Remedial therapy through games: The psychology behind gamified treatments
Hareesh P V (Research Scholar)& Dr Aswathy Gopi (Assistant Professor)
Department of Psychology, SRM University-AP (Amaravati)
“24/7 you are gaming, gaming, gaming…. Can’t you just open a book and read?”
This is a statement that almost every 21st-century child has heard from their parents. Although it started in the late 70s, gaming culture became a booming craze in the minds of people in the 21st century. Be it arcade, video, mobile, console, or PC games, interest in spending time on gaming entertainment has always been prevalent. We understood that these games had secret ingredients that attracted a large number of users, regardless of age or gender, and kept them actively involved. The researchers noticed this phenomenon and adapted its strengths to benefit treatments. This paved the way for game-based learning and interventions.
Game-based interventions use gaming elements to create a playful, entertaining context that changes human skills or behaviour. They are also used to increase treatment adherence among patients. Even though gamification might sound as simple as making therapy fun, it relies on a complex set of psychological concepts to work effectively. Play is an inevitable part of childhood development. Children learn to communicate, socialise, regulate emotions, solve problems, and many more skills through play. The gamification principle utilises this natural tendency to enhance remedial therapies for children with special needs. Let’s understand the game mechanisms that contribute to this.
Game rewards
“If you study for 4 hours, I will buy you an ice cream!”
Rewards are known to motivate individuals to complete a task or achieve an outcome of interest. These rewards are not only physical in nature but also psychological, such as happiness. A child having to complete 10 exercises as part of therapy might get bored easily. So, keeping some type of reward for the completion of the task will motivate the child to adhere to therapy. Although tangible rewards are more convincing for children, games introduce intangiblerewards that they can own within the game (Xiao & Hew, 2023). The game Subway Surfersmotivates users to run longer on the digital rail track by providing digital gold coins and other ‘power-ups’ as rewards along the way. The rewards are not delayed but given continually for completing each part of a specific task (Sathianathan& Rajan, 2017).
Immediate feedback
Most children might hate advises, but feedbacks are not direct advice in games. They can take the form of hints to achieve the outcome or helpful suggestions offers a benefit to the user. The results can be observed in real-time for the tasks in the game. While playing a word puzzle, alerting the child to wrong selections with a red glow is an example. This prompts the childto be attentive in problem-solving and try another method. The correct steps can also be hinted at in similar ways. As each task is completed, the child knows what has been achieved in an instant. So, there is evidence for the user to believe in (Llorens-Largo et al., 2016).
Fewer distractions and more clarity
When a child is engaged in gaming, it is difficult to distract them from the game as they are well focused in it. Colours, pictures, sounds, and similar sensory elements are more often used in game interfaces to keep the child focused in it. They also ensure to consistently change the elements little by little so that boredom doesn’t affect the user. The goals in each level of the game are made clear to the child, such as ‘Find the red apple’. Instructions will be made as simple as possible while providing maximum clarity. This ensures that the child locks on to the task with a feeling of accomplishment.
Time flies, mind flies
Another interesting ability of games is making the user lose the sense of how much time has passed in the real world and preventing their consciousness from acting every time. A child who does not like to write for five minutes might play a typing game for 30 minutes. The game elements work in synchrony to keep the child engaged and focused in the task given, so that he/she does not track time or consciously measure how much activity has been done. It happens like a continuous flow without self-monitoring. This doesn’t mean an endless gaming period, because other factors such as fatigue come into play. Therefore, while designing a game for therapeutic purposes, designers ensure that the user does not continue the game beyond the required period and level of task (Csikszentmihalyi, 1990).
Autonomy and Competence
Both autonomy (sense of control of own choices) and competence (feeling of accomplishment) play a major role in the prolonged engagement of a user in the game. A child could refuse to play if the task feels too difficult, complex, or does not give enough freedom of choice (Llorens-Largo et al., 2016). There is a huge fan base and many users of the famous game ‘Grand Theft Auto (GTA)’ mainly due to its user autonomy. The user can move the character in the game with very few restrictions, and every outcome of the free world (in the game) can be controlled at will. This concept is directly explained in the self-determination theory. It assumes the inherent drive of humans for psychological growth and integration happens through these factors (Ryan & Deci, 2020)
Gamifying remedial therapies
As we understood how games can influence the task completion process in an individual, let us look into what it means for gamification of remedial therapies. Gamifying doesn’t mean making the child become a ‘reward point chaser’ or ‘addicted’. The designers tweak the elements in such a way that the game creates an environment for the child to have more intrinsic motivation (a drive that comes from within) and engage of their own will. A child who is poor at reading might refuse to read lengthy paragraphs. The gamified version can split the paragraph into smaller portions of achievable goals to read, and further rewards can be added. The immediate feedback system ensures the child can correct the mistakes made and make necessary adjustments for another try (Al-Khresheh, 2025).
Sometimes children do not engage in therapeutic activities because they feel embarrassed about mistakes, as many people might be observing them (McGregor & Elliot, 2005). Gamification provides a convenient and comfortable space for the child to let go of thoughts that lead to such feelings. In a game, a failed attempt is a lesson closer to learning how to succeed. However, not all games work the same for all neurodivergent children. The games have to be personalized to match the requirements of the specific child. Gamified interventions can be overstimulating for children with autism if they have flashy colours and loud music. Children with behavioural problems could get aggressive after a failed attempt. So, the interface is designed for the therapeutic objectives(Taranu & Eriksson, 2026).
Now, a concern that could arise is ‘Will the success in the game reflect in the real world too?’ Researchers and clinicians are constantly working on this aspect of gamification. For therapeutic benefit, game skills need to transfer to real life. Children are monitored and supported to practice the skills learnt through games in the outside world. Technology is not the therapist here, but rather a support system for human care. The objective of gamification was not to replace conventional therapies. Gamified interventions enhance the efficiency of those therapies and thus bring about beneficial psychological changes among the children with special needs.
