Therapeutic Meeples: Economy of Therapy

As is often the case, I was pondering a game idea and thinking about how it would, or if it would, relate to the therapeutic setting. Over the years of designing games, I have found a number of publishers are looking for what they term “family-friendly”, “gateway”, or “easily accessible” games.  In a sense, they are looking for games that are often ideal in a therapeutic setting. Games that are fun, fairly light, and visually appealing. These games also tend to be quick playing and offer an opportunity for looking inwardly regarding one’s experiences. Often they can be a catalyst for conversation.

market photoBut I started thinking about something different: games with an economic core to facilitate therapy. I considered a number of possible options when looking at this idea. In an economy, the participant is seeking to input some sort of good/material/service in order to claim something different in return. Many board games use economies of scale. The player is activating something in order to acquire something else.

The notion is that if you have a game with an economy, it needs to get setup and move along in fairly short order. Talking to a game developer friend of mine, he was saying how he saw value in a game, but was frustrated that the economy was too slow in getting setup. His take was for such a short game, then it should be rolling within a few turns, rather than pending 9 or so turns. I could certainly see his point.

To this end, a client is going to look for some traction in therapy early on, a therapy that unpacking may prove less appealing than a brief type of therapy.

He was alluding to cost versus value. The notion that if something has a high cost, or high barrier to entry, it may be seen as valuable. Though in this case, the high cost was a negative as it reflected the value not being what he desired. This is not always true, in therapy it can go either way frankly. Some therapy is quite expensive and quite good. Other may be expensive, but less worthwhile. In fewer cases, the cost is minimal, but the value derived is quite extensive. In other cases, both may be low.

candies photo
Photo by K Tao

I feel like there is a line about candies in there somewhere. To be fair, not everyone is looking for the same thing in therapy. In my own experience with therapy, I wanted to have someone to talk through things with, maybe ask some clarifying questions. At other times, it helped to have another counselor to drop some knowledge about how to work with challenging clients.  I’m often not the norm though.

Ideally, I would like to go see a therapist who does play therapy for adults. Specifically board games. I think that would be a blast. In cultures where the focus is for more work and less play the harmonious balance is impacted.

It’s the therapist and light bulb joke. It takes 1, but only if change is desired.

With therapy, the economy is a multifaceted one as there is a level of “buy-in” or to use a proper economic term: priming the pump. The therapist has already bought into what they perceive as a good set of therapeutic techniques. Techniques like Cognitive Behavioral Therapy or Psychodynamic. This then presents the client with the need to “buy-in” also, to invest in their treatment.  It’s the therapist and light bulb joke. It takes 1, but only if change is desired. In games, this is also true. If we consider the metaphor of the publisher/designer/developer/artist as therapist. They present the milieu. The player and client are then the ones who decide if the milieu is one they want to jump into. It can be helpful to interview a therapist before beginning therapy, just as reading reviews about a game can help decide if it is something worth pursuing.

Just as the economy is set, it may change. The client may need something different. The therapist needs to be flexible and recognize change when it happens. So too with board games. I may find myself deeply engaged in a game for a number of plays, but later find that I need something different. This is not to say that board games require the level of emotional investment of therapy, they don’t. They can be tools toward that investment however, helping to deepen the relationship with the client and in this fashion, where the overlap occurs we see the significant difference.

Cover image courtesy of Board Game Geek

The economy within the economy if you will. The investment in the milieu then deepens the personal investment from client and therapist. If we consider a game with an economy such as Race for the Galaxy (Rio Grande Games). Acquiring cards allows for production and then sales of the produced goods. The player is invested in further development to maximize their ability to gain more points for the end game.

In this fashion, the investment is applied and then pays out over time. In games we can see the direct result of investment. There is some sort of gain and by the end the player can see their direct investment paying dividends. At other times, the economic investment creates more opportunities for more efficient economic gain.

The real goal of investment is return on investment (ROI). The idea that the investment pays dividends. As shown with Race for the Galaxy, the return on the initial investment is to funnel it back, in part, to growing the economy. So then the ROI in therapy is what exactly?

The goal is reduction in symptoms so the ROI would be any movement off of the baseline. It can be helpful to have the client perform a self assessment such as a Beck Depression or Beck Anxiety Inventory to help determine current symptom level. Movement off of the previous inventory can be shown to the client to help their engagement or buy-in. An outside element, such as a client’s friend or family member, may help also in this way by pointing out the successes.

The benefit here is that the client is more likely to be invested in continuing therapy as they are seeing a direct benefit of their efforts.

It may be difficult for the client to see these changes initially. Alternatively, the client may feel better right away. The benefit here is that the client is more likely to be invested in continuing therapy as they are seeing a direct benefit of their efforts. They can also apply that new found sense of well being toward other areas of their lives. This may also be the time when clients “drop out” of therapy as they feel better. Obviously the therapist would prefer they continue to avoid “plateauing”, meaning the symptoms are mostly lowered, but the symptoms could return without further investment both by therapist and client.

This would effectively like ending a game of Race for the Galaxy early. There are a massive pile of credits and it can feel like, good enough! Though it may be beneficial to shift to a lengthier schedule. Maybe taking more time between appointments to see if the client is feeling symptom free and continues doing well.

The ROI, in therapy then, is of great benefit to the therapist as they may feel they provided the help that was needed. Also for the client who was helped. It can mark the completion of a small journey before preparing for the next one. Pack something fun for the next leg!

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