340 Chapter 8 and motivation to change did not significantly influence game experiences and in-game play behaviours. These findings suggest that MindLight is a viable prevention program suitable for children exhibiting elevated anxiety symptoms. In this thesis, we not only uncovered promising results for MindLight but also our systematic review in Chapter 2 highlighted the potential of a diverse range of both applied and casual games to enhance mental health among youth with (sub)clinical symptom levels. Particularly noteworthy is that many of these games proved as effective as traditional, expert-led clinical gold standard programs, even when utilised without the direct involvement of therapists. These findings offer a potential solution to the escalating mental health problems and the subsequent widening gap between the demand and supply of mental health services (Bijl et al., 2003; Collishaw, 2015; Olfson et al., 2015). This gap is exacerbated by the shortage of mental health professionals and long waiting lists (Van Den Broek et al., 2022; Vektis, 2022). To address the growing demand for mental health services, effective applied games that do not necessitate expert supervision could be provided to youth while they are on the waiting list for mental health services. This approach may prevent demotivation among youth facing long waiting times. By offering access to applied games proven to be effective in reducing (elevated) mental health symptoms, it becomes possible to alleviate some of their mental health challenges early on and potentially shortening the overall duration of therapeutic services or its necessity at all. Additionally, engaging with a video game during this waiting period may serve as a non-threatening and non-stigmatising entry point for youth into their mental health service journey (McGonigal, 2011), further enhancing engagement and motivation and thereby the likelihood that youth will actively participate in subsequent mental health services (Fleming et al., 2017; Granic et al., 2014; Kazdin, 2015). While the implementation of games during the waitlist period holds promise, future research should examine the specific conditions under which this implementation is most fruitful and how it should be structured in practice. It is suggested that the evaluation of this approach is conducted in the exact setting where it will be deployed (Mohr et al., 2017). While the advantages of video games lie in their ability to be distributed at low cost and with minimal effort, offering substantial scalability and costeffectiveness (Granic et al., 2014; Kazdin, 2015), it is crucial not to underestimate the initial investment required. Designing and testing truly engaging and intrinsically motivating games require partnering up with professional game designers, as well as entail considerable monetary expenses and time
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