Videogame use as a tool for assessing and intervening with identify formation and social development

Australian and New Zealand Journal of Family Therapy 2018, 39, 5–20 doi: 10.1002/anzf.1282

Video Game Use as a Tool for Assessing and Intervening with Identity Formation and Social Development in Family Therapy Ryan M. Earl The Family Institute at Northwestern University, Evanston, USA Because video games are becoming such an integral part of our culture, modern family therapists are more likely than ever to encounter families with members who play them. It is easy to overlook video game use in terms of its potential as a therapeutic tool, particularly if a therapist possesses only limited knowledge of the medium.

Using existing literature and my experience as a lifelong gamer, I provide family therapists with a background of the major video game genres and explain how video games can aid in the assessment of factors such as identity formation and social development. I also provide a systemic case example, recommendations for practice, and a table for quick reference to highlight potential videogame-based family therapy interventions.

Keywords: video games, client gamer, identity formation, social development, assessment intervention

Key Points 1 Video games are a growing part of our culture, and family therapists will undoubtedly encounter an increased number of individuals and families who play them.

2 Many family therapists may be unfamiliar with the variety of video game genres and/or how a person’s choice of video games might be clinically relevant.

3 Video game use can be used to assess phenomena such as identity formation and social development.

4 Video game use can be used as an intervention tool or as part of treatment planning for issues related to social development and/or identity formation.

5 A clinician’s increased understanding of the complexity and variety of video games may directly contribute to their ability to join with clients who play video games.

Video games are more popular than ever (Galarneau, 2014). As a result, family therapists will inevitably encounter families with members who play them. According to the Entertainment Software Association (2015), as of early 2015, nearly one-third (115 million) of Americans are playing video games. There is an average of two gamers in a US household; 80% of these households own at least one device that plays video games. Forty-two percent of Americans play video games at least three hours per week. Whether played on a personal computer (PC) or on a console like an Xbox or PlayStation, video games are, for many, a part of everyday family life.

Though the popular consensus seems to be that video games exist merely for entertainment purposes, this is not necessarily the case. In fact, video games also serve as an escape from the everyday, as a means of identity formation (Allison, von Wahlde, Shockley, & Gabbard, 2006), connection, community, challenge, competition (Greenberg et al., 2010), and much more (Olson, 2010).

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It is no wonder, then, that families with video-gaming members are increasingly citing video game use as a contributor to or as the culprit of the problems they bring to therapy. For example, it is quite common for non-gaming family members to see a gamer’s video game use as a problematic addiction, particularly if a lot of time is spent playing the game (Hertlein & Hawkins, 2012). Some researchers cite family cohesion as a potential factor in the treatment of problematic video game use (Han, Kim, Lee, & Renshaw, 2012). So, how can family therapists use video games to not just better understand clients who play them, but also to help non-gaming family members understand them as well?

Hertlein and Ancheta (2014) urge family therapists to shift their attitudes about technology toward seeing them as useful tools in therapy. Video games are currently an untapped area in terms of their potential as an assessment tool in family therapy, especially for family therapists who have little or no knowledge of or experience with video gaming (Hertlein & Hawkins, 2012). For this reason, video game use is often overlooked unless clients and/or therapists consider it to be part of the presenting problem. Whether part of the defined presenting problem or not, the choice of what video games members of a given family play can say a lot about who they are and/or what they perceive about themselves and others (Konijin, Nije Bijvank, & Bushman, 2007; Olson, 2010). Again, video game use in the household is quite common, but little-to-no literature discusses their potential benefit to family therapists, either as an assessment and intervention tool or as a way to join with clients who play them. In this article, I integrate information from literature on video game use with my own insider knowledge of the gaming world. I am a lifelong gamer, ex-seven-year GameStop employee, and family therapist. I offer illustrations, including a case example and a handy reference table (see Table 1), focused on how family therapists might use a family member’s video game use for both assessment and intervention in therapy even if they may not be gamers themselves.

Popular Video Game Genres: A Background Hertlein and Hawkins (2012) explain that a therapist who is knowledgeable about the gaming world is more likely to notice issues related to video game use, and, in turn, is better suited to collaborate with family systems that contain members who play them. They also suggest that family therapists need to address problematic cycles of blame, defensiveness, guilt, and resentment related to perceived problematic video game use in a way that is consistent with the family therapist’s established assessment and intervention framework. As with any specialised topic, therapists can benefit from a general working knowledge of video games in order to integrate them into their established frameworks and to effectively use them as a tool in family therapy.

Because many therapists do not possess such a working knowledge, I offer the following section as an introduction to important foundational concepts that will help therapists understand client gamers and untangle some of the medium’s complexity.

For the sake of brevity, the following sections focus on five of the most popular video game genres, including popular games within these genres, all of which can inform an assessment of identity formation and/or social development, as discussed in later sections, differently. They are: 1) First-Person Shooters (FPS); 2) Role-Playing Games (RPG); 3) Massively Multiplayer Online Role Playing Games (MMORPG or MMO); 4) Real-Time Strategy Games (RTS); and 5) Multiplayer Online Battle Arena

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Guild Wars II

Star Wars:

Role-Playing

Scrolls Online

The Elder

Mass Effect series

Grand Theft Auto V

Scrolls V: Skyrim

The Elder

Dragon Age series

Creed series

Assassin’s

Online

Multiplayer

Massively

Game (RPG)

Role-Playing

Halo series

gamers.

filled with millions of other

exclusively in an online world

Similar to RPGs, but are played

within the game world.

that have future consequences

The player must make decisions

open-ended.

Stories are diverse and often

development.

Focus on character creation and

Highly immersive.

storytelling with rich settings.

Grounded in deep, detailed

people. Stories and settings vary.

Can be played online with other

that include blood and gore.

Violent, with (often) graphic deaths

who is holding a weapon.

Destiny

Played from the perspective of

the game’s main protagonist

Battlefield series

First-Person

Basic characteristics

Call of Duty series

and series

game genre

Shooter (FPS)

Popular titles

Video

she plays the game.

challenge, etc.)

or why not? purposes other than for entertainment?

(continued)

worlds relative to the way he or she sees

Explore how the client sees different game

world (friendship, connection,

she plays in the real world? Why Does the client use video games for

game world if not accessible in the real

may be fulfilling unmet needs within the

Focus on met and unmet needs: the client

applies skills from the games he or

Does the client feel like he or she

this type of role appeal to him or her?

take on in online settings? Why does

Discuss how that affects the way he or

or herself and/or the idealised self.

What role does the client generally

closely resembles how he or she sees him-

A combination?

Have the client create an avatar that

applicable.

are highlighted through video gaming, if

Determine which parts of a client’s identity

friends, or online with strangers?

Does the client play alone, online with

or ‘evil’ when given the choice? Why?

Does the client prefer to play as ‘good’

idealised image?

might be integrated into the real world.

games (leadership, coordination, etc.)

Does the client create the character in his or her own image and/or

Discuss the way skills learned in video

chooses which avatars to play.

creates his or her avatars and/or

Discuss meaning behind the way a client

Ideas for intervention

does the client like to play or create?

What kind of characters (class)

particular genre of video game?

Why does the client enjoy this

(all genres)

Potential questions

Brief guide to video game genres, potential assessment questions, and potential interventions

TABLE 1

Video Game Use As A Family Therapy Tool

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8

often fast-paced.

gamers to be successful.

coordination between

games require teamwork and

Exclusively online, these

abilities and characteristics.

‘hero’ avatars with special

team’s ‘base’ by controlling

(MOBA)

genres.

Mix between RTS and MMORPG

Goal is to destroy opposing

League of Legends

Dota 2

perform well, as games are

and cognitive processing to

Requires advanced dexterity

opposing player’s units.

countermoves to destroy the

StarCraft II:

Wings of Liberty

series of moves and

manoeuvre military units in a

game world to construct and

Players use resources in the

No defined ‘end’ to the game.

teamwork, and player interaction.

Focus on character development,

Civilization series

Conquer series

Command &

Age of Empires series

World of Warcraft

Basic characteristics

Arena

Online Battle

Multiplayer

Game (RTS)

Strategy

Real-Time

(MMORPG)

The Old Republic

and series

game genre

Game

Popular titles

Video

Table 1 (continued)

real life?

the client sees him- or herself in

How does gaming contribute to how

(all genres)

Potential questions

rather than dismissing it as ‘just a hobby.’

Join with clients over their video game use

the real world.

Ideas for intervention

Ryan M. Earl

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Games (MOBA). The initialisms and acronyms are included because gamers will tend to identify them this way if a person asks about what types of games they play.

First-Person Shooters (FPS)

Popular games: Battlefield series, Call of Duty series, Destiny, Halo series. FPS are video games played from the perspective of the main character/s or protagonist/s. The player takes the perspective of the character on screen, and interacts with the game world accordingly (Barlett, Harris, & Baldassaro, 2007). Per the genre’s title, ‘shooter,’ character holds a weapon, often in the form of a gun or knife. These weapons are used to kill or injure other avatars (computer forms of the player) or enemies in the game world. How graphic these deaths are ranges from the killed avatar simply disappearing, to intense, detailed explosions, blood, and gore. Though FPS vary in terms of storyline, they generally follow the same premise, where the player shoots or stabs his/her/their way through a serious of levels, enemies, and objectives until the storyline ends.

The settings of FPS, while diverse, tend to fall into two general categories. Games like Halo or Destiny take place in fantasy worlds, where the primary targets are alien species (Destiny, 2014). These fantasy titles often have an exaggerated sense of purpose, such as saving humanity from total annihilation. Games like Call of Duty and Battlefield, however, generally take place in more realistic settings. These grandiose titles tend to focus more on the emotion of war, relationships, and tragedy (Battlefield 4, 2013; Call of Duty: Advanced Warfare, 2014). They are designed in a way that is relatable, and they can illicit more emotion from the gamer as a result.

In addition, many FPS games have an online component that is optional to play, where teams or individuals compete in objective-based gameplay (e.g., capture the flag) or in death-matches, where the goal is to score the most points through killing the other team or players. Different FPS games require different skillsets when played online. For example, Halo tends to be a more team-based game when played online, where players must talk to each other and coordinate efforts to accomplish teamoriented tasks and succeed. However, games like Call of Duty tend to be more individually oriented (‘free for all’) in the context of team play, where the player scores individual points to unlock upgrades such as better weapons. Different games require different behaviours. Knowing which specific games a client gamer prefers to play over others can provide insight into behavioural preferences outside the game world.

For example, somebody who plays Call of Duty might be more interested in meeting his/her/their own needs before meeting the needs of other family members.

In the literature, FPS are often linked to increased aggression, hostility, frustration, and psychological arousal (Barlett et al., 2007; Sherry, 2001). Konijin et al. (2007) suggest that the interactive nature of games like FPS encourage players to closely identify with characters whose very essence is built upon violence. This forced violent perspective is necessary for the game to be played, which might help explain why playing FPS is often linked to the aforementioned factors.

Role-Playing Games (RPG)

Popular games: Assassin’s Creed series, The Division, The Elder Scrolls V: Skyrim, Grand Theft Auto series, Mass Effect series. RPG are, perhaps, the most diverse and complex of the video game genres. These games are grounded in deep, detailed storytelling with rich settings that seek to immerse the player in the digital world. An ª 2018 Australian Association of Family Therapy

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important aspect of the RPG is its tendency to focus on character development, as well as on dynamic relationships and interactions with non-player characters (NPCs).

NPCs are digital characters that populate the game world as part of the environment, but they are not controlled by actual gamers. Coded with virtual intelligence and often fully voiced, NPCs can have complex backstories and narratives that dictate the scripted ways they interact with the gamer’s controlled character, which often resemble everyday, real-life social interactions. In addition, most RPGs are played from the third-person perspective, where gamers can see the character they are controlling in its entirety.

Unlike FPS, which tend to progress step-by-step, RPG tend to be open-ended, where players navigate and engage in the game world and its relative story in whatever order they please. As part of this storytelling dynamic, modern RPG often force gamers to make key decisions during the game’s storyline. These decisions can have short- and/or long-term consequences within the game. Star Wars: Knights of the Old Republic, for example, uses player decisions to move the player’s avatar toward the light or dark side of the force. Evil actions, like killing innocent NPCs, move the player toward the ‘dark side,’ which changes the way other NPCs interact with the player throughout the game (e.g., NPCs may fear the gamer’s character) (Star Wars: Knights of the Old Republic, 2003).

Character creation is almost always one of the most important aspects of the RPG. The degree of customisation varies, but even the simplest character creation tools allow the player to choose race, gender, and age (Higgin, 2008; Williams, Martins, Consalvo, & Ivory, 2009). Games like Mass Effect and The Elder Scrolls V: Skyrim have highly detailed character-creation tools. Mass Effect, for example, allows the player to choose their character’s history, psychological profile, military specialisation, talents, and special abilities in addition to physical characteristics, including facial structure, race, hairstyle, and cheek, eye, nose, mouth, head, and jaw shapes.

There is a nearly infinite number of combinations, which allow gamers to have their own avatars that are unique to anyone else who also plays Mass Effect (Mass Effect, 2007). Games like The Elder Scrolls V: Skyrim take physical characteristics even further, where the player can choose non-human races and features (The Elder Scrolls V: Skyrim, 2011). As I discuss later, RPG can play a role in the formation and/or reflection of identity (Allison et al., 2006; Higgin, 2008; Konijin et al., 2007; Williams et al., 2009), of which character creation is the major vehicle.

Massively Multiplayer Online Role-Playing Games (MMORPG)

Popular games: Guild Wars II, The Elder Scrolls Online, Star Wars: The Old Republic, World of Warcraft. MMORPG share many traits with RPG, such as in-depth character customisation, deep storytelling, and rich settings, but there are a few major differences, the most prominent of which is that MMORPG are played exclusively online with, depending on the game, thousands or even millions (10 million people currently subscribe to World of Warcraft) (Grubb, 2015) of other gamers who simultaneously share and interact with the game world. The primary goal of a MMORPG is for the gamer to move his or her character through a series of levels, gained by acquiring experience via quests and tasks, in an effort to strengthen the created avatar relative to other players’ avatars (Cole & Griffiths, 2007). The defining characteristic of the MMORPG is social interaction with other gamers, often at a global level (Losup et al., 2014). Such social interaction is emphasised through what are called

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‘guilds’ or ‘clans,’ where players find a sense of belonging to groups within the game that focus on common goals, like quest completion and destruction of opposing factions in addition to earning rewards and building status/prestige within the community.

Teamwork among gamers is essential, and every type of avatar has a unique skillset and purpose in relation to others (Yee, 2006). For instance, some players may choose to play as an avatar that has the ability to heal players who take damage from others, while other players might choose to play as avatars that can use magic to do more damage to other players or NPCs. Gamers can communicate with one another via text or voice chat in real-time as a means to coordinate goals or to simply chat with each other as they play. While gamers who play MMORPG often play with friends, they inevitably interact anonymously with strangers, with whom they may or may not form deeper relationships (Yee, 2006).

It is also important to note that, unlike the other genres that have been/will be discussed, MMORPG do not have a defined ‘end’ to the game. Characters continue to develop as the game world itself evolves (Dickey, 2007). For this reason, MMORPG require a considerable amount of financial, time, and emotional investment on the player’s behalf. In terms of financial investment, most MMORPGs like World of Warcraft, require a monthly subscription fee, usually somewhere around US $15 per month, per account. From a sample of 5,471 MMORPG players, Yee (2006) found that users spend an average of 22.72 hours per week, and a small percentage (8%) spend 40 hours per week or more playing the game. On top of the financial and time investments, MMORPG players report considerable emotional investment in their avatars and in the game world. In Yee’s (2006) sample, 27% and 33% of respondents indicated that their most and least satisfying experience, respectively, within the prior week happened within the game as opposed to in reality.

Real-Time Strategy Games (RTS)

Popular games: Age of Empires II, Civilization V, StarCraft II: Wings of Liberty. The premise of RTS games is that the player uses resources within the generated game world to construct military structures and units. These units are manoeuvred around a battlefield with the purpose of attacking and destroying other players’ armies and structures through a series of moves and countermoves, carried out through player commands. Building and manoeuvering armies over the isometrically displayed map is a cognitively taxing process that requires high dexterity and multi-tasking ability from the gamer – some of the most skilled RTS players can complete hundreds of actions, sometimes referred to as ‘clicks,’ per minute. Units are diverse – each type has its own strengths and weaknesses relative to enemy units – as are the armies themselves. Often there are different ‘races’ or ‘factions’ with their own unique units with unique strengths that fit different play-styles (Geryk, 2008).

RTS games can be analogised as fast-paced, resource-intensive chess matches. Players must analyse and use the battlefield’s resources, scout the opposing player(s), and manufacture units that counterbalance the opponent’s with constantly gathered, limited resources. The player must continuously bounce back and forth between building defences for his or her base while also manoeuvering offensive units across the battlefield. Players use a variety of military-esque tactics; one such example is ‘rushing’ the enemy with offensive units before the opponent is able to construct ample defence.

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popular RTS games like StarCraft II: Wings of Liberty are played professionally at events that draw thousands of spectators and millions of online spectators (Cheung & Huang, 2011).

There is little existing research that focuses on the cognitive capacity/abilities of gamers who play RTS games, particularly at high levels; however, due to the nature of RTS games, client gamers that excel in these games must possess high capacities to multi-task, strategise, and remain calm amidst chaotic or demanding situations. This could lead a therapist to conclude that these client gamers are highly intelligent or logical; in my experience this is the case, but there is no current research to support such a hypothesis. Like MMORPG, players often invest several hours per week into playing RTS games. Though RTS games do not generally contain characters or storylines to become engrossed in, RTS players often, in my experience, become emotionally invested in how to build better, more efficient armies quicker by increasing actions-per-minute. The little research that does exist often explores the addictive nature of RTS games like StarCraft II: Wings of Liberty (Young, 2009).

Multiplayer Online Battle Arena Games (MOBA)

Popular games: League of Legends, Dota 2, Heroes of the Storm. MOBA, like MMORPGs, are games that are exclusively played online. These games are best described as a mix between RTS and MMORPG. The objective of MOBA is to destroy the opposing team’s main structure, similar to what happens in RTS games, with the help of intervally spawned (automatically added to the battlefield in set increments of time), computer-controlled units. The player controls one of a wide assortment of powerful ‘hero’ avatars that have specialised abilities, characteristics, strengths, and weaknesses, and navigates the online battlefield as part of a team of other players who also control a hero character of their own. Social interaction and coordination of strategy are core components of the MOBA genre, similar to MMORPG (Ferrari, 2013).

Though MOBA are a mix of MMORPG and RTS games, the objectives, processes, and strategies are unique to the genre. Whereas RTS games are typically individually oriented, MOBA focus on team interaction and accountability. Players are heavily penalised for leaving games early. For example, players who leave early may be restricted from entering another match for a set period of time. Unlike MMORPG that have a continuous, never-ending game world, typical MOBA matches generally last 30 to 45 minutes. They do not require the same level of multi-tasking as RTS games do, and are therefore less resource intensive. For these reasons, among others (e.g., they are generally free to play), MOBA are becoming an increasingly popular genre. League of Legends, for example, has a player population of over 27 million players who play the game daily (Tassi, 2014). Unfortunately, very little, if any research exists in relation to the way MOBA intersect with psychological health (Ferrari, 2013).

Using Video Games for Assessment Given the range of video game genres, the video games a client gamer chooses to play may tell the family therapist a great deal about him/her/them. As part of her multitheoretical model of technology in family life, Hertlein (2012) suggests that people may be more comfortable expressing vulnerability and personality traits through

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technology, which can divide family relationships. If a family therapist knows what to ask, video games provide an opportunity to peek into a client gamer’s inner-world in a way that family members have not, and that might not have been possible otherwise. The following sections are not an exhaustive list of potential assessment criteria, but they do lay a foundation for an expanded view of video game use as a clinically relevant tool as opposed to a dismissible pastime. To illustrate, in the following sections I discuss two ways video game use can be employed for assessment: 1) exploring identity formation/reflection and 2) assessing social development.

Identity formation

Video games can heavily contribute to the development and reflection of identity (Allison et al., 2006; Konijin et al., 2007; Olson, 2010). Perhaps the easiest and most effective way to assess for these dynamics is through the exploration, ideally with other family members present, of the chosen or created characters client gamers control.

Von Feilitzen and Linne (1975) drew a distinction between similarity identification and wishful identification. Similarity identification involves gamers creating characters with whom they share major characteristics. In effect, gamers construct an avatar in a way that reflects the way they see their self in the context of a situation in which they must overcome obstacles to pursue whatever noble cause or goal the game sets forth.

For example, the goal of Mass Effect is to save humanity from destruction by a synthetic race known as the Reapers (Mass Effect, 2007). Wishful identification, on the other hand, involves the gamers creating avatars that possess traits they desire to emulate. For example, a boy who describes himself as ‘scrawny’ might give his avatar muscles of an exaggerated size. Avatars constructed in the context of wishful identification might overcompensate for the gamer’s perceived flaws of self. On the other hand, a gamer might construct an avatar in a certain way as a means to experiment with the way an idealised or different version of the self might interact with the world, such as if a male-identified gamer chooses to play as a female avatar (Konijin et al., 2007; Olson, 2010).

As part of the multi-theoretical model of technology in couple and family relationships, Hertlein (2012) suggests that advanced technologies, like video games, provide an environment where people can explore and operationalise such similarity and/or wishful identification through a process of accommodation. Family therapists can open up discussions related to such identity formation and accommodation through asking about the traits of characters that client gamers play and/or create. By having the gamer describe his/her/their avatar, the clinician develops a sense of how the client gamer sees his/her/their self and/or how the client wishes to be seen while the family bears witness. Perhaps an individual assigned female at birth who is struggling with their gender identity plays strictly as male characters when given the choice. This gamer may not feel comfortable exploring such an identity in the family, so he/she turns to doing so in the game as an alternative. Or maybe a child who feels ignored by the family chooses an alien race because that race possesses unique, idealised traits (like the ability to fly or breathe underwater) that help it stand out within the game world. The possibilities are endless. A family therapist that overlooks this aspect of role-playing video games potentially misses a goldmine of identity-based information, as well as an opportunity to talk about family and couple interactions that create roles through which these identities manifest.

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In addition, whether a client plays an RPG as a ‘good’ or ‘evil’ character may say something about the way the client wishes to be perceived by others. A therapist might ask what it is about playing evil characters that appeals to a client, or if the way they try to be perceived in games is related to the way they wish to be perceived by their family or friends. The therapist can also facilitate conversations around these issues within the family. Similarly, a gamer who is presenting with problematic behaviour might play RPG as a ‘good’ character who helps others through good deeds and bravery. This could be a reflection of an innate desire to treat others well, a desire that presents as an interesting juxtaposition to the problematic behaviour that brings the client gamer into therapy as the identified patient of a family. Regardless, the therapist and family need to see all sides of the gamer to better understand and respond in ways that are helpful/effective.

The therapist and the family can also explore the preferred roles taken on by client gamers in the games they play. Through assessing which role the client gamer prefers to take in relation to others, such as being a healer versus an attacker, or an organiser/leader versus a follower when completing team-oriented tasks, the family therapist can gain valuable insight into how the client gamer sees him- or herself in relation to others, including family members. Perhaps they like sitting back and aiding in the success of others (healing) rather than leading the charge (attacking) or bearing the brunt of responsibility (absorbing damage). When families face challenges and/or have problems, members often take on different roles. The role client gamers prefer to take in their games of choice may indeed be a reflection of the roles they assume or wish they could assume in reality (Yee, 2006) or in the family context.

Social development

Video games, particularly when played in a relationally based, online multiplayer setting, are ripe with processes that can contribute to social development. Client gamers who play online are able to coordinate with others, make friends, find opportunities for leadership, and compete with one another (Jansz & Tanis, 2007; Olson, 2010).

Cole and Griffiths (2007) found that 76.2% and 74.4% of male and female MMORPG players, respectively, indicated that they had made good friends within the game, often in addition to already established friends who played with them. Yee (2006) found that 39.4% and 53.3% of male and female MMORPG players, respectively, felt that their online gaming friends were comparable or even better than friends in the real world. In Cole and Griffiths’ (2007) study, 39.9% of the participants said that there were sensitive emotional issues that they would discuss with online friends in the game, but not with real friends or family. If the family environment of a client gamer is not currently fit for ideal social development, the gamer may turn to video games as a means to meet these needs. From a systemic perspective, understanding what social needs the game is addressing could shed light on family processes that might be constraining development outside the game.

As Yee (2006) discusses, MMORPG can help players develop administrative skills, such as role assignment, task delegation, crisis management, logistical planning, and how to share rewards with others. Players can also take on leadership responsibilities like motivating group members, dealing with conflict, and fostering cohesion within the groups to which they belong. Though Yee (2006) discusses these factors in relation to MMORPG, development of these sorts of skills can be developed by the other genres as well. In the context of therapy, a clinician might help client gamers realise

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that they can translate these skills into the real world or into the family, particularly if they seem to be reporting struggles associated with these types of behaviours. For example, a client gamer who runs a guild in a MMORPG might be able to translate learned (and applied) leadership skills into managing how s/he handles sibling relationships in the real world.

Integration of Video Games, Identity Formation, and Social Development: A Case Example

To illustrate how the aforementioned information might be applied in family therapy, I offer a case illustration that highlights the intersection of video game use, identity formation, and social development. This example demonstrates how the ideas presented in this article are a new assessment and intervention tool that family therapists, even those not familiar with gaming, can use to better understand client gamers and their families.

Marcus, a 15-year-old black adolescent, and his adoptive white parents, Tom and Kate, came to therapy because Marcus, the identified patient, reported a struggle with ‘figuring out who he is.’ When the therapist asked Marcus to elaborate, he described difficulties with understanding his own racial identity in the context of an adoptive family that was upper-class and white – a stark contrast to his family of origin. He was forced into foster care at the age of 10 because his biological parents, both black and lower-class, died in a tragic car accident. Marcus was grateful for Tom and Kate, whom he got along with very well and even referred to as ‘mum and Dad.’ However, Tom and Kate explained to the therapist that they were finding it more and more difficult to help Marcus make sense of his racial identity as he was getting older and more independent. Tom and Kate were concerned because Marcus was often upset when he came home from school, but would shut himself in his room instead of talking with them about whatever was going on.

Marcus reported that he was beginning to struggle with defining his racial identity, particularly since his autonomy was becoming more important to him as a teenager.

This was very difficult for him to discuss with his parents since he perceived them as ‘biased since they are white.’ He explained that he would oscillate between ‘both worlds,’ and claimed that he would feel more at ease if he could figure out which race more closely defined him. Kate and Tom explained that they simply wanted to know how to support their son in his quest to figure himself out, and that neither had an agenda in terms of ‘picking a race.’ The goals in therapy were for Marcus to form a more concretised sense of identity and for Tom and Kate to better understand how to support this newly emerging identity.

After a few sessions, therapy seemed to stall. Marcus was increasingly frustrated that he seemed to take on either a white or black identity depending on context rather than holding on to a constant identity that mixed the two. He felt pressure to be white around Tom and Kate, which made these discussions awkward for him both in session and at home. Marcus’ oscillation appeared in therapy, where the therapist would talk to ‘black Marcus’ or ‘white Marcus.’ When the therapist asked what happens when he gets overwhelmed, Marcus mentioned that, rather than talk to Tom and Kate, he would shut himself in his room and play video games for hours on end to escape. The therapist, seeing potential in this disclosure, engaged in a deeper discussion with Marcus about his video game use to better understand him. His ª 2018 Australian Association of Family Therapy

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favourite game to play was the RPG Mass Effect. He spent hours upon hours moving his created character through the game’s storyline. Because the therapist knew that Mass Effect is a RPG with an in-depth character creation tool, he thought this might be a useful way to help everyone understand how Marcus saw and/or wanted to see himself, while also building an alliance through a shared interest/knowledge about the video games he played.

First, the therapist asked if the avatar Marcus created was representative of actual traits or of idealised traits. Marcus explained that he had not really thought about it, but that it was probably a mixture of both. What was most important to him, he claimed, was that the character he created allowed him to become immersed in the experience. Marcus had a revelation when the therapist asked him to describe the avatar he created. The avatar was white. In fact, any time Marcus could create his own avatar in different games (he also played the MMORPG World of Warcraft), he always created a white, male character. Only once had he ever created a black character. When the therapist asked how Marcus tended to play the game, he said that he preferred to play as a paragon (the ‘good’ side of morality) because he wanted the people in the game to like him and feel as if he is on their side. On the other hand, he played the one black character he created as a renegade (the ‘bad’ side of morality) because he wanted the character to be isolated from and feared by other characters in the game.

Marcus, Tom, and Kate learned that it was no coincidence that his white characters were good and his only black character was bad through a discussion of what the polarisation of attributes relative to character race meant. Marcus was subconsciously categorising white as good and black as bad, a consequence of resenting his biological parents’ death and appreciating his white parents’ adopting him, and he was playing that out in his video games. The therapist wondered aloud if there might be other parallel dynamics between Marcus’ everyday life and his lives within Mass Effect and World of Warcraft. Marcus said that he liked the way other players treated him in World of Warcraft, where he played as a white, human warrior. The vast majority of his friends at school were white, and Marcus said he felt more comfortable interacting with them because both the game and his adoptive family context allowed him to practice a white identity. He had, in effect, used the game to develop a sense of comfort within the white community that he judged as being more similar to himself. ‘I guess I choose to be white in my games because I can’t technically be white in real life,’ he said, through tears, at one point. Marcus also worried that Tom and Kate would be disappointed if he embodied more of a black identity. Both Tom and Kate were surprised and sad to hear him say this, and they were quick to reassure him that they had no interest in what identity/identities he took on, so long as he felt comfortable.

In later sessions, Marcus suggested that he would like to get in touch with the ‘blacker’ parts of him, but he did not feel comfortable doing so, nor did he know how. The therapist suggested that Marcus create a black character in both Mass Effect and in World of Warcraft, but that he play the black characters in the way he would normally play white ones, as a paragon and as a healer, respectively. The therapist hoped that Marcus would develop a sense of what it might be like to be ‘good’ and black at the same time in Mass Effect so that he could see what it would be like for the black parts of him to accomplish goals and save humanity. Since healers tend to be rare in World of Warcraft, and are therefore highly appreciated and sought after by

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other players, the therapist hoped that playing as a black healer would show Marcus that the black parts of him could be appreciated by others, and, in turn, by himself.

Tom and Kate were instructed to process with Marcus after he played with a deliberate emphasis on how his identity was playing out relative to the other characters and players in the game world. The therapist encouraged isomorphism between the game and reality by telling Tom and Kate to be particularly mindful of and empathic toward Marcus’ emerging black identity. Marcus’ final task, after he played as his black characters for a few weeks, was to construct an avatar that he felt integrated his white and black identities into a single, personal identity. In World of Warcraft, Marcus did this by constructing a druid-class, green troll. When asked why that was what he came up with, he said that the troll is unique, and that because he was a druid, he could change into different animals, similar to how he occasionally had to change between white and black. The goal of helping Marcus construct his identity was accomplished when, after several sessions, he said, I feel like I am a mix of white and black. People appreciate both, and I guess I should too. My white identity comes out more “warrior-like,” I guess. It’s up close and personal. But my black identity is there too, and is just as capable of relating with people.

It’s different, but I know that I can hold both simultaneously as a combination. I keep telling myself to be more like my troll – I never realised that I’m the one who gets to decide who I am.

This was helpful to Tom and Kate, too, because they were able to show Marcus their support and bear witness to him as he constructed his identity. They were thankful that his video game use opened up collaborative discussions that they would not otherwise have had with him. Marcus felt understood, and therefore felt more comfortable talking with Tom and Kate about his emerging identity rather than shutting himself in his room. Had the therapist viewed Marcus’ video game use as merely a distraction rather than as a launching pad into deeper conversations about the presenting problem, the family may never have been given a foundation from which to engage in the complex discussions of Marcus’ identity.

Ultimately, the therapist’s knowledge of video games and their potential for assessing and intervening with identity formation and social development allowed therapy with Marcus and his adoptive parents to achieve a high degree of success. Knowing that Mass Effect was an RPG meant that the therapist knew there was likely a character creation tool that may provide insight into Marcus’ sense of self in his current systemic context. Had the therapist not had knowledge of video games and their potential, he very likely would have dismissed Marcus’ video gaming as simply a source of entertainment, or even a means to avoid. Instead, the therapist was able to use Marcus’ video gaming as a way to bridge Marcus’ struggle with forming his identity in a context within which it felt safer to explore.

Recommendations to Therapists

Upon reading all of this information, particularly if all or most of it is ‘brand new,’ a therapist may be left wondering ‘what do I do with it?’ Knowing this information already puts a therapist who works with clients that play video games at an advantage, because it expands the role video games can play in the therapeutic context. That said, I do have some specific recommendations for how to use the information from this article in practice: ª 2018 Australian Association of Family Therapy

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If a client mentions that they play video games, ask what kind of video games they play: Not only will asking for more information about a person’s video gaming likely positively affect the therapeutic alliance, but the therapist will also get a sense of the types of video games that person plays (genre, specific titles).

Ask clients what types of roles they enjoy playing in their video games: As mentioned earlier, the various roles clients take on in their video games may say something about the roles they enjoy (or could) take on in their real lives.

Do some research and be curious: Take some time to read about the video games a client is playing. What genres, storylines, themes, roles, etc. are common? What time commitment do the games require? How might that affect their role in their respective system(s)?

Ask clients about the characters they create or prefer to play as: Understanding the types of characters clients create or choose to play as can say a lot about their respective wishful and similarity identification. Ask specific questions about whether the gamer consciously chooses how to create their characters, or if the way they create them is in any way meaningful.

Avoid assuming that if a client plays video games they must be ‘addicted’ or that they are merely used for entertainment purposes: These assumptions negate the very real possibility that a client’s video gaming could play a vital role in their life. Trivialising the playing of video games could damage the therapeutic alliance in this type of situation, and the therapist may potentially miss out on the valuable information described in this article.

Conclusion

In this article, I introduced family therapists to a new way of using video games as an assessment and intervention tool in family therapy. I discussed the variety of video game genres, explained how video games might contribute to identity formation/reflection and/or social development, and provided a case example to illustrate the use of video games as a clinically relevant assessment and intervention tool. There is an infinite number of ways to do this, and, of course, this article is simply a starting point. Although I have extensive experience with video gaming both in and outside the family therapy world, not all information I provided in this conceptual article is founded in research. Hopefully, these initial thoughts will stimulate others to take a closer look at the potential of video gaming as an assessment and intervention resource that speaks directly to the lives of many of our current and future clients.

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