CThere are people who, unconsciously, to defend themselves from emotions that are too difficult to experience, talk about their crises and pains with detachment and coldness. Others who even struggle to talk about themselves, with little or no ability to recognize and understand their feelings. To face and overcome such situations from 2024, in several Italian mental health centers, the therapeutic use of video games, or video game therapy, is being tested.
«In both cases there is an inaccessible malaise: the video game can be a tool that allows you to come into contact with your own traumas to process». Elena Del Fante, digital psychologist and researcher at the Bicocca University of Milan in the development of video games for neurorehabilitationis part of the scientific committee of the Italian model of video game therapy. An innovative therapeutic approach based on the use of commercial video games.
Video game therapy. When the virtual challenge becomes a therapeutic tool
«Therapy can be combined with a path of traditional psychotherapy to accelerate self-awareness of one’s behavior, which is fundamental for personal growth. In some cases, the use of video games may become the only way to involve the person and make her work on her fragilities” specifies Del Fante, a thirty-three-year-old competitive gaming talent, who in 2016 was national champion in video gaming Call of Duty: Black Ops III.
The effectiveness of the use of video games in educational, training and clinical settings is confirmed by 40 years of scientific literature. The Italian model of video game therapy was developed by psychotherapist Francesco Bocci in 2021. (Getty Images)
The “missions” to face in video games, an allegory of the real ones
Learning to survive inside a spaceship, carrying out missions in the ocean depths, defeating enemies, solving puzzles to win trophies, building shelters to protect yourself from nocturnal monsters: the hardships faced in video games become an allegory of real ones. «The player immerses himself completely in the narrative of the game, until he reaches a state of peace interior where he loses track of time. Everything he does is automatic, so he is no longer afraid of not making it. Those who use the console (the gaming device, ed.) experience safety and self-confidence. He will therefore be more inclined to reflect on the emotions aroused by the game and which refer to its history.”
Not just for very young geeks
These are the mechanisms triggered by video game therapy, an ideal support tool for teenagers and young adults. But not only that. «To those who are not familiar with the vehicle, but are interested experience, a one-week training course can be offered” says the expert. «The objective is to increase cognitive, learning, memory, concentration and problem-solving skills, relational skills and emotion regulation.
Anyone who is going through a difficult time due to bereavement, divorce, unemployment, mobbing or family conflict can benefit from it. A father realized that he was unable to carve out time for himself because he didn’t feel he had the right to it due to an excessive sense of duty transmitted by the family environment.
Video game therapy also works for those with pathological suffering: anxiety, depression and other mood disorders, self-harm, eating and personality disorders, neurodegenerative diseases”, adds Del Fante. «It can be useful for post-stroke cognitive rehabilitation and to improve the well-being of children with neurodivergence (such as autism, attention deficit, hyperactivity), who have difficulty controlling impulses».
Next to you, there is always the psychotherapist
The game is chosen based on the user’s preferences and needs, taking into account whether he needs reassurance or loves the unexpected. To be effective, the sessions, generally offered free of charge, must be at least ten, each lasting an hour, an hour and a half, and each gaming session ends with an interview with the therapist, who always remains at the player’s side. «The specialist intervenes in the critical phases: if he sees that the person continues to make the same mistake while he tries to steer a ship, and impulsively gives up everything, he invites us to analyze the problem and divide it into smaller aspects to understand what isn’t working. In this way, the patient learns to manage frustration and not to give in.”
In the protagonist of the video game, the patient recognizes the trauma
Among the organizations that have adopted video game therapy is the Psychosocial Center of the Spedali civili healthcare company in Brescia. «We offer it to patients between 16 and 20 years oldin transition from the child neuropsychiatry service to the adult psychiatry service. They suffer from anxiety, depression, bipolarism, obsessive-compulsive or eating disorder, emotional dysregulation. In 2025 we took care of almost a dozen of them with this method” explains Decla Vivolo, psychotherapist of the team.
«By identifying with the protagonist of the video game – perhaps an orphan, or one who has run away from home or who gets into trouble and has no friends – the boy manages to approach his traumatized side and question himself. By talking to the therapist he realizes that he can reduce the discomfort. Then, after overcoming the challenges of the game, for example by not giving in to an enemy’s provocations, he feels more capable when faced with the problem initially considered insurmountable» observes Vivolo.
From game challenges to real life
«It is a process that integrates reflections and actions: the discussion with the therapist allows the patient to immediately test himself in the virtual world and understand that the same solution could work in real life too».
Doctor Vivolo recounts the first results: «There are those who have managed to bring out traumas that never emerged in two years of psychotherapy. A girl with strong social anxiety, who didn’t leave home, went back to school and found a boyfriend. Another, suffering from panic attacks, enrolled in university, supports herself with a small job and continues with individual psychotherapy.”
Good results, also for group video game therapy
In Corgeno, in the province of Varese, in the L’Aquilone cooperative, social withdrawal is fought with ten stations with PCs and consoles for group video game therapy sessions. «The participants are young people aged between 13 and 25, with serious relational difficulties, who perhaps only attend school and refuse other activities with their peers» reports Matteo Zanon, psychotherapist of the cooperative. “At first they walked in looking at the tips of their shoes, today they are organizing a dinner together.”
The video game room has transformed into a “relationship gym”
«Sometimes, to hook them up, we meet them in the bedroom at home. Many would never have come to us if there hadn’t been the video game. It is a tool in which they invest much of their time. They feel understood, keep their relational and organizational skills alive, exchange opinions in chat with other players on the characteristics of the characters and the fears they reflect. We make sure that recognize these skills and transfer them outside the digital world to make new friendsordering pizzas on the phone, doing school homework or shopping” adds Zanon. In play, kids are more open to meeting others.
«Perceiving themselves as competent, they lower their defenses and the other person appears less threatening to them. This benefit continues after the video game session, so much so that in the same room the kids also experiment with other ways of being together, such as chatting, watching a TV series or playing a board game. We followed about twenty patients and 90 percent of them have taken back their futurereturning to school, or enrolling in a vocational training course or civil service.”
Centers that use video game therapy
Video games are used as a treatment tool in several countries around the world. «What changes are the integrated psychological intervention techniques» explains Dr. Elena Del Fante. The Italian model of video game therapy was developed by the psychotherapist Francesco Bocci in 2021. «Today he is employed in around forty public and private mental health centres. Including the Asst Spedali Civili of Brescia, the Asst of the Seven Lakes of Varese, the Irccs Mondino of Pavia, the Serd of Cremona, the Local Health Authority of Tuscany South-East. The eating disorder center of the ASL of Reggio Emilia, the child neuropsychiatry of the ASL of Modena, the ASL of Imperia. Furthermore, the L’Aquilone social cooperative in Corgeno (Varese) and the Borghetti psychiatric day center in Ospitaletto (Brescia). Soon the service will also be active at the Niguarda hospital in Milan.” Del Fante also highlights that «the effectiveness of the use of video games in educational, training and clinical fields is confirmed by 40 years of scientific literature».