Post to a Young Therapist

I’m a big believer in twofers.  When you run your own business, twofers are essential.  So when I get several emails about a topic I try to craft a post in response.  Recently I have been getting emails from many therapists or therapists in training who want advice on how to pursue a career as a gamer therapist.  Many of them grew up playing video games and have a lot more comfort and familiarity with them than their therapists who have been around for a bit.

Take Claire for example, who has graciously allowed me to share an excerpt from her email to me:

For most of my life, both video games and service to others have been passions of mine. I’ve recently been working at a game company in XYZ, and have been immersed in the gaming culture more than ever. The more I see it (and experience it first-hand) the more I see a need for therapists who can address the issues so many gamers face as a result of their passion.

Before today, I had no idea if anyone had pioneered this field of study, of if there was even a place for it. And then I found you. A quick perusal of your website tells me that you and I are very much aligned in our beliefs about how games affect us, and why they matter. Seeing that you have crafted this job for yourself inspires me to look further into the possibility of knitting together these passions of mine.

Note the use of the word “passion” here.  I hear from these younger folks how their interest and curiosity around video games and technology in general is met with skepticism and often hostility.  Supervisors turn into lawyers before their very eyes and begin every conversation about technology with the words “HIPAA” and “liability.”  The only question asked in the exploration of patient’s video game is “how many hours are they on the computer?”

Part of the problem with this disconnect is that many up and coming therapists become inadvertently ashamed of the fact that they are gamers themselves.  The implicit or explicit pathologizing of video games and tech use shapes the behavior and expectations about whether discussing gaming, or even using it as an intervention, stops before it begins.

Those of us who have been in the field for a while can often become set in our ways.  We can act as if education and the workplace haven’t changed much since we started our practice.  Insulated in our office and routine, we stick with the phone, maybe email, and play therapy games that have changed little since the 70s.  With this stance we are not prepared to work with patients in the 21st century, let alone supervise 21st century trainees.

If you are training to be a therapist, here’s what I recommend if you want to be a gamer therapist:

1. Start from Within

Repeat after me, “It is okay to experience excitement and enjoyment when I am working with patients.”  Somewhere along the line our graduate programs have begun to give you the message that you are supposed to be an evidence-based automaton with little emotional investment in treatment.  I have had students who have heard dozens of times in their training ideas like “emotional detachment,” and “inappropriate boundaries;” yet not once has anyone talked to them about feeling excited and enjoyment in their sessions.  Even trainees doing play therapy express guilt or fear about getting “caught up” in the play.  You’d think we were supposed to spend our entire careers with dull, depressing people!  Allowing for a range of emotional experience with patients means the whole range, including excitement and fun.  So if you are going to be a gamer therapist, start building your capacity to enjoy yourself in sessions.

2.  Create A Gamer-Affirmative Environment

Did you know that research has suggested that 1 out of 4 comic book readers are age 65 or older?  Yet how many offices have comic books for their adult patients alongside People and Time?  The same is true for video games.  Geeking up your office and waiting room sends the message that you don’t equate video games or technology with “toys.”  In my waiting room I don’t have comic books currently, but I do have Wired magazine and titles devoted to video games.  Many conversations have begun as a result.  I also have a Deathwing statue and other game-related memorabilia.  Recently someone saw a Post-It I had with the word Katamari on it.  I had made a note of the game to remind myself to check it out.  That Post-It was all it took to begin a very excited and meaningful conversation about the game (which has a free App, by the way.)  The smallest changes to your office can convey that you are interested.

3. Try (and I mean play) lots of different video games

This is the fun part, usually.  I have the major game platforms and am always trying one or two new games a week.  If a patient mentions a game in a session, I make a note to try it ASAP if I haven’t already.  Sometimes this requires discipline, because like most people I don’t like every sort of game.  But each game I test out helps me understand the patient better.

4. Have video games in your office

I have always had handheld video game consoles in my office, but in addition I have an XBox 360 as well.  I don’t think you can be doing contemporary play therapy well without it.

5. Disclose that you play video games

The fact that you have game consoles probably implies this a bit, but let’s be explicit. Regardless of age, 64% of Americans play video games, and the percentage is much higher under 40.  So if you have played video games, disclose that you have.  If you have a supervisor who sees that disclosure as more akin to “I smoked pot as a teen” than “Yes, I saw Star Wars” run away.  Video games are an art form not a controlled substance, and there is a big difference between those two conversations.

6. That said, be on the lookout for countertransference.

Whether you like or hate, play or avoid, video games, you need to be mindful of the reasons why and when you talk about aspects of it.  If your patient is telling you that they managed to fish up the giant sea turtle in WoW, it is an empathic failure to say, “Yeah I got that last week, isn’t it cool,” rather than to reflect to them what that says about their persistence and discipline.  Note any feelings of competition you have (or don’t have) and wonder about it.

7. Get good supervision, even if you have to pay for it privately.

One of the downsides of licensure having a (in MA) 2 year post-graduate supervision requirement before you get your independent license is that it inadvertently sends the message to fledgling clinicians that after two years you don’t need it any more.  That is not true.  I encourage new therapists to consider ongoing supervision of some sort to be a business expense to build right into your practice.  I had the opportunity to have weekly supervision for free at my workplace for 12 years.  That sort of job benefit has gone the way of the milkman in many places today.  This means you’ll need to buy some.

If you buy private supervision, remember that it is a different experience from your earlier or agency experiences with it.  This is not your boss, you are hiring them.  Hiring people means interviewing them, and screening them for fit.  If they are technophobic they are not going to be a good fit for a gamer therapist, so it is important to let them know your pro-technology and gaming stance from the beginning.

If you are interested in participating in a small group supervision experience, you may want to check out the Supervision Package I’ll be offering this fall.  You can find out more about it here.

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  1. Vanessa Lemminger says


    Thank you for the great read! I enjoy your passion and your intelligent outlook on how to approach therapy. The truth is that our work is less about the actual object of interest/focus (whether that be a video game, a specific toy, a movie, spaghetti, whatever!) and more about the meaning it holds or the narrative that is created around that object/focus. I think your approach applies not only to therapists interest in working with gamers, but all therapists. It’s important for us to look at how these objects that may seem unimportant in our eyes, hold meaning in our clients life, and to push ourselves to experience those things to better understand our client’s perspective. I also enjoy your article because you shed some light on a population that is often misunderstood. Thank you again for the great read this morning!

  2. As always, thought provoking. I’ll be using this post and your site that is chock full of interesting twists and turns as this month’s homework assignement for my LPC supervison group consisting of 7 talented therapists in the Philadelphia area. Supervisees, feel free to comment.

  3. I am a middle aged non-gamer therapist who reads your blog with pleasure.
    I have never held a game console in my hands in my life, but when I have clients who play games I am always very interested in what characters they create, what the story lines are, what kinds of characters that they interact with… or if it’s something like Sims.. what sort of characters or world they create. Because I am a psychoanalytically oriented therapist, I am always interested in people’s fantasy lives… their dreams and imaginations. So I WANT to know who their favorite comic book heros are and how they describe those character’s personal qualities.
    It is an incredibly rich source of information about their hopes and dreams and relationships. As a psychodynamic therapist I try always to be attuned to how we all project our inner world on all kinds of things outside ourselves.
    I can remember one time in group supervision, a fellow student talking about a client who was addicted to some role playing video game. I was intensely disturbed that the gaming was treated as a problem to be stopped. Neither the therapist or our supervisor ever asked what was the STORY that she was so deeply engrossed in that it distanced her so effectively from the rest of the world?

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