Thorens et al argue that the naturalistic use (ie, outside of traditional interventions) of digital games may be particularly helpful given game design practices that motivate players to continue to play, such as online, social play, and reward schemes. In fact, a number of commercial games have been adopted and tested as unique forms of therapy. Games can increase the impact of mental health interventions due, in part, to their broad appeal, accessibility, and ability to keep participants engaged. Research shows that games appear to be well-suited for promoting mental health awareness and possibly as interventions. With regard to games and mental health, researchers and therapists have increasingly turned to digital games for new forms of treatments and interventions for those dealing with mental health issues. The results of this study should help us better understand Hellblade’s depiction of mental illness but also the collaborative design process behind its creation. Specifically, we examine how various frames and design choices were used to create a compelling experience related to mental illness while alleviating concerns of trivializing such a serious topic. Secondly, this study turns to the use of frame analysis in order to better understand the design and development decisions used by Ninja Theory to depict symptoms of psychosis and how future games can emulate Hellblade’s success. This formal analysis was used to identify the components, actions, and goals present in Hellblade. First, Hellblade is used as a case study in which a formal analysis was conducted. This paper analyzes Hellblade in two ways. As a result, Hellblade is a game that could contribute to numerous conversations across various fields, such as psychology and game studies. Hellblade is significant because it is one of only a very few commercial video games to ever tackle the serious topic of mental illness and perhaps the most successful, returning a profit in sales after only 3 months. Hellblade’s presentation of Senua’s psychosis provides interesting insights into how games can depict challenging, controversial topics. In Hellblade, players take on the role of Senua, a female Pict warrior on a quest that quite literally tests her sanity. Hellblade: Senua’s Sacrifice, hereby also referred to as Hellblade, is a digital game developed and independently published by Ninja Theory, which is a British game development studio based out of Cambridge, England. Researchers and smaller independent game designers frequently create serious games that are typically smaller games or game-like experiences whose primary purpose is not simply entertainment. These issues, particularly notions of trivialization or stigmatization, are common among larger commercial games created primarily for profit. The integration of serious topics within digital games brings with it debates regarding the acceptability of “playing” with such serious subject matter. Not only are games being applied to various roles, but designers are also approaching more serious topics such as humanitarian crises, the realities of war, and mental health. Digital games and game design practices have been applied to fitness, job training, education, and even therapeutic practices. The growth of digital games in terms of both popularity and technology has pushed games into various roles beyond simply entertainment.
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