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Therapeutic and social video games, an interview with Fabio Viola

The social and therapeutic role of video games – A dialogue with Fabio Viola

Read the interview with Fabio Viola to explore video games’ potential in the social and therapeutic spheres, discover success stories, and learn valuable resources to use video games in the future!


Video games have become increasingly relevant to how we spend our time. They have crossed the boundaries of entertainment, entering new realms of human value. Today, video games are used in sectors that were unthinkable a few years ago, including in social and therapeutic settings. This evolution is a direct testimony to a video game’s ability to positively impact our lives, mental health, interpersonal relationships, and learning.

Digital connectivity is, in fact, the basis of our daily interactions. Video games have created new virtual realities where people can connect, collaborate, play, and compete. Through online games, for example, virtual players’ communities have, in many cases, transformed into real social gathering places, allowing people to develop significant relationships, share experiences, and, in some cases, fight social isolation.

Furthermore, video games are proven to have considerable therapeutic potential and, in some cases, to be safe comfort zones for patients of all ages. For example, Super Poteri by Brave Portions, which we will talk about later, and StomyCraft, a project on display at Maker Faire Rome 2023. Significant research has highlighted how certain games can help manage stress or anxiety: immersion in virtual worlds can offer an opportunity to disconnect from the reality of everyday life and provide an emotional escape. In the digital age, therefore, it’s essential to consider the benefits of this tool.

We discussed this issue with Fabio Viola, a renowned international game designer, and a Maker Faire Rome 2023 Opening Conference presenter. We explored the potential of video games socially and therapeutically, looked at success stories, and discovered key suggestions for the future.

In your opinion, what are the main social applications of video games?

 There are many. The video game, or what’s called gamification, or a playful approach, works like this: “I forget, show me a memory, involve me, and I learn.” This is, obviously, not my theory, perhaps it’s from Benjamin Franklin, or someone else even earlier. In short, what did they understand in a pre-videogame or pre–technological digital era? If I say something tomorrow, whoever listens to me will remember 10% of what was said. If I say and show something tomorrow, the listener will probably be left with 20% of the content. But if I say, show, and immerse the listener in the content by making them live it on an experiential level, they’ll probably remember 40% of that content or training tomorrow.

This is why video games are ideal for elementary school teaching and corporate training. A good video game is nothing more than a place where people exercise power and choices. This means that if a student, or anyone else, makes a decision, they’re immersed in the experience because they feel responsible. A video game allows you to test your theory or choice in real-time, or almost. For example, to convey to someone the importance of not throwing trash on the ground, you can’t immediately simulate the damage that this generates in real life, you’d have to wait 100 or 300 years, depending on the material, to see the consequences. In a video game, however, you can speed up time, which applies to mathematics, physical education, geography, etc.

Does this role for video games also apply to the therapeutic field? And how?

There are already many projects in the therapeutic field, and I have worked on some. What is happening in this sector in general? Three or four years ago, EndeavorRx was created to treat Attention Deficit Disorder. Why was it a milestone? For the first time in the video game world, after passing the typical drug trials, the American Food and Drug Administration (the equivalent of the Italian AIFA) approved the game to become a full-fledged drug. Therefore, you can’t find that game on store shelves or download it whenever you want, but it’s accessible with a doctor’s prescription. This is a video game that works to cure ADD while you play. From there, a trend began called “digital medicine, which includes video games but also other technologies or virtual reality applications, some of which aren’t even strictly video games.

In Europe, much work is being done on digital medicine’s use in the pre-screening phases of neurodegenerative disorders, for compliance with medical protocols, and physical or neural rehabilitation. They can be used to communicate or raise awareness. I worked with the International Hospital Consortia on a video game related to leukemia and the new Car-T. While you play, you have a diary that shows a real clinical diary of a patient. In that case, its purpose isn’t to cure because that’s obviously not possible with a digital drug, but it does help people understand that new therapies exist. Furthermore, it has proven to be an essential tool for patient empathy. Many projects are in progress and the growth phase, and Big Pharma is teaming up with video game companies for education and research.

Can we say, therefore, that video games create a comfort zone for patients, a real place of comfort?

Yes, there are many of these projects. I’ll give you an Italian example that I’ve worked on. The project is called “Super Poteri (Super Powers)” by Brave Potions and essentially consists of a kit purchased by hospitals, doctors’ offices, dentists, etc.

The digital and physical kit aims to help children see medical experiences — such as a CT scan or going to the dentist — as less scary. Experiencing hesitation and fear leading up to and at a medical visit can have real socio-health impacts. If a child, afraid of a CT scan, is sedated, this will increase preparation time, and also make the procedure more expensive. But how does Super Poteri (Super Powers) work? You download the app, choose which hero to be, and play digitally. When a child goes to the doctor’s office with their family, the doctor — who has access to a database — will know what type of hero the child is, let’s say a Ninja, for example. Based on the character, the doctor will talk about the procedure, such as a CT scan or using needles. The child will be immersed in storytelling and receive a theme card with a QR Code as soon as the treatment is finished. If inserted into the app, the code will unlock additional powers for the character, and as the digital experience continues, the child will want to move forward in the game and the story and not be as afraid of the doctors’ offices.

Today, however, technology is perceived in many different ways and can be worrisome for parents. How would you reassure an overly apprehensive parent? In your opinion, what are the risks and advantages of gaming?

That’s a legitimate question that I often hear, which means we still have a lot to work on. There are risks, and they concern not only video games but everything that is an interactive image. Video games, social networks, and other media where people take an active role. In this context, there are differences, obviously, between being exposed to a book or film versus video gaming and social networks. Without getting too technical, everything that involves input and generates a variable output that transports us into a social context alters our emotions. Video games today are all social experiences, just as social networks are. There’s no longer a game like in the ‘80s, which was already much closer to a book rather than a film, despite being interactive. Today, almost all games involve real-time cooperation and competition with other people: see Fortnite, Minecraft, Roblox, Call of Duty. All are mood-altering. Studies are still in progress about this topic, and others have been published, but it’s all relatively new. What is clear is that suggestions have been released that video games, like all interactive languages, should provide guidelines for use, especially for those who have not yet fully formed emotionally or cognitively — children.

Without a fully formed cognitive road map, video games — like other interactive languages ​​— can alter them. For example, the American Psychological Association has very stringent guidelines on the age limits for video games, smartphones, and tablets, the amount of exposure per day, and the time of day allowed. This is the “warning” part to take into consideration. What is already known from numerous studies, however, is that when well used and introduced into a person’s life, video games can stimulate a whole series of brain areas, improve hand-eye coordination, and stimulate the transfer of skills such as active participation and resilience. This is what video games have in common with any other type of game. Play is usually the best way to transfer values. If we think about it, when we are little (if we assume children are developing), we learn to be in the world by playing: touching, exploring, pretending to be cowboys and astronauts, learning the rules through the game. Games that are nothing more than a composition of rules and, for this reason, bring with them a whole series of other positive tools.

Do you think it makes sense to educate the public to use this medium, which will become even more immersive?

Literacy is an important theme in video games. It’s obvious that for a young child who is still developing their judgement, the role of family, school, or the educational community in general, is fundamental. But what about navigating the language of video games? Many parents, for whom video games are unfamiliar, are afraid of them and, therefore, cannot guide their children to the right choice. This, however, is the same problem that parents faced with films and TV starting at the end of the nineteenth century. We can look at what people who worked in the theater — or grew up with theater as the primary form of a moving image — said about cinema. At a certain point in history, movies arrived, and novelist Luigi Pirandello and others described it in a brutal, negative way, speaking of harmful impacts on the next generations. The same happened with comics, in the 1970s and even before that at the beginning of the 19th century with the arrival of photography, which set off painters.

There are difficulties with any new technology — when seen as a technology rather than a language. What must be done, however, is to educate children about video games. We must ensure the educational community can direct students and add games to their curricula. There are games, such as War of Mine, which are mandatory textbooks in some countries because it’s a game where people experience war from a citizen’s point of view, learning how to make choices amid a war. War of Mine is part of the curricula for Civics and History. It’s just one example, but it’s obvious that this will become a widespread reality. Libraries will begin to include video games on their shelves, not just in separate areas. It could be possible to find on a “World War II” themed shelf a film, a statuette, and a video game because they all contribute to telling, in their way, part of the same story.

Meet Fabio Viola at the Opening Conference of Maker Faire Rome 2023. This year’s festival celebrating innovation will host an area of events and activities dedicated to the wonderful gaming universe!

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