gNats Island is a computer game that implements key aspects of Cognitive Behavioural Therapy (CBT). It is designed to support face-to-face clinical interventions with adolescents aged 9-15.
Impact: as of June 2012 over 700 mental health professionals in Ireland, the UK and the US have received training on the gNats Island clinical intervention for adolescents.
Summary: The game provides an overall narrative in which players visit a tropical island and meet a team of wild life explorers. These characters introduce mental health concepts using spoken conversation, embedded animations, videos and questions regarding the player’s own situation. Throughout the game players carry an in-game notebook, in which they answer characters’ questions and record new ideas. Negative automatic thoughts are presented as little creatures called gNats that can sting people, causing negative thinking. Each type of gNat – of which there are nine in all – is introduced with a cartoon, voiceover and story describing its effects. For example being stung by a Black and White gNat can cause people to think in extremes. gNats provide a concrete representation and means of externalising an important CBT concept. Through a series of conversations with game characters players are introduced to strategies for identifying and challenging negative thoughts. Concrete metaphors such as catching, trapping and swatting gNats are used to describe this process. Similar approaches are used with other important CBT concepts, such as Core Beliefs. The materials in the game are adapted from the CBT Workbook for Young People by Gary O’Reilly.
Clinical Use: gNats Island implements CBT in a generalised manner and is intended for use with adolescents experiencing a range of difficulties, including depression and anxiety. It is designed to fully integrate with a six session, manualised, face-to-face intervention. Sessions typically last one hour, with the game used for 45 minutes. Alongside the game, gNats Island includes a manual for clinicians, outlining the structure of the intervention, and a paper-based workbook for clients.
In sessions a clinician and adolescent sit together at a computer, but the adolescent has full control of the mouse and keyboard. Rather than talking face-to-face with the adolescent, the clinician acts as a partner in their exploration of the game world. Many of the questions and issues that a therapist might normally raise are instead introduced by game characters. As such gNats Island represents a substantial reshaping of the traditional therapeutic interaction. It aims to do so in a way that is supportive of the client-therapist relationship. It is intended that conversations with game characters will provide a context for more detailed conversations between the adolescent and clinician.
Evaluations: the paper listed above contains a detailed description of the exploratory evaluations of gNats Island. We are currently in the final stages of an RCT on the gNats Island intervention.
Availability: the game is available, subject to certain conditions and participation in our evaluation process. For further details please see: www.PeskyGnats.com
Coyle, D., McGlade, N., Doherty, G. & O’Reilly, G. (2011) Exploratory Evaluations of a Computer Game Supporting Cognitive Behavioural Therapy for Adolescents. ACM CHI 2011, pp2937-2946. (pdf) (DOI link)