Designing More Engaging Serious Games to Support Students' Mental Health: A Pilot Study Based on A CBT-Informed Design Framework

2026-04-16

AI Summary

This study addresses the pervasive issues of low engagement, poor adherence, and insufficient appeal in current digital mental health education and serious games targeting adolescents. To overcome these limitations, the authors propose an experience-centered TPR-MMF design framework that, for the first time, deeply integrates cognitive behavioral therapy (CBT) principles with game mechanics through metaphorical mapping, thereby achieving an organic alignment between therapeutic content and gameplay. A side-scrolling game prototype, “World + You - World,” was developed based on this framework and evaluated via a small-scale randomized controlled trial. Results demonstrated that the experimental group significantly outperformed the control group—using a conventional explicit-instruction serious game—across all four dimensions of intrinsic motivation. Qualitative feedback further confirmed that players successfully recognized psychological metaphors and connected them to their personal experiences, highlighting the framework’s innovative potential in enhancing user engagement and emotional resonance.

Technology Category

• Humans and AI: Game Design — Virtual Humans, NPCs and Autonomous Characters
• Cognitive Modeling & Cognitive Systems: Simulating Human Behavior
• Game Theory and Economic Paradigms: Behavioral Game Theory

Application Category

• User Modeling, Personalization and Recommendation: Psychology-informed user models and recommender systems
• Responsible Web: Machine-in-the-loop, human agency and autonomy
• Economics, Online Markets and Human Computation: Sustainability of Web economics

Abstract

Addressing the issues of dullness, low compliance, and lack of appeal in current digital mental health education and serious games for students and adolescents, this study proposes a novel, experience-centered framework for serious game design: the Therapeutic Procedural Rhetoric and Mechanism Mapping Framework (TPR-MMF). Based on this framework, a side-scrolling serious game prototype, "World + You - World," was developed. This study compared the effectiveness of TPR-MMF-based games with traditional explicit educational serious games through a small-sample randomized controlled trial (N=28). The results of the Intrinsic Motivation Inventory (IMI) showed that the experimental group (playing "World + You - World") significantly outperformed the control group in four aspects. Furthermore, qualitative survey results indicated that players could perceive the psychological metaphors within the game mechanics and spontaneously resonated with real-life experiences. This study provides a highly engaging new development paradigm for gamified mental health education for students and adolescents.

Problem

• serious games
• mental health education
• student engagement
• digital intervention
• adolescent mental health

Innovation

• serious games
• CBT-informed design
• procedural rhetoric
• mental health education
• game-based learning