"Press Any Key to Start"
THERAPY + GAMING
I am including this page as a resource and a record of my old website that was primarily dedicated to a blog about my interest in video game and technology overuse. At the time I was exploring new ways of helping teens and adults that found themselves too tethered to their electronics. While I still continue to do this work in my practice, it is not as central as it once. That being said, I wanted clients to still be able to access some of the information from the old site. Thanks for reading!
My Philosophy on Gaming
I have been a therapist for nearly a decade, and I have been a gamer for most of my life. It is at the intersection of these two fields where I have found true passion. The mental health field is currently poised to roll out it's "Internet Gaming Disorder" in one of the next iterations of the DSM, and as a mental health practitioner working with adolescents I find myself on the front lines working with the demographic most likely to receive that diagnosis. Whether it is at home or work, on a computer,console, or phone; video games are everywhere. As with any new cultural movement there has arisen a societal fear of overuse, addiction and corruption of impressionable minds. Video games are
here, like it or not, and whether you are a therapist or a parent they provide a window into our client's/children's lives that we can use to help them achieve their goals. I do not dispute that problematic gaming exists, it does. What I do dispute is the prevalence of that problem, and also the manner in which we treat it. Abstinence, while not impossible, is certainly improbable, and so we come to harm reduction as our most meaningful tool. One may find the information in my blog to be relatively one sided in it's quest to educate parents and therapists alike; however, I feel I am providing a counterpoint to the over saturated "other side" that is the moral panic of video game addiction. Feel free to disagree, but I hope you do so with an open mind. Thanks and happy reading.
-Ben Pleasure
Happy Teens and Screen time
I came across this article in my morning paper and I was fully prepared to tear it apart line by line; that was until I looked up the study it was based on. More often than not, when I come across a sensationalist headline about gaming and the negative effect it has on children, I find that it is based upon research that is statistically insignificant. For instance, it might have followed ten adolescents for one week, or perhaps it draws causal relationships between two factors when it would be difficult to even prove correlation, let alone causation. However, in this case, the study looked at a sample size of more than one million teens, over the past five years. Moreover, the author was careful to distinguish between correlation and causation and providing reasoning why alternative explanations might not be at play here. Lastly, screen time in general is used as the x-factor, versus targeting one particular type like gaming, or social media, or television, which I think makes for a more effective target than a single scapegoat; a screen is a screen is a screen. What I found intriguing, is that for years I have been hearing from researchers like Jane McGonigal that 21 hours is the magic number for screen time. Anything below that and one can reap the benefits of the medium, anything over and the detriment begins to climb as the benefits wane. However; until now I was never clear on where they got that number. It was always just stated "the research shows..." but where was that research? Well, here it is. Twenty hours folks that's all. Also, keep in mind, your child likely uses screens for five to ten hours just during their regular school day, and that counts towards the twenty.
The Problem With Technology Abstinence
In the substance abuse field, there is an overwhelming amount of research that indicates that the true solution to substance abuse and dependence is abstinence. To be sure, there have been programs that touted their ability to teach addicts and alcoholics to use in moderation; however one would be hard pressed to find any real data to support that. And whatever one's feelings are about the 12 step programs, the one relatively undisputed feature is that a successful recovery includes abstinence from substances (and I am not going to address nicotine and caffeine as it isn't pertinent to this discussion). This is what leads to a fundamental difficulty with lumping gaming and technology addiction in with other substances. How could anyone, let alone an adolescent, in today's culture maintain an abstinent lifestyle from technology? What would this mean; no TV, no computer, no Ipad, no phone? If you have school age children, chances are that they are using either a Chromebook or an Ipad as part of their daily curriculum in school. If they are an adolescent or older, they may already have their own smartphone, and let's be honest, when your smartphone buzzes in your pocket, don't you check to see who is calling or texting? When you are in a waiting room, how many people are still reading the outdated magazines, and how many are on their phones checking their news feed, or their favorite shopping apps? Preaching abstinence to teens, even those that fall into the problematic gamer category, is a losing proposition. We also don't have to throw our hands up and call it quits either. Unlike in other types of substance abuse, we are going to have to find a way to teach moderation. In a world of instant information, we may need to retrain minds to be OK with delayed gratification. In a world where gaming is become a more viable "way of life" (albeit slowly, more on this in my upcoming post about professional gaming) we are going to have to coax our children back out into other activities that may not provide the immediate reinforcing feedback that video games do. Now, just to cover all the bases here, there is the option of pursuing a temporary break from technology in an effort to sort of reset the behavior when it has become compulsive. This might be in the form of a residential or wilderness program and there is research that shows that the dopamine receptors can be regenerated (up-regulation) with a period of "sobriety." This isn't a terrible option in particularly severe cases. However; as was discussed, in all likelihood, the person will return to their life at some point and go back to using technology and video games. This is why we need to re-frame this using a different paradigm than that of substance abuse. Whether we force a period of sobriety or not, the critical piece of the work is teaching a new set of skills that will help the person moderate their usage in the future as well as develop a heightened awareness for warning signs that their gaming or technology use is slipping back to problematic levels so that intervention can happen sooner rather than later.
Eight Ideas For Getting A (Social) Life
One of the most difficult but crucial elements of moving a teenager away from video games and technology is to find a new interest for them to pursue. Limiting time with electronics is not adequate in and of itself, a replacement behavior has to be identified and encouraged. Part one of this move is that I find that my clients are often more amenable to suggestions that come from me rather than their parents as they generally see me as an ally; however, every parent/teen relationship is different and if your teen doesn’t dig their heels in when you make a suggestion, than by all means make as many as you can. Part two is identifying activities that fit the child. What I mean by this is that if you have an a teenager that doesn’t venture out of the house often, tends to seek solo or sedentary activities, suggesting that they join the lacrosse team at school may not make a lot of sense. Whereas for a highly active and social teen, it might be the perfect fit. So figuring out what kind of kid you are working with should lead you to a road of viable options. Below I have listed a few that are more geared towards the “indoor” teen, as these can be harder to pinpoint for parents. One word of advice, put aside judgement you may have of these activities. It is easy to think that some of them are weird or uncool, but the goal is to get your client/child engaged in a more social world, regardless of whether you would have joined when you were younger. Good luck! 1. Coding - The most obvious choice for a serious gamer is to push coding or game design. Most gamers have considered making their own games, they may have even designed a few on paper before, but learning to code is often a hurdle they haven't yet jumped. There are actually a number of websites that teach coding to kids, some are even free, but the goal here is to get your kid out and about, so that wouldn't be my first choice. Some schools have started to teach programming courses, and there are numerous camps all over the country, both day camps and sleep away, that focus on this skill set. 2. Art - If you have a kid that almost fits the coding milieu but can't quite get past the math that is involved, you might try moving them towards the more artistic side of game design in the form of drawing classes. These are everywhere and this aspect of game design is as important as the coding. Similarly, I have had success in moving kids towards all sorts of artistic endeavors such as woodworking (which is fortunately locally available to me through the Woodworkers Club in Rockville, MD), writing classes, painting, pottery etc… Most gamers have a fairly creative streak in them, so this tends to be a good fit. 3. Tabletop Gaming and/or LARPING - Yes, more gaming. But tabletop gaming like Dungeons and Dragons, or Magic the Gathering, is inherently more social than video games. To participate you have to physically be in the same space as your co-players and the community around these types of games is extremely diverse and can be fairly welcoming to newcomers. For instance, most card and comic shops use their spaces for Friday Night Magic, a gaming get together that happens all over the world on Friday nights. Usually, these same shops offer free afternoon or evening classes for newcomers and often provide the first sets of cards for free. Just google card shops or comic book stores in your area and chances are you can find a gathering place. The other side of this is LARPING. LARP stands for Live Action Role Play and you may remember it from your college campus, sometimes called The Society for Creative Anachronism. Yes, those guys, the ones that made their own armor and practiced sword fighting with foam swords. Remember what I said, put aside your judgement. Not only are the people involved interested in finding new people to play with, they are often from all walks of life, and are interested in history and storytelling. So stay focused on the goal of getting your kid to be more social, there are worse things than nerdy (and as an aside, I don't personally find it to be nerdy, just saying). 4. Music - Again, the creative streak should be used to your advantage here. Who hasn’t had dreams of being in a band, and the research out there shows that people who play instruments develop areas of their brains that others don’t. The caveat here is that if you go the route of private lessons, it is going to be a year or two before your kid is good enough to be a part of a band. That is, unless you send them to a music school like School of Rock, or Bach to Rock. These places offer private lessons but group the kids according to skill levels in their very own rock bands. The idea is that their skill and interest in continuing lessons will grow from the experience of playing with others and not just alone in their room. Plus, they skip over the boring stuff, like Twinkle Twinkle Little Star, and go right to Led Zeppelin, and AC/DC. 5. A Job - I know this one is a long shot. But sometimes the older adolescents and young adults are willing to go down this road as they know that some extra scratch will help them get some of the gadgets they want. Try suggesting places like Gamestop, Microcenter, or Best Buy. Show them that their knowledge of all things technological could be useful in the working world. As a side note, you might also suggest internships. Depending on where you live, you can even explore video game companies as possibilities for an internship. Bethesda Games has an office local to me, and I am sure they always need gophers. 6. PC Building - This is a tricky one, but if done right, can be fulfilling. So most hardcore gamers want to build their own PC, it is rite of passage for them. Unfortunately, it is expensive, and once they have the parts, it only takes a couple of hours to assemble, and that is the end of the hobby. However; if you steer them towards something like a Raspberry Pi (a credit card sized computer that costs around $30) they can use that to create any number of projects. I have seen people that have made them into robots, into a device that monitors water and temperature levels of a house plant and then tweets the owner whenever it needs to be moved out of the sun or watered, and the most popular which is a retro gaming computer. They are cheap, flexible, and can be used over and over again. Also, you can find maker spaces all over the country that offer classes in tech design just like this, so they can learn with others instead of in a vacuum. 7. Sports off the beaten path - So we discussed not getting the indoor kid into lacrosse, but there are sports out there that are more interesting to the indoor kid. For the brave, there are martial arts, which give kids body confidence, a community, a sense of mastery, and best of all, don’t have the pressure on achievement that comes from team sports. And for others, there are things like archery, which you can sometimes find through local parks departments. 8. Hobby Shop - When all else fails, encourage them to go to a local hobby shop and browse the aisles. There are model rockets, RC cars, trains, etc… Tell them they have to pick one thing to try and then go from there. Sometimes their imagination will be sparked by something they see there, and, those shops are great places to learn about all sorts of activities that go on your area that you might not otherwise know about.
Two Major Mistake Therapists Make With Gamers
Although my primarily goal in defining myself as a gaming therapist is to be the best therapist I can be for my clients, there are a few other avenues that I am trying to explore. Another facet of my dedication is to help other therapists gain a better understanding of the topic as well as hone their skills at working with said population. Hence, this blog post... So you just sat down with a new client, a 14 year old boy, whose parents told you on the phone is addicted to video games, isn't doing well in school, and never goes out with friends. They told you he has tried a few other therapists and hasn't liked any of them. So we all do our intakes a bit differently, and yes, it can take weeks to build real rapport with a new client. However, I believe you really only have those first 20 or 30 minutes before that client has made a judgement about whether you are the right fit or not, so you have to bring your A game. That being said, you also have to be genuine, so if you don't agree with what I am suggesting, don't try it, because teens smell a phony a mile away. In that first session, you are likely going to ask a litany of questions; how do you do in school, who lives in your house, what is your relationship like with your parents, what is your friend group like, how do you feel about being here, etc... The first big misstep happens when you get to the questions about what they do for fun. When they tell you about playing video games (and you already knew this from the parents) DO NOT under any circumstances ask, "How many hours a day do you play?" In fact, don't ask about quantity at all. The moment you bring that up, that client categorizes you as another adult that thinks they play too much. In just a few words you have communicated that you believe video games are a pathology. If they told you that they played chess, or football, or loved to sing, would you ask how many hours a day they do that? And yes, you might ask that down the road, and of course knowing how many hours they play video games a day will be something you want to assess, when you ask it so early on, you are shooting yourself in the foot. So what should you ask instead, how about, "What games do you play?" Or maybe "Oh really, do you play on a PC or on a console?" Then let them explain as much as they want to about it, let them be the expert if you haven't played a video game since Pong came on the market. It is as simple as that, a slight change of direction and you have differentiated yourself from every other adult they have spoken to about this interest of theirs. That was mistake number one, the second big mistake is similar, but it takes a bigger shift in our perspective on what we believe constitutes a social life. When this client tells you about their friends, they may talk about a friend of theirs that they have never met in person, that lives in another state or country, and that they only interact with via Skype or Discord, or via in-game texting, just as if they were speaking about the neighbor that they grew up with. The internet, via multiplayer games, has turned our clients/kids into true citizens of the world, and for them, those relationships are just as real as the ones they may have at school. So when you are working with a client that has an online friend group, you need to be careful when saying things like "real life" or "real friends" as the connotation there is that there is less value to those online friends. I do tend to believe that having social interactions face to face is an important part of a healthy lifestyle, that being said, for some kids who are truly struggling socially for any number of reasons, online friends can be a lifeline for them. So to take away value from that you are invalidating a huge piece of who they are. Just as an aside, I am not going to discuss the danger of online interactions in this post, with regard to predators and the like, not because I don't believe it to be of concern, but because online safety is a subject unto itself and deserves more than a paragraph. Long story short, validate these friendships for your client, let them know that you see their online life as "real life" not "virtual", because the line between those two is becoming less clear, and less relevant every day.
10 Easy Ways for Parents to Start Setting Limits on Gaming
I am frequently asked by the parents/guardians of my clients for ways in which they can support the therapeutic process in their home. The truth is, the bulk of the work starts at home, and so helping parents set some reasonable, effective limitations on gaming and technology in their homes makes the work that is being done on the emotional elements in my office far more effective. Addressing an issue from multiple angles usually increases the positive outcomes exponentially. However; a note for therapists, there is often a fine line between helping the parents set limits and your client (their child) feeling that you are playing both sides of the field. Because of this, it is important that you have a strong rapport with the client already, and if parents need more assistance setting and holding limits beyond these general tips, I usually advise bringing in another therapist to work exclusively with the parents. Below you will find 10 effective tips for parents to use at home. Remember, every family, and every child is different, so flexibility can sometimes be even more important than consistency. 1. First things first, assess how much time is being spent on video games and technology (for entertainment purposes / schoolwork not included) per day. If one end of the spectrum is no technology at all, we need to know what the other end is before we can begin to find a middle path. 2. For kids that are spending money excessively on gaming or apps, parents should remove the credit cards from all accounts - Xbox, PS4, Nintendo eshop, Steam, Paypal, Itunes, Google Play, Amazon, etc.... Also, if your child has already spent a lot of money without permission, try calling the company before you pay the bill. I have found that the majority of these companies will offer a refund if you explain that the purchases were made by a minor without parental authorization. 3. If your child is going to be home alone (sick days, after school, school refusal) take the controllers or power cords to work with you, maybe even the router. However, taking the router is trickier these days since FIOS is all integrated. 4. You can put data caps on phones that are on a family plan to limit your child's usage, however they can still access data via wifi with certain services. Most service providers are happy to help you set this up if you call them. There are all sorts of devices for sale that will allow you to have complete control of your home Wifi from an app on your phone or tablet. I will post some reviews of these in the future. Also, some Internet Service Providers offer free parental controls, so check with yours before you buy anything. 5. Institute some time limits on gameplay or tech usage. Some research out there says that as high as 3 hours per day is OK. I generally try to get it down to an hour and half a day on weekdays, with more flexibility on weekends. This part of the puzzle is a work in progress, every kid is different and some can handle more than others. 6. An alternative to time limits is to have the time be earned. Offer your child 30 minutes or one round of whatever game they play in exchange for one sheet of homework. 7. Make sure to look for old iPods, phones, DS's, etc... Kids can often find some device that has been left in a drawer and get it to be functional enough for their needs. 8. Try not to institute unrealistic punishments "NO VIDEO GAMES EVER AGAIN" or "YOU HAVE LOST YOUR PHONE FOREVER OR UNTIL WE FEEL YOU HAVE PROVED YOURSELF!" If the punishments are extreme or the expectations are vague, it won't function as a motivator anymore. Your child will just give up on earning it back and just find a way around the rules. The punishment should fit the crime and the way to earn it back should be manageable and clear. Never underestimate the power of an "Earn Back." 9. If they need a computer for homework, have them do it in front of parents. Move the computer to the dining room table or the living room. 10. Change the Wifi password every day, and have it be something that is earned by doing chores or homework. This takes a bit of tech savvy but once you figure it out it is fairly easy to do in less than a minute each morning.
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GAME OVER
