Fun: a new prescription for social anxiety

Anxiety affects us all. Sometimes, a little bit is a good thing. It can sharpen our minds before a performance or help us to complete a piece of work, for example. More often, though, it can get in the way of leading a normal, productive life. Severe anxiety can stop us sleeping, going out and getting on with our lives.

Research in the US has found that as many as one in ten people suffer from social anxiety disorder – a persistent fear of social situations – at some point in their lives. National Institute for Health and Care Excellence guidance recommends medication or psychological therapy for the treatment of social anxiety. However, only about half of adults seek help and most only do so after experiencing problems with their anxiety for over 20 years.

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With the support of the RSA Catalyst Fund, I am working with Philippe Greier of Playmakers Industries to create the ClearFear game. Along the way, we have harnessed the expertise of people recovering from substance use problems at Kingston Recovery Initiative Social Enterprise and researchers in the Connecting People study team to design the game.

ClearFear is a real-life social game in which players are helped to find their own super-powers. By becoming our own superheroes, ClearFear game players tackle missions with the support of a small team to overcome their fears. Together, game players create a secret smiling society which no longer fears fear.

The ClearFear game has been tested by many people in the UK, Austria, Bolivia and Sweden. Our latest test has been with people recovering from substance use problems in the West Kent Recovery Service, where the RSA is piloting its Whole Person Recovery System.

The feedback we received from players has been positive. The laughter emanating from the attic room in Tonbridge where we played the game yesterday suggests that it can be fun. Perhaps that was because the missions which players completed were completely bizarre, such as asking a stranger to move their car from one place to another or making a box out of twigs. Others included finding out an interesting fact about Tonbridge from someone in a local shop – which took a few attempts – or hugging a stranger – which, as you might expect, met with diverse responses.

The missions took people slightly out of their comfort zone, but as they were completed in a team their successes were celebrated together. But does playing the game actually make a difference?

We don’t yet have an answer to this question, but at the International Centre for Mental Health Social Research (University of York) we’re evaluating a pilot of the game to see if it helps to connect people, reduce anxiety and improve players’ well-being and feelings of empowerment. We have some ideas how it may work.

The ClearFear game superhero narrative provides a fictional frame for the exploration of reality. Unlike psychological therapy which takes people towards their fear, ClearFear takes players away from it into a fictional frame to poke fun at it. This ‘dramatic distancing’ is somewhat paradoxical, but enables players to engage with buried aspects of themselves more profoundly. Fear becomes a nemesis to overcome through a series of fun missions.

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Missions are the antithesis of gradual exposure techniques, which are typically used in psychological therapy to carefully expose people to situations which they are fearful of. ClearFear missions are fun, some may say frivolous, but being part of a team of players where everyone has a mission to complete equalises the status of the tasks and reduces individuals’ anxiety about what they have to do. Teams of three can frequently complete their missions in under one and a half hours, demonstrating that exposure to fearful situations with the support of other players can be tackled with fun.

The superhero narrative of the game reminds players that they have strengths. Developing and testing the game with people recovering from severe problems who sometimes feel that they have nothing to offer to society has demonstrated how powerful this can be. Starting off talking about the problems they have experienced in their lives, players help each other to identify what they are good at and enjoy doing most. Asset-based approaches help communities to develop and we see the same beginning to happen with the ClearFear secret smiling society.

But there is a long way to go. We need to take the game to the next level and to complete our evaluation to see if it works. To help us, we are launching a crowd funding campaign at the RSA on 16^th September.

We aim to source some additional funding to enable us to develop a fully-functioning website with clear instructions how to play the game. We want to create a private online space for the secret smiling society to celebrate success in our completed missions and support one another with new missions. We want the website to be able to connect ClearFear game players across the globe and play online. We also want to include slot machines and other games to engage and connect people.

We all have mental health and we need to look after it. Let’s embrace the possibility that social gaming is good for our mental health. Let’s clear fear together!