Lynn E. Fiellin is the founder and director of the play2PREVENT Lab and start-up Playbl, which creates video games designed to educate kids about the risks of using habit-forming substances and the dangers of addiction. She shared her thoughts on why games are an effective way to convey this subject matter to young people and the role this technology plays in the grand scheme of behavioral health.
Lynn E. Fiellin, M.D.
Professor, Biomedical Data Science, Center for Technology and Behavioral Health, Dartmouth College; Founding Director, play2PREVENT Lab; Founder, Playbl, Inc.; Professor Adjunct, Yale University
“If you have high-quality developers and your target audience is involved in the design and development, you can take any topic area and make it more engaging.”
How did you come up with the idea to use digital health in mental health care and addiction treatment?
It really grew out of both professional and personal experiences. Before I launched into this area of research, I was focused mainly on developing and optimizing treatment models around areas of addiction for adults. At the same time, I was also spending a lot of time providing clinical care for young adults with issues around addiction. And what I kept hearing over and over again, was “If only I knew then what I know now.” If we could turn back the clock, we might be able to focus on preventing these things from developing in the first place.
In my personal life, I was raising three teenagers who were experiencing all the wonderful things about adolescence. Everyone was on a device, everyone was playing games, and they still do love playing games. I thought, “if I can take advantage of when they’re engaged and give them a dose of something healthy to help them make good decisions, that’s a win-win.” So, I submitted a grant to the National Institutes of Health proposing to develop and evaluate a video game that addresses risk reduction and HIV prevention in young teens, and eventually established the play2PREVENT lab to really build out this work.
How have you made your technologies user-friendly?
For all of our games, we’ve worked with a very talented commercial game developer called Schell Games — they brought the experience of really knowing how to design and develop games geared toward young people. We also engage with adolescents from the very beginning — they are involved with co-designing, giving feedback, vetting everything, building the stories. They really set a sort of foundation for what they will ultimately be playing. I think that’s the best way to make it not only user-friendly, but really authentic and relevant to teens, especially in the behavioral health space.
Teens don’t always talk a lot, but when you ask them for their opinions, they will give them to you. And that was what led to an incredible opportunity to make each of these games, something that came through their eyes and their voices. As adults, we can’t replace that.
What improvements have you seen from shifting behavioral health care into the digital world?
We haven’t truly been able to engage kids with behavioral health in the past. If you have a really strong, evidence-based curriculum, but you can’t get through to the kids, it’s going to have no impact.
When I look back on some of the resources offered around behavioral health, it’s almost like looking at something from a museum — these resources are almost all on CD-ROM. How do you get these resources into people’s hands immediately? The notion of engagement, accessibility, and scalability is just huge, not to mention the content has to be really high quality and evidence-based.
I think there are many ways in which our games can have universal applications. In doctors’ waiting rooms, you already have a captive audience, so you can give them a game on a tablet that kids can take home their login information and log in again at home. Humans like to play — if you have high-quality developers and your target audience is involved in the design and development, you can take any topic area and make it more engaging. It’s a great application in the healthcare system of providing this type of content with endless opportunities because, ultimately, it’s a vehicle that works.
What do you anticipate for the future of digital behavioral health?
The reflex answer is of course artificial intelligence and machine learning. The way we’ve designed our games, each individual has their own game because certain things will unlock and someone can choose to go this way, and someone can choose to go another way. I think the notion of building on that more and having algorithms that make it even more tailored to the individuals so as to give them personalized feedback could help give users the biggest bang for their buck. Tailoring these types of experiences more for the individual would have even more impact on the outcome.
I’m a little old fashioned in that I also feel like human beings can’t be replaced. When I think about digital games, I really see them as augmenting what humans do, and maybe replacing the parts humans don’t need to do. A game can help educate a child on the hazards of different drugs or alcohol, and provide that content to children in a way that is really engaging. Then I as the clinician can do the human part, which is debriefing, answering questions, and driving home some of the points to clarify and solidify what my patient has learned. If digital technologies can help with that, I think that’s a win for everybody.