Are Improvements in Anxiety Associated with How Children Play MindLight?

Project Lead Category Project status
Aniek Wols Anxiety | Depression Completed

The video game MindLight has been found to be an effective anxiety prevention program (see project: MindLight - Childhood Anxiety Prevention). However, we don’t know whether the clinical techniques incorporated in the game were responsible for the observed changes in anxiety symptoms. In this project we examined how children play MindLight, to what extent they interact with the clinical techniques in the game and how that relates to their anxiety improvements.

Project team


Anxiety disorder is the most prevalent and frequently diagnosed disorder in youth, and associated with serious negative health outcomes. Our most effective prevention programs, however, have several limitations. These limitations can be addressed using game-based interventions1. Results from two randomized controlled trials on the video game MindLight show improvements in anxiety that are maintained up to six months2,3. The game was designed based on evidence-based therapeutic techniques; however, it is unclear if children’s engagement with these techniques actually predict improvements in anxiety symptoms. An important advantage of game-based interventions is that they provide excellent opportunities to isolate therapeutic action mechanisms and test their impact on intervention outcomes. In the current study4, on-screen videotaped output while playing MindLight was coded and analysed for forty-three 8 to 12-year old children with elevated levels of anxiety. Results showed that changes in in-game play behaviours representing therapeutic exposure techniques predicted improvements in anxiety symptoms three months later (when children had not played the game for three months). The current study is a first step towards identifying and validating game mechanics that can be used in new applied games to target anxiety symptoms or other psychopathologies with the same underlying deficits.


Estimation of sub-clinical levels of anxiety in children


Variance in anxiety symptoms explained by in-game play behaviours


Children's succesrate of destroying fear events and monsters


  • Preregistration: The Effect of Expectations on Experienced Fun, Mood, State-Anxiety and In-Game Play Behaviours while playing MindLight

    Wols, A., Hollenstein, T., Lichtwarck-Aschoff, A., & Granic, I. (2019).

    Author: Aniek Wols

    Upload date: 07-05-2019

  • In-Game Play Behaviours during an Applied Video Game for Anxiety Prevention Predict Successful Intervention Outcomes

    Wols, A., Lichtwarck-Aschoff, A., Schoneveld, E. A., & Granic, I. (2018). Journal of Psychopathology and Behavioral Assessment, 40, 655-668.

    Author: Aniek Wols

    Upload date: 06-11-2018

Project team

Aniek Wols title=
Aniek Wols
Researcher at GEMH Lab

I am interested in how and why applied games for mental health work, with a specific focus on the influence of one's mindset, motivation and expectations.


PhD-Candidate at Radboud University


E-mail Aniek

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

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

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


All sources
  1. Granic, I., Lobel, A., & Engels, R. C. M. E. (2014). The benefits of playing video games. American Psychologist, 69, 66-78. doi:10.1037/a0034857
  2. Schoneveld, E. A., Malmberg, M., Lichtwarck-Aschoff, A., Verheijen, G. P., Engels, R. C. M. E., & Granic, I. (2016). A neurofeedback video game (MindLight) to prevent anxiety in children: A randomized controlled trial. Computers in Human Behavior, 63, 321-333. doi: 10.1016/j.chb.2016.05.005
  3. Schoneveld, E. A., Lichtwarck-Aschoff, A., & Granic, I. (2018). Preventing childhood anxiety disorders: Is an applied game as effective as a cognitive behavioral therapy-based program? Prevention Science, 19(2), 220-232. doi: 10.1007/s11121-017-0843-8

  4. Wols, A., Lichtwarck-Aschoff, A., Schoneveld, E. A., & Granic, I. (2018). In-game play behaviours during an applied video game for anxiety prevention predict successful intervention outcomes. Journal of psychopathology and behavioral assessment, 40(4), 655-668.