22 Chapter 1 I. Oliver et al., 2005; Sawyer et al., 2012; Van Starrenburg et al., 2017). Yet, little research has examined the influence of symptom severity on the engagement and positive outcomes of applied games. While certain nonspecific factors may have independent effects in applied games, they may also interact with one another. For instance, individuals’ motivation to change may be related to the severity of symptoms experienced (Dozois et al., 2004). Additionally, the influence of expectations on engagement and positive intervention outcomes may be moderated by motivation to change and symptoms severity (Buday, 2015; M. B. Oliver & Krakowiak, 2009). Furthermore, it has been hypothesised that nonspecific factors interact with specific factors in the prediction of positive intervention outcomes (Boot et al., 2013; Greenberg et al., 2006; Kazdin, 2005; Messer & Wampold, 2002). For example, an individual more motivated to change or experiencing more severe symptoms may engage more with the (specific) therapeutic techniques in the game, and subsequently show larger improvements in mental health (Buday, 2015; Dean et al., 2016; M. B. Oliver & Krakowiak, 2009). Conversely, it is possible that individuals experiencing more severe symptoms exhibit lower levels of engagement with the therapeutic techniques embedded in the game, as it confronts them with their problems (Poppelaars, Lichtwarck-Aschoff et al., 2018). It is important to devote attention to these interaction effects as insights into the complexity of factors at work may give critical information about individual differences in intervention outcomes. By utilising knowledge about both specific and nonspecific factors, applied games for mental health can be optimised. PROMOTING AND DELIVERING GAMES FOR MENTAL HEALTH: INTERVENTION REACH AND UPTAKE As outlined earlier, video games offer a significant advantage when it comes to their implementation potential (Granic et al., 2014; Kazdin, 2015; Lau et al., 2017). On the one hand, effective applied and casual games can be used in a clinical setting to complement traditional intervention approaches, reinforcing therapeutic techniques, providing additional support or enhancing engagement between sessions (e.g., Beaumont et al., 2021; Ducharme et al., 2021; Schuurmans et al., 2018). They can also be utilised as replacements for (school-based) prevention programs, offering interactive and engaging interventions to address mental health concerns (e.g., Schoneveld et al., 2018). On the other hand, video games also have the capacity to be distributed and
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