When you discover that your client's primary pastime is video gaming, consuming 6-10 hours a day, you might catch yourself rolling your eyes. Every spare moment seems to revolve around gaming, and their entire social circle comprises internet gamers. It's easy to engage in negative self-talk, labeling it as a colossal waste of time and questioning the authenticity of their online friendships. Negative stereotypes and overgeneralizations often surround this generation of video gamers. But let's challenge our biases. Would you react the same way if your client told you they were an avid reader, spending most of their free time engrossed in books, attending book clubs, and hosting some themselves? Perhaps not, or at least with less negativity.

Understanding Video Gaming:

While it is true that video gaming can become a detrimental behavioral addiction for a small minority, it does not hold true for the vast majority of gamers. The DSM-5 categorizes it as a condition for further study, while the ICD-11 includes it as "Gaming Disorder." Research suggests that gaming disorder affects around 3%-8% of individuals. Whether or not your client's gaming habit reaches the level of a diagnosis, there is valuable information to be discovered if you are willing to invest some time in understanding gaming and its role in their life.

Building Rapport through Video Gaming:

In this blog post, I hope to convey the idea that paying attention to video gaming can be beneficial. Just like any other activity that occupies the majority of your client's leisure time, showing genuine interest in it can help you connect with them, develop rapport, and demonstrate positive regard. The wide range of game types, objectives, and available personas within video games can act as a sort of informal "projective test," providing valuable insights into your client's psychological needs and desires. The planning, strategy, skills, and social connections developed through gaming should not be dismissed. The choices they make within games and the personas they create hold meaning for them, much like the narratives young clients construct in play therapy or the subject matter and rendering choices in art therapy. To unlock these insights, we need to set aside our biases and listen and learn.

Video Gaming 101:

It's understandable if you haven't played most, if any, of the modern video games. Embrace your lack of knowledge as an advantage because when you ask your client to describe their experiences, favorite games, created personas, and emotional reactions during gameplay, your genuine curiosity will lead to insightful conversations. However, for a rough roadmap, here are some basic game genres:

1. Sandbox: Games with open-ended goals that encourage experimentation and building (e.g., The Sims, Minecraft).
2. Real-time Strategy: Games where players and AI control competing factions in real-time, emphasizing strategy and resource management (e.g., Warcraft, Age of Empires).
3. Multiplayer Online Battle Arena: Similar to real-time strategy games, but players can form teams with other gamers in real-time to compete (e.g., League of Legends, Smite).
4. Shooters (First Person/Third Person): Action-packed games where players engage in battles and wars, with a first-person or third-person perspective (e.g., Halo, DOOM).
5. Role-Playing Games: Games where players control characters who navigate a fantasy world, facing challenges and leveling up (e.g., Skyrim, Fallout 4).
6. Action Adventure: These games can have complex plot lines. They are often highly immersive with the players solving mysteries or puzzles in a first-person perspective. Significant combat elements are often present. (e.g. Legend of Zelda, Assassins Creed)
7. Simulation & Sports: Here you fly the airplanes, drive the cars or play the sports in very realistic ways. (e.g. Madden NFL, Forza Motorsport)
8. Other genres: Puzzles and Party Games, Survival and Horror, Platformer.

It is not necessary to become an expert in these genres and there is significant overlap between the categories. The bottom line is that when you learn that your client identifies as a video gamer, it will be helpful to understand their favorite two or three games. Ask them which games they play the most and do some research to understand the game and why they might be choosing to spend their time immersed in these worlds.

Archetypes

One of the most instructive aspects of video gaming for a therapist is understanding the concept of archetypes. When gamers choose or create avatars, they embark on immersive journeys within captivating fantasy worlds. It's not far-fetched to consider that players often deeply identify with their alter egos, reflecting their psychological needs and desires. Let's delve into the prevalent archetypes commonly observed:

1. Orphans: The blank slate to project onto
2. Warriors: Natural leaders, eager for battle
3. Healers: Nurturers who keep friends healthy and have with healing abilities
4. Rangers/scouts: Trailblazers, explorers, trackers, and hunters
5. Rouges: Cunning survivors, existing in the shadows as assassins and spies
6. Spellcasters: Masters of magic, wielding spells, and supernatural powers
7. Engineers: Methodical problem solvers, steady and calculated
8. Athletes: Always up for a challenge and striving for superiority
9. Hero: The objective for all the above types as they journey through the game

As you learn about your clients favorite games, how the game works and how they have chosen to engage in the game here are some questions for you to consider or even pose to your client.

• Why did you choose this particular game? What draws you to it? How does it surpass others? Describe the enjoyment it brings you.
• Do you prefer playing the game yourself or watching others play? Why?
• Do you enjoy team interactions or prefer facing the game's challenges alone? Describe the relationships you have developed.
• Tell me about your created avatar. What gender are they? What role do they play in the game? What powers do they possess? What are their limitations? Compare/contrast how you solve problems versus how your avatar does.
• What makes your avatar unique? How did you name your avatar and other characters? What additional powers do you hope to acquire?
• Describe the game's villain/enemy. What powers do they possess? How do they defeat you?
• Do you consistently play the same role, or do you switch roles? Why?
• How do you feel when you are playing, whether winning or losing?
• Does your game/avatar have limitations and rules which must be abided?
• Can you draw parallels between your gaming experiences and life outside the game? Are there problem-solving skills in your gaming life that you might employ in life outside of gaming?

By delving into your client's video gaming experiences, you not only acknowledge this important aspect of their life but also gain hypotheses and potential insights into their social, cognitive, and emotional functioning.

Credit where credit is due. Just about everything I know, and I’ve shared here about video gaming comes from the work of Anthony M. Bean, Ph.D. He’s a self-confessed video gamer but also has studied and written extensively about it. He’s the real deal. I’ve listed a couple of references below if you want to get the full story from his primary sources.

Sources

Bean, A. M. (2019) Working therapeutically with video gamers and their families. Journal of Health Service Psychology, 45, 40-46.

Bean, A. M. (2018) Working with video gamers and games in therapy: A clinician’s guide. Routledge Publishers.

Pavlovic, D. (2020) Video Game Genres: Everything You Need to Know. HP Tech Takes. https://www.hp.com/us-en/shop/tech-takes/video-game-genre