10.26686/wgtn.12331280.v1 Theresa Fleming Theresa Fleming D de Beurs D de Beurs Y Khazaal Y Khazaal A Gaggioli A Gaggioli G Riva G Riva C Botella C Botella RM Baños RM Baños F Aschieri F Aschieri LM Bavin LM Bavin A Kleiboer A Kleiboer S Merry S Merry HM Lau HM Lau H Riper H Riper Maximizing the impact of E-Therapy and Serious Gaming: Time for a paradigm shift Open Access Te Herenga Waka-Victoria University of Wellington 2020 computerized therapy serious games implementation cCBT Health services & systems Public Health Clinical Trials and Supportive Activities Clinical Research Behavioral and Social Science Prevention Mental Health Science & Technology Life Sciences & Biomedicine Psychiatry RANDOMIZED CONTROLLED-TRIAL COGNITIVE-BEHAVIOR THERAPY CASUAL VIDEOGAME PLAY MENTAL-HEALTH EMOTIONAL DISORDERS SELF-HELP DEPRESSION ANXIETY METAANALYSIS INTERNET Public Health and Health Services Clinical Sciences Psychology 2020-05-19 23:49:45 Journal contribution https://openaccess.wgtn.ac.nz/articles/journal_contribution/Maximizing_the_impact_of_E-Therapy_and_Serious_Gaming_Time_for_a_paradigm_shift/12331280 © 2016 Fleming, de Beurs, Khazaal, Gaggioli, Riva, Botella, Baños, Aschieri, Bavin, Kleiboer, Merry, Lau and Riper. Internet interventions for mental health, including serious games, online programs, and apps, hold promise for increasing access to evidence-based treatments and prevention. Many such interventions have been shown to be effective and acceptable in trials; however, uptake and adherence outside of trials is seldom reported, and where it is, adherence at least, generally appears to be underwhelming. In response, an international Collaboration On Maximizing the impact of E-Therapy and Serious Gaming (COMETS) was formed. In this perspectives' paper, we call for a paradigm shift to increase the impact of internet interventions toward the ultimate goal of improved population mental health. We propose four pillars for change: (1) increased focus on user-centered approaches, including both user-centered design of programs and greater individualization within programs, with the latter perhaps utilizing increased modularization; (2) Increased emphasis on engagement utilizing processes such as gaming, gamification, telepresence, and persuasive technology; (3) Increased collaboration in program development, testing, and data sharing, across both sectors and regions, in order to achieve higher quality, more sustainable outcomes with greater reach; and (4) Rapid testing and implementation, including the measurement of reach, engagement, and effectiveness, and timely implementation. We suggest it is time for researchers, clinicians, developers, and end-users to collaborate on these aspects in order to maximize the impact of e-therapies and serious gaming.