC, Ford T, Kuyken W; MYRIAD Team. Young People’s Mental Health Changes, Risk, and Resilience During the COVID-19 Pandemic. JAMA Netw Open. 2023 Sep 5;6(9):e2335016. doi: 10.1001/jamanetworkopen.2023.35016. PMID: 37733343; PMCID: PMC10514742.
Newlove-Delgado T, Williams T, Robertson K, et al.(2022) Mental health of children and young people in England, 2021. NHS Digital. September 30

Neumann, Michelle & Keioskie, Meryl & Patterson, Dale & Neumann, David. (2022). Virtual, Augmented, and Mixed Reality: Benefits and Barriers for Early Childhood Education. Childhood Education. 98. 68-79.  Parents concerns on their kid’s gaming habits https://www.internetmatters.org/resources/play-together-playsmart-gaming-research-infographic/

Key Texts in the Gaming Therapies Field

Cheng Lee, Beckett M & Ireland S 2026 (in Press)
Game-based therapy for school-age children and young adults with mental health concerns.

Summary:
This UK study with the Atrium Clinic team, followed through over 60 young people from school and community/institutional settings in a gaming therapy mediated intervention and identified that 90% of young people who took part improved their wellbeing. A UK pocket book as a Guide for clinicians based on the protocol used in the study, is available from Routledge Summer 26
Kowert, R., & Quandt, T. (Eds.) (2020).

The Video Game Debate 2: Revisiting the Physical, Social, and Psychological Effects of Video Games. Routledge/Taylor & Francis.
Summary:
This book returns to the longstanding debates about video games’ effects — both positive and negative — with updated research coverage of newer technologies such as mobile gaming, loot boxes, virtual/augmented reality, esports, and serious games. Structural inequalities in gaming culture, participatory platforms like Twitch, and the therapeutic use of video games are explored in a research-based overview.

Rice, R. (2022).
Video Games in Psychotherapy. Routledge/Taylor & Francis.
Summary:
This book offers a practical, session-by-session framework for integrating video games and interactive media into psychotherapy, especially with children, adolescents, and young adults. It draws on narrative, cognitive-behavioral, and collaborative approaches to propose how video games can help with emotional regulation, anxious feelings, neurodivergent trait symptoms, and other clinical issues. It includes references to case work, helpful activities and some examples of popular games.

Schlegel, L., & Kowert, R. (Eds.) (2024).
Gaming and Extremism: The Radicalization of Digital Playgrounds. Routledge/Taylor & Francis.
Summary:
This book examines how video games and adjacent digital spaces (e.g., Discord, Twitch, Steam) can link with extremist propaganda, recruitment, and mobilization. Theories of digital radicalization, research on game-related extremist content, and policy and prevention strategies are presented. The book addresses challenges, gaps, and potential counter-extremism practices relevant to researchers, practitioners, and policymakers concerned with digital radicalization.

Stone, J. (2022). (Often cited online with a 2021/2022 edition)
Digital Play Therapy: A Clinician’s Guide to Comfort and Competence. Routledge/Taylor & Francis.
Summary:
Stone’s American text is a clinician-oriented guide for integrating digital tools into play therapy. It offers foundations in play therapy principles and practical guidance for using digital modalities  ethically and competently with children and families

Stone, J. (Ed.) (2019).
Integrating Technology into Modern Therapies: A Clinician’s Guide to Developments and Interventions. Routledge/Taylor & Francis.
Summary:
This American edited collection of contributions describes how technology is being incorporated into clinical practice. The book blends theory, research, and clinical case material to support clinicians in adopting appropriate technological interventions.