MindLight - Childhood Anxiety Prevention

Project Lead Category Project status
Elke Schoneveld Anxiety | Depression Completed

Many children have difficulties with fearful situations and are anxious. Interventions can help to teach children to cope effectively with anxiety-inducing situations. In our project, we rigorously tested whether an intervention in the form of a video game (MindLight) is effective in significantly reducing anxiety symptoms in children 8-12 years old. We did this by comparing MindLight to 1) a commercial game and 2) the gold-standard, cognitive-behavioural therapy for anxiety (Coping Cat). Furthermore, we evaluated the motivational characteristics of MindLight and for whom (e.g., age and gender differences) it is effective.

Project team


Childhood anxiety is a global mental health concern (Merikangas et al., 2010). However, our most advanced programs often lead to disappointing outcomes (Fisak, Richard, & Mann, 2011; Mychailyszyn, Brodman, Read, & Kendall, 2012). Interventions are needed that are effective, cost less, are more accessible and engage children long enough to build emotional resilience skills through practice. Video games promise a new, playful training ground that may address limitations of past prevention programs (Granic, Lobel, & Engels, 2014). Yet validated games for mental health are virtually nonexistent. We evaluated the effectiveness of MindLight, a new applied game, through two randomized controlled trials (RCTs).

MindLight is a 3D neurofeedback game designed to translate evidence-based, but often dull, clinical techniques for anxiety reduction into game mechanics that provides children with an immersive game world. Techniques embedded in the game are neurofeedback training (Price & Budzynski, 2009), exposure training (e.g. Feske & Chambless, 1995) and attention bias modification (Bar-Haim, Morag, & Glickman, 2011). MindLight aims to prevent the escalation of anxiety in at-risk children. In addition to the evaluation, we addressed serious methodological limitations of past studies on applied games, such as the lack of RCTs, a focus on short term effects and the use of a non-active control group.

The two RCTs followed a similar method: over 750 elementary school children (7-13 years old) were screened for elevated anxiety. Selected children (RCT 1: n = 136; RCT 2: n = 174) were randomly assigned to play MindLight or to a control condition, which was the commercial video game Max and the Magic Marker (RCT 1) or the most effective cognitive behavioral prevention program: Kendall’s Coping Cat (RCT 2; Flannery-Schroeder & Kendall, 1996). Self- and parent-reported anxiety was assessed at pre-, post-intervention, 3- and 6-months (RCT 2 only) follow-up.

The primary hypothesis of the first RCT was that children who played MindLight, compared to Max, would report reduced symptoms of anxiety at post-intervention and 3-month follow-up. Intent-to-treat analyses revealed an overall significant reduction in child- and parent-reported anxiety, but the magnitude of improvements did not differ between conditions (Schoneveld, et al., 2016).

The second RCT was registered as a non-inferiority trial: it was hypothesized that children in both conditions (MindLight and Coping Cat) would show a decrease in anxiety levels at post-intervention, 3- and 6-months follow-up. As expected, similar results were found: children in both conditions showed an overall significant reduction in anxiety, but the magnitude of improvements did not differ between conditions.


Estimation of sub-clinical levels of anxiety in children


Completed interventions


Recommends MindLight to other children


Both randomized controlled trials have shown that MindLight reduces anxiety levels. The first trial showed that MindLight was equally effective as a commercial game, Max and the Magic Marker. The second trial showed that it was as effective as the gold-standard cognitive behavioral therapy for anxiety.


  • The Benefits of Playing Video Games

    Granic, I., Lobel, A., & Engels, R. C. (2014). American Psychologist, 69, 66-78.

    Author: Isabela Granic

    Upload date: 01-17-2014

  • Reductions of Anxiety Symptoms, State Anxiety, and Anxious Arousal in Youth Playing the Videogame MindLight Compared to Online Cognitive Behavioral Therapy

    Tsui, T. Y., DeFrance, K., Khalid-Khan, S., Granic, I., & Hollenstein, T. (2021). Games for Health Journal, 10(5), 330-338. https://doi.org/10.1089/g4h.2020.0083

    Author: Tiffany Y.L. Tsui

    Upload date: 09-28-2021

  • Mental Health Outcomes of an Applied Game for Children with Elevated Anxiety Symptoms: A Randomized Controlled Non-inferiority Trial

    Schoneveld, E.A., Wols, A., Lichtwarck-Aschoff, A., Otten, R., & Granic I. (2020). Journal of Child and Family Studies. https://doi.org/10.1007/s10826-020-01728-y

    Author: Elke Schoneveld

    Upload date: 06-24-2020

  • What Keeps Them Motivated? Children’s Views on an Applied Game for Anxiety

    Schoneveld, E. A., Lichtwarck-Aschoff, A., & Granic, I. (2019). Entertainment Computing, 29, 69-74.

    Author: Elke Schoneveld

    Upload date: 03-01-2019

  • Childhood Anxiety Prevention: An Evaluation of the Applied Game MindLight [Doctoral Dissertation]

    Schoneveld, E. A. (2019). Doctoral dissertation

    Author: Elke Schoneveld

    Upload date: 02-26-2019

  • Preventing Childhood Anxiety Disorders: Is an Applied Game as Effective as a Cognitive Behavioral Therapy-Based Program?

    Schoneveld, E. A., Lichtwarck-Aschoff, A., & Granic, I. (2017). Prevention Science, 1-13.

    Author: Elke Schoneveld

    Upload date: 09-27-2017

  • A Neurofeedback Video Game (MindLight) to Prevent Anxiety in Children: A Randomized Controlled Trial

    Schoneveld, E. A., Malmberg, M., Lichtwarck-Aschoff, A., Verheijen, G. P., Engels, R. C., & Granic, I. (2016). Computers in Human Behavior, 63, 321-333.

    Author: Elke Schoneveld

    Upload date: 10-01-2016

Project team

Elke Schoneveld title=
Elke Schoneveld

Graduate and psychologist interested in the effect of games on mental health. Likes why-questions, social impact and multidisciplinary collaboration. Bubbly, (not so crazy) cat lady and outdoor enthusiast.




E-mail Elke

Anna Lichtwarck-Aschoff title=
Anna Lichtwarck-Aschoff

I am not so interested in *whether* certain interventions work but *how* they work. That is, I am mainly focusing on underlying processes and mechanisms of change across diagnostic categories and different treatment modalities. Mother of two wild boys!


Professor of Orthopedagogics at University of Groningen


E-mail Anna

Isabela Granic title=
Isabela Granic
Director of GEMH Lab

Professor and Chair of the Developmental Psychopathology department in the Behavioural Science Institute; writer; voracious podcast consumer; mother of two upstanding little gamers


Professor at McMaster's University & Co-founder of PlayNice Interactive


E-mail Isabela

Rutger Engels title=
Rutger Engels


CEO at Trimbos Institute / Professor Developmental Psychopathology Utrecht University


E-mail Rutger

Geert Verheijen title=
Geert Verheijen

Researcher with a focus on the social development of teens, interested in the effects of average, day-to-day video game use. enthusiastic board gamer & self-proclaimed institutional champion of Super Smash Brothers.




E-mail Geert

Tom Hollenstein title=
Tom Hollenstein

Associate Professor in Developmental Psychology at Queen's University in Kingston, Ontario, Canada.


Associate Professor at Queen's University


E-mail Tom


All sources
  1. Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., ... & Swendsen, J. (2010). Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980-989.
  2. Fisak, B. J., Jr., Richard, D., & Mann, A. (2011). The prevention of child and adolescent anxiety: a meta-analytic review. Prevention Science, 12(3), 255e268. http://dx.doi.org/10.1007/s11121-011-0210-0.
  3. Mychailyszyn, M. P., Brodman, D. M., Read, K. L., & Kendall, P. C. (2012). Cognitive behavioral school-based interventions for anxious and depressed youth: a meta-analysis of outcomes. Clinical Psychology-Science and Practice, 19(2), 129e153. http://dx.doi.org/10.1111/j.1468-2850.2012.01279.x.
  4. Granic, I., Lobel, A., & Engels, R. C. M. E. (2014). The benefits of playing video games. American Psychologist, 69(1), 66e78. http://dx.doi.org/10.1037/a0034857.
  5. Price, J., & Budzynski, T. (2009). Anxiety, EEG patterns, and neurofeedback. Introduction to quantitative EEG and neurofeedback: Advanced theory and applications, 453-470.
  6. Feske, U., & Chambless, D. L. (1995). Cognitive-behavioral versus exposure only treatment for social phobia: a meta-analysis. Behavior Therapy, 26(4), 695e720.http://dx.doi.org/10.1016/s0005-7894(05)80040-1.
  7. Bar-Haim, Y., Morag, I., & Glickman, S. (2011). Training anxious children to disengage attention from threat: a randomized controlled trial. Journal of Child Psychology and Psychiatry, 52(8), 861e869. http://dx.doi.org/10.1111/j.1469-7610.2011.02368.x.
  8. Flannery-Schroeder, E. C., & Kendall, P. C. (1996). Cognitive-behavioral therapy for anxious children: Therapist manual for group treatment. Ardmore, PA: Workbook.
  9.  Schoneveld, E. A., Malmberg, M., Lichtwarck-Aschoff, A., Verheijen, G. P., Engels, R. C., & Granic, I. (2016). A neurofeedback video game (MindLight) to prevent anxiety in children: A randomized controlled trial. Computers in Human Behavior, 63, 321-333.