I know many social workers who are just lack a sense of self-efficacy in using technology and they are really afraid that something terrible will happen. I would love to see a game for people like this..one that encourage exploration of new ways to use some technologies along the path to reach that adolescent who has been kidnapped by the Monster of Apathy while doing battle with their fears. The game would need to provide lots of positive feedback (points, badges) for efforts to explore and learn things like texting, facebook, twitter (simulations of these in the game).

Any good game design people out there?

You are right that CBT lends very well to many games, and I’ve mentioned the Epic Win as an example of that. But more psychodynamic therapies can make use of sand play, online gaming or sessions in Second Life, and more. And the narrative therapy approach of Michael White et al would lend to creating epic solutions to the presenting problems. Clearly though we all need to think more deeply than broadly to make the most effective interventions in Tx, and explore the meanings and boundary concerns that might arise in virtual worlds.