Game-changing therapy

Understanding therapist Monet Goldman’s unique approach to mental health in the video gaming community

Brian Xu

During the COVID-19 pandemic, video games have seen a spike in popularity like never before, with three out of four Americans playing video games in the month of June alone, and half of them playing over five hours each week. Since quarantine has started, junior Collin Ong has personally found more time to play video games.

“With quarantine, I can manage my time a lot better, especially with homework,” Ong said. “And quarantine allows me to cut corners with time, so I don’t have to worry about commuting to school, which is like half an hour, there and back. I don’t need to worry about waking up and doing all this stuff. So I can drive to school and arrive there half an hour early. Yeah, that allows for so much more time to do things and once I finish all my homework, I just get on Discord with my Texas friends or my friend on Minecraft and just play.”

The rise in gaming has also brought along challenges such as balancing games with daily responsibilities as well as coping with deeper mental health issues. But licensed marriage and family therapist Monet Goldman has found opportunity from games as well, pioneering the use of video games in a private practice to improve mental wellness and develop healthier habits. After noticing how games helped him destress during quarantine beyond methods like meditation, he saw an opportunity to use video games to help his patients.

“Before video game therapy, I was talking with kids and people online, and they just were not engaged,” Goldman said. “They would ghost me, or they’d complain to their moms about having to see me. So finally I just was like, ‘Well, what do you want to do,’ and they were, like, ‘let’s play Roblox or let’s play Call of Duty or let’s play this game.’ We’re always trying to enter our clients’ world, we’re always trying to meet them where we’re at. We’re the ones being flexible to our clients. And so, that’s what I did: I entered their world — I was playing Roblox or Minecraft and creating these different worlds with them. And they opened up so much more than even in person. Because there’s somewhat of that distance: I’m this big, kind of guy and they’re a little middle schooler, so when they had that kind of control, and it was a level playing field, they really started opening up.”

Goldman’s unique form of video game therapy is a culmination of a long-time passion for gaming. Ever since he was 5 years old, Goldman found video games to be a great stress reliever, which continued to be a passion of his through college and beyond.

“I had my first season in college wrestling, and I’m always getting nervous and you’re just dreading having to do all the crazy workouts and sprints and so we had an N-64 in our locker room, and we’d all just be playing Super Smash,” Goldman said. :And we felt so great, all the anxiety went away; it’s almost like you suppress all the negative emotions and you just feel all the positive stuff come out and then right when you’re about to go to practice, you just rush in. And you just start off with a clean slate because you just haven’t been running through the negative scenarios, the daunting tasks you have to do.”

Goldman is currently one of the youngest employees at Uplift Family Services, a company with over 10,000 employees. Here, he takes part in a tech initiative to use apps and games for experimental therapy.

“You’ll find this out when you enter the workforce,” Goldman said. “But a lot of people at the top making the decisions are in their 50s, 60s, 70s and never played a video game, [and] have no understanding of it … The psychiatrist who is the medical director was like, ‘Look, when I went to grad school, mammoths were still roaming the world … I could attend a webinar about digital tech, but it doesn’t matter if I don’t actually use it.’ And so, I think it’s such a new field. And there’s a lot of unknown. And I think that’s why the younger generation is the one that is going to come in, so it takes gamers to help other gamers.”

Sophomore Kailey Daugherty also agrees with the importance of trying out video games for those unfamiliar to the gaming scene, as the experience is often different from how outsiders view it.

“I think it can be difficult to get into obviously because some people have not had the influence of video games their entire life or growing up,” Daugherty said. “But it’s always fun to get into. I feel like even just Minecraft, getting into playing it or watching people play it can always be fun … Obviously, parents view it as a waste of time, because it’s like, ‘Oh, you should be focusing on school,’ but I don’t know. I think some people, it can be beneficial for them, a way to relieve stress.” 

Goldman shares that people who have never experienced playing video games sometimes mischaracterize them as addictive drugs or entirely negative activities, which doesn’t capture their nature.

“It’s not a drug,” Goldman said. “With video games, there’s still kind of a neurological impact. You get like dopamine, you get adrenaline, you get this great rush, it’s super immersive, it’s different than watching Netflix, because you are playing it. So it’s a lot more fun in my eyes. And it’s just easy to lose six, seven hours, eight hours a day. So I think it’s easier to get into that time warp. It’s so much more immersive. It’s so, so much more fun.”

Ong has personally experienced the time warp of video games, pointing out the difficulty of stopping once he starts to play. 

“When you’re having fun, time flies,” Ong said. “It’s hard to manage time because you’d be like, ‘Oh, I want to play one game.’ But then I’m like having a lot of fun. So I’m like, ‘Oh, one more shouldn’t hurt.’ And then four hours pass and you realize your homework’s due in 30 minutes.”

In order to maintain a healthy balance between playing games and other responsibilities, Goldman recommends a few strategies.

“You want to build insight around your behaviors and awareness,” Goldman said. “And I think everybody at Monta Vista is able to apply that kind of scientific method to themselves. So, build insight, understand yourself, understand the connection between your thoughts, feelings and your actions, what your driving forces are … Do what you know you can do, because don’t make this goal of ‘I’m going to quit gaming for a whole month,’ and you haven’t taken a break in gaming for the past 12 years. Because you’re just going to set yourself up for failure. So just do something manageable. You know, that might be like, ‘Alright, maybe in the morning, I just won’t game’ or ‘Maybe in the afternoon, I won’t game. But I’m going to game the other eight hours I have free’ or something, and see what happens because you want to give your brain time and space and some quiet to reflect and address yourself and then provide you the space to do the things you need to do to because if you’re gaming all the time, that is the problem.”

After experimenting with a system of providing therapy through video games, Goldman has found that video games can play an important role in his clinical practice. He sees several unique advantages that video games possess over traditional forms of therapy, especially during the COVID-19 period.

“One of the studies I saw about PTSD veterans and how Call of Duty was able to help [war veterans] was that Call of Duty somewhat triggered them, reminded them of the battlefield,” Goldman said. “Say if they drove by an oil tank on fire, they would actually smell the gas, the oil, the flames and smoke, and have kind of a response to that. But because of that distance, they could start using the self regulation skills that their therapist taught them, how to manage that and and ride through that and so it’s a very healthy way of doing exposure therapy that’s probably more immersive than what you can do in a room.”

Another advantage Goldman shares is that video games provide patients with confidence that is hard to find elsewhere.

“I think a lot of the kids with more neurodiverse wirings on the autism spectrum, or [with] ADHD or selective mutism, things like that, when we would take them out into the community, they would shut down [and be] super overwhelmed,” Goldman said. “But then in the game, they understand the environment, they can control the environment. So they are the ones that are leading, that are more social, communicative and starting to use leadership skills, which you would not have seen at all, especially with death and grief. As I’m playing this game, [one] kid is able to reenact some of the death themes, and actually label my character as their parental figure that passed away, and have this nurturing moment where they could still interact with that family member and also feel safe enough to do that with me, because it’s also in a video game … It’s just given me a lot of faith in what video game therapy can be.”

In the future, Goldman hopes to expand his use of video games in therapy, and he is also looking forward to starting a YouTube channel and maintaining a blog of information about his findings. Overall, he is grateful for the opportunities that this unique field has given him.

“I feel so lucky that the pandemic has actually brought me something positive in my life, because I was feeling somewhat lost, and who would have thought video game therapy could be a thing?” Goldman said. “But here we are.”