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INNOVATION BY DESIGN

Most mental health apps don’t work as advertised. This one actually does—and it’s a video game

Modeled after an addictive video game, ‘The Guardians’ will hook you on taking care of yourself.

Most mental health apps don’t work as advertised. This one actually does—and it’s a video game

BY Mark Wilson3 minute read

There are things we should all do, ranging from managing our finances to reading more books. But let’s be honest: Playing video games is more fun than balancing a checkbook, and more seductive than reading Tolstoy.

That’s why Craig Ferguson, lead platforms engineer at MIT’s Affective Computing group, has combined the two ideas into a groundbreaking app called The Guardians: Unite the Realms. It’s the winner of Fast Company’s 20201 Innovation by Design award in the Wellness category.

The Guardians—available for free download on iOS and Android—is basically a Trojan horse mental health app. At first glance, it’s like any monster-collecting and leveling game you know, filled with cartoonish magical creatures you need to assemble to take down evil. However, the only way to actually advance in the game is to step out of it—and accept real-life, on-your-honor tasks to complete.

[Image: MIT Media Lab]
Scientists call these tasks “behavioral activation.” Whether it’s exercise like going on a walk, or feeding your artistic side by drawing a picture, these positive experiences are proven therapy for anxiety and depression. Plus, they can help you acquire new skills or hobbies you might always find yourself putting off. So behavioral activation is a means of self-improvement, too.

We first wrote about The Guardians in 2020. Since publishing, the app has gained over 7,000 regular users, which has allowed the team to analyze data to understand the impact of its own game. You can read the full results in the public research paper here, but as Ferguson explains, the app shows the value of gamifying wellness. Whereas a whole industry of wellness apps claim to address mental health, a 2019 meta-analysis published in Nature concluded that there was no evidence these apps worked. Ferguson actually hopes that more apps might steal some of his ideas in the name of public health.

[Image: MIT Media Lab]
The Guardianshas a 15-day retention rate of 10%, and a 30-day retention rate of 6.6%. Those figures might not sound high, but they are double the retention rate of the average digital mental health app. “That actually put us in line with what’s widely considered to be in the top 15% of mobile games [period],” says Ferguson. Meanwhile, when most people play the game, they really do take part in these healthy suggested behaviors. On 69% of days played, users will take on a beneficial task in real life (IRL) to unlock a reward in the game. That figure is higher than the industry average of people who will watch an advertisement to unlock a reward (about 60%).

[Image: MIT Media Lab]
Could there be cheaters who simply pretend to do tasks inThe Guardiansbut really don’t? Sure, but from the anonymous player data that Ferguson has analyzed, he suspects 10% of people are cheating the system at most. Meanwhile, an in-game prompt asks players if they feel better after competing the tasks the game offers them. An astounding 80% of players do, meaning that a video game is measurably improving their mental health (on a short-term basis, at least). It’s also offering more evidence to the very theory of behavioral activation: Doing the things that are meaningful to you really will make you happier.

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Now, for all of its measurable effectiveness, Ferguson does note that The Guardians should not be a replacement for seeking out professional help around mental health. “No app is anywhere close to replacing therapists,” he says, which is consistent with the findings in the Nature study. However, he points out that proven apps could be assistive for therapists, helping their inherently finite consultation spread further. Apps could be complementary tools during treatment to reinforce, motivate, or demonstrate therapeutic techniques (like cognitive behavioral therapy).

As for what’s next, Ferguson is planning some creature comfort improvements to The Guardians. Since he’s been using the software to conduct a controlled scientific study, he hasn’t been able to add new content, or tweak bits of user interface, lest he invalidate his own research. “We really had to leave the game alone,” says Ferguson. “I received a lot of fan feedback. People are excited about it, and want more [content] but we can’t really change it [midstream].”

Meanwhile, Ferguson is planning to release a more polished sequel later this year, which will usher players from an enchanted forest to a tropical island. What a wonderful opportunity for us all to get hooked on our own mental health.

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ABOUT THE AUTHOR

Mark Wilson is the Global Design Editor at Fast Company. He has written about design, technology, and culture for almost 15 years More


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