292 Chapter 6 anticipating that they would have to explain their choice. In everyday situations, game choice may be a more instinctive choice (i.e., based on unconscious decision processes) as well as a more implicit choice (i.e., multiple games may be played and selecting game X does not rule out playing game Y). Consequently, future research exploring more promotion channels for therapeutic games and the relative success of explicit and stealth messaging will be valuable. Youth can be recommended video games through a myriad of sources such as friends, blogs, forums, online video game stores (e.g., Steam), video game news and review sites and popular video game players who demonstrate games online (e.g., on YouTube or Twitch). Research on any of these sources of recommendations can help clarify if messaging may need to be adapted per situation. Additionally, alternative messaging may be explored. For example, messaging may combine entertainment and mental health messaging in various proportions or alternatively explicit messaging may describe causes of mental health issues rather than the effects of the game. A recent study shows that young adults believed a mental health app to be more useful and had higher intentions to use it if a prior message emphasized internal causes of depression (Khan & Peña, 2017). Furthermore, in real-life youth may only play a video game after receiving recommendations from multiple sources (e.g., a friend, review site and popular gamer recommending the same game) and future research may study this complexity (see Konijn et al., 2013 for methods to use YouTube for research purposes). In order to enhance the generalisability of the research results further, researchers may provide more choice to youth. Certainly, if youth are presented with an entire webpage of video games, which may easily contain 50 video games, the chances of them selecting a single mental health game will be lower than the almost 60% found in the present study. However, given the fact that youth would not necessarily only play one game recommended on such a page, it will be critical to see if youth will consider mental health games in such a scenario and what aspects influence the likelihood for youth to play therapeutic games. In addition to messaging, individual characteristics besides symptoms may also influence game choice and experience. The current study did not assess if participants were diagnosed with a mental health disorder nor if they themselves believed that they had a mental health disorder. Participants who are aware of a mental disorder may be more likely to select a mental health game as they feel that is meant for them in comparison to participants who do not identify their symptoms as a coherent mental issue. Additionally, game choice is likely affected by personal motivational factors, the individual’s
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