While there has been increasing interest in the use of gamification in mental health care, there is a lack of design knowledge on how elements from games could be integrated into existing therapeutic treatment activities in a manner that is balanced and effective. To help address this issue, we propose a design process framework to support the development of mental health gamification. Based on the concept of experienced game versus therapy worlds, we highlight 4 different therapeutic components that could be gamified to increase user engagement. By means of a Dual-Loop model, designers can balance the therapeutic and game design components and design the core elements of a mental health care gamification. To support the proposed framework, 4 cases of game design in mental health care (eg, therapeutic protocols for addiction, anxiety, and low self-esteem) are presented.

We designed and implemented a gamified eHealth application for youth mental healthcare, to study how game design techniques could be applied within this context. This resulted in the design of a gamified mobile application aimed at supporting therapeutic goal setting: the ReadySetGoals game. The design process itself involved four key stages: (1) Identifying the transfer effect to be aimed-for, (2) Exploring the user context, (3) Designing the gamification, and (4) Evaluating the gamification. Following a preliminary evaluation, we applied a final design iteration to the app that was implemented in therapeutic practice. However, fewer therapists than expected used the app when given the opportunity and information. In a series of qualitative interviews, we investigated their reasons for not using it. Analysis of the results generated three themes that inhibit eHealth adoption: (1) Fittingness of gamification with individual users, (2) Fittingness of eHealth with face-to-face practice, (3) Distortion of therapeutic alliance by eHealth and gamification. Based on these outcomes and our design process we identified the following three recommendations to enhance implementation and adoption of eHealth in mental healthcare: (1) Align expectations of stakeholders through framing (2) Integrate therapeutic aspects in gamification, and (3) Focus on personalisation.

Although the potential benefits of applying game design techniques for healthcare purposes has been recognized in the past, there has not yet been much research on how such applied games could be created and used in practice. This paper presents the learnings and challenges for designing such a game from a research through design perspective. Central in this paper is the process employed to design the ReadySetGoals, a gamified mobile application aimed at supporting therapeutic goal setting within a substance addiction treatment context. The design process involved four key stages. 1) The 'transfer effect' was identified and then 2) The 'Real World' context examined. 3) Different gamification concepts were evaluated and a 'core gamification loop' was designed. 4)The ReadySetGoals was then prototyped, user tested and iteratively refined. During the design process, three key learnings emerged and are discussed: 1) Aligning stakeholder expectations though framing 2)Integrating real world therapeutic aspects in a game world experience and 3) The value of personalization.

A novel sensor-based Internet of Educational Things (IoET) platform named OBSY was iteratively designed, developed and evaluated to support education in rural regions in Thailand. To assess the effectiveness of this platform, a study was carried out at four primary schools located near the Thai northern border with 244 students and 8 teachers. Participants were asked to carry out three science-based learning activities and were measured for improvements in learning outcome and learning engagement. Overall, the results showed that students in the IoET group who had used OBSY to learn showed significantly higher learning outcome and had better learning engagement than those in the control condition. In addition, for those in the IoET group, there was no significant effect regarding gender, home location (Urban or Rural), age, prior experience with technology and ethnicity on learning outcome. For learning engagement, only age was found to influence interest/enjoyment. The study demonstrated the potential of IoET technologies in underprivileged area, through a co-design approach with teachers and students, taking into account the local contexts.

This paper describes two case studies of virtual environment systems designed for older people. In particular, the paper outlines the process and technology used to develop the virtual environments as well as the lessons learnt from the iterative design process. The first case study describes two multi-user virtual environments that were designed as a social interaction platform for older people staying at home. This system was conceptualized through an initial focus group session and was refined through iterative testing. The second case study describes a virtual environment system that was developed for a care home setting to encourage interaction between People with Dementia and their care givers. To better facilitate engagement for such users, the system made use of tangible user interfaces through physical artifacts embedded with NFC tags.