Another interesting distinction in game genres or game types is that of Exergames. Broadly speaking ‘exergames’ are all games that are controlled by bodily movement. Think of a game of virtual tennis, bowling or raft racing (Wii) and games like Dance Dance Revolution.

“Recently videogames that use physical input devices have been dubbed “exergames” — games that combine play and exercise.” (Bogost, 2005)

There was – and sometimes still is – concern that playing all these videogames is making us less physically active. Video games over the years have moved from the arcades of the 1970’s and 1980’s to desktops or game consoles in our living rooms, as well as to mobile platforms in our pockets. This means that we went from playing games (mostly) while standing up, slamming on big buttons and rattling a joystick to playing games (mostly) while sitting down and manipulating smaller buttons or keys with our fingertips (Bogost, 2005). By adding to our screen-time and our sedentary lifestyle, gaming was thought to be bad for our health and especially the health of our young people (Vandewater, Shim, & Caplovitz, 2004). In a time when the problem of child-obesity is of epidemic proportions, these concerns seem relevant. So eyes and hopes were turned to promoting a different method of game interaction; still on a screen but obliging the player to move around in order to control the game. Exergaming seems like a promising solution to the threat of sedentary gaming.

In order for all exergaming to work, some sort of sensoring is required. Sensors that can capture our bodily movements became more advanced and cheaper – making their way from research and therapeutic settings into peoples’ homes. Exergames are now used voluntarily in many living rooms, where the physical interaction is not viewed as ‘exercise’ but the whole game experience is viewed as entertainment.

Interacting with an exergame requires a certain expenditure of energy – more than a sedentary screen based interaction would – but not to the same amount as the original physical interaction that is being mimicked in the game environment (Daley, 2009).

Bogost, I. (2005). The rhetoric of exergaming. Proceedings of the Digital Arts and Cultures (DAC).
Vandewater, E. A., Shim, M.-s., & Caplovitz, A. G. (2004). Linking obesity and activity level with children’s television and video game use. Journal of adolescence, 27(1), 71-85.
Daley, A. J. (2009). Can exergaming contribute to improving physical activity levels and health outcomes in children? Pediatrics, 124(2), 763-771. doi: 10.1542/peds.2008-2357

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DEAL WITH IT / Serenity

One of the things out there that can give us more insight into coping by breaking a few things down is the structure of Primary and Secondary Appraisal (Chesney, Neilands, Chambers, Taylor, & Folkman, 2006). These are the two connected processes of looking at a situation to see if it is stressful and then deciding how to deal with it (being of aware of these two processes and being able to purposefully direct them would be meta-cognition).

Primary Appraisal is where we ask ourselves “Do I care?”. If we think that yes, this does matter to us and that this might take a lot of resources than the situation is judged as possibly stressful.

If so, secondary appraisal begins by asking “What can I do about it?”. Immediately tapping into your sense of control – or not – and your sense of self-efficacy – or not. It matters here that you value yourself and your skills and you recognize the abilities you have and foresee yourself applying them with vigour. It also matters that you see the situation for what it is and make a realistic judgement about how much of it can be changed. By you or by anyone else.

Secondary Appraisal continues into “What am I going to do about it?”. The answer to this question is your selected coping strategy – and more effort is not always the right answer. Sometimes in life there is really not much we can change about a situation. You would be better of trying to deal with it differently instead of trying to change it. There is no predetermined right or wrong coping strategy because it always depends. Mostly it depends on how much control you can have and how many resources you have available, emotional or otherwise.

When you choose a coping strategy that matches the amount of control you have, we call this ‘adaptive coping’ and this leads to fewer negative psychological symptoms than ‘maladaptive coping’ (Park, Folkman & Bostrom, 2001). Adaptive coping might mean that you select to do nothing because there is nothing that can be done, except deal with how you feel about it.

In my opinion this Secondary Appraisal process is most eloquently expressed in the Serenity Prayer (Reinhold Niebuhr, 1892-1971), famously used by Alcoholics Anonymous:

God, grant me the serenity to accept the things I cannot change,
The courage to change the things I can,
And the wisdom to know the difference.


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Rehabilitation thinking for games in health

Designing and researching games in health has underlayers of models we (unwittingly) hold on what rehabilitation should be  – and held within this our concepts of disability – driving our design decisions or the questions we ask.

Rehabilitation: all measures that aim to lessen bodily, mental or psychological disability or social isolation or the effects thereof and to guide those afflicted by it (back) into society

(Franke, 2010).

Following this definition every measure that was intended to lessen suffering should be thought of as rehabilitation. It would follow that any measure intended to rehabilitate someone is ‘rehabilitation’ regardless of the effect of such a measure, at the same time the definition does not leave room for measures that might not have been intended to rehabilitate but in effect lessen a person’s disability. Here we find the same hopeful designer-driven definition as we do in Serious Games versus the more effect driven definition of Serious Gaming (see my chapter Understanding Serious Gaming for more on this).

In the application of gaming in rehabilitation we can often recognise INTEGRATION and even SEGREGATION thinking. Supposedly, a subgroup of humans (the disabled) is in need of games that are different from games for ‘normal’ people. In this line of thinking segregation occurs for example when hard- and software platforms are especially built for the disabled. An integration approach would be to build different games for the disabled but using the same platform as ‘normal’ players.

When a game is prescribed as part of a therapy – when the game is on a device made exclusively for the disabled and the gameplay is entirely focused on rehabilitative action, than these games adhere to the MEDICAL or NATURAL MODEL. In this model of thinking disease is an opposite state to health and never the twain shall meet. The SALUTOGENESE MODEL views health and disease not as a dichotomy but as a gliding scale (Lindstrom, 2010). In this model every person at every moment in their lives is healthy to some extend and unhealthy to some extend. So even when we are diagnosed as diseased (by the medical model) there are parts of our lives in which we are healthy. Thinking within either the medical or the salutogenese model leads to a different approach of the player and possibilities for gameplay. One can approach the design as for the ‘disabled’ or for a ‘player with a disability’.

Some definitions of disability concern the limitations in the expression of individuality, normality, adaptation and differentiation (Franke, 2010). Games can allow for all different kinds of expression by their designers and by their players. They move in between the realms of art, exploration, creation and learning.  There are different ways in which mediated games could be used to bend limitations of expression that disabled people might struggle with. A game designed in such a way that the experience of a disabled person may be shared with any another human being connects the gameplay to the Right of Community and Participation (Franke, 2010).

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Keep your arousal high

We often think of the responses of our body and our emotional state as linked to our performance. “My heart is racing. I am terribly nervous because I am no good at…..”. However, this is not necessarily a valid conclusion. ‘Nervous’ is a combination of a physical state (aroused) and an emotional one (anxious) which is attached to a moral judgement of your behaviour (no good). Seems logical. But the response of our body could have been attached to a different judgement, accompanied by a different emotion and it would seem just as logical. “My heart is racing. I am all pumped up and ready to go rock this….”. You still have an aroused physical state but with a positive emotion (excitement) and the moral judgement turns the other way (all good).

One of the factors determining the likelihood of you going emotionally one way or the other is your sense of self-efficacy. People with a high sense of self-efficacy tend to see arousal as some extra push by their body, a trigger to ACT. People with a low sense of self-efficacy interpret the same arousal as an obstacle. A sign to stop and sit down until the arousal goes away or even worse, they take it as a sign that their capabilities are insufficient and that they cannot possibly do this.

The advice we get to combat nervousness and plummeting self-esteem often targets our level of arousal: sit down and take a few breaths – in through your nose, down to your belly button and out your mouth. Sound familiar? You could also, perhaps more effectively, leave your arousal where it is and try to change your emotional state by focusing on what is going to make this a positive experience for you. Connect it to some core value you have, play with it and shape it in some way you would actually enjoy experiencing it.

Most importantly focus on that which YOU believe you can do – connect it to where your self-efficacy is highest and start shaping it from there. Keep your arousal high and let it work for you. Your higher heart rate makes you more alert and gives all your senses a boost to perform at their best. It is the same experience of an athlete, crouched down and ready to race.

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Does a game prompt make us excited? Small online experiment

Finally online at ResearchGate – my presentation during Berlin Playweek 2016 at the Researching Games Barcamp

The effect of a Game Prompt on Self-Efficacy concering problem solving challenges of living with Diabetes type II.


Initial results, would love to know your thoughts or comments on @ThePrisca

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Dopamine Jackpot! by Sapolsky

Sapolsky explaining why we respond so strongly to to ‘what if’ and ‘maybe’.
Part of the motivation power in gaming comes from the effect of ‘maybe’ on the dopamine system. Give chance a chance.

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