David OA & Fodor LA. Preventing mental illness in children that experienced maltreatment the efficacy of REThink online therapeutic game. npj Digit. Med. 6, 106 (2023). https://doi.org/10.1038/s41746-023-00849-0
This article reports on a randomized controlled trial to test the efficacy of REThink, an online therapeutic game, compared to usual care in preventing mental illness in children who have experienced maltreatment. REThink was developed based on a transdiagnostic cognitive-behavioral therapy and has an action and adventure approach to learning and practicing therapeutic tasks. Each REThink level/session is completed weekly using a mobile device under the supervision of study staff. Children aged 8-12 years with self-reported maltreatment history (N=294) were recruited from schools. Participants completed pre- and post-intervention assessments measuring mental health, emotion regulation, and irrational cognitions. In the REThink group, 65% of the children completed all of the levels/sessions of the game and 18% dropped out from treatment. The REThink intervention arm was found to have a significantly lower level of emotional problems (d=0.42, p=0.001), mental health problems (d=0.35, p=0.007), maladaptive emotion regulation strategies (catastrophizing: d=0.41, p=0.002; self-blame: d=0.26, p=0.017) and irrational cognitions (d=0.54, p<0.001) compared to the control arm post-intervention. Additionally, children with higher maltreatment severity benefitted the most from the REThink game and children with lower parent attachment security benefited the least. Future research is needed to test the long-term efficacy of the REThink game.