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Horizon: Resilience – Design of a Serious Game for Ecological Momentary Intervention for Depression

Depression is the world’s most prevalent mental disorder and the primary source of disability adjusted life years (DALY). While traditional face-to-face therapies have been shown to be effective, alternative delivery methods, e.g. internet-based therapies, have been investigated to overcome barriers to access, such as lack of availability of therapists and infrastructure. This article presents the design of a mobile serious game as a novel psychological momentary ecological intervention for depressive symptoms. We discuss how selected principles and techniques of common psychological frameworks used to tackle depression, namely Cognitive Behavioral Therapy (including Behavioral Activation) and Positive Psychotherapy, were integrated in the game concept, gameplay and game mechanics of ”Horizon: Resilience”, a City Building and Decision Making serious game. The selected techniques are put central in the game design by introducing ”the Power R(esilience)”, which groups the psychological principles of motivation for change, cognitive flexibility, activation and positivity. While identifying with game characters and maintaining high levels of the Power R, the players are introduced to and learn to use Cognitive Behavioral Therapy and Positive Psychotherapy strategies, which they can ultimately apply in their real-life depressive symptomatology.