Ryan Douglas is the co-founder of DeepWell DTx, a digital therapeutics Venture Lab focused on creating immersive experiences that address mental health concerns.
Ryan has created numerous medical devices, along with several profitable startups. He has deep experience with the regulatory landscape for digital therapeutics, and is pushing to get digital therapeutics accepted by the medical community.
Check out the video here: https://youtu.be/xuXe-HtmBMk
Ryan Douglas is the co-founder of DeepWell DTx, a digital therapeutics Venture Lab focused on creating immersive experiences that address mental health concerns.
Ryan has created numerous medical devices, along with several profitable startups. He has deep experience with the regulatory landscape for digital therapeutics, and is pushing to get digital therapeutics accepted by the medical community.
Check out the video here: https://youtu.be/xuXe-HtmBMk
Intro: [00:00:00] From Silicon Valley, the heart of startup land, it's Getting2Alpha. The show about creating innovative, compelling experiences that people love. And now, here's your host, game designer, entrepreneur, and startup coach, Amy Jo Kim.
Amy: Ryan Douglas is the visionary co-founder of Deepwell DTx, a company that merges digital therapeutics with immersive gaming to address critical mental health issues. Ryan has decades of experience developing innovative medical devices and is now working hard to get mental health games widely accepted by the medical community. Like many people, Ryan didn't start off believing that video games could be good for you.
Ryan: I started with the mentality that most people have. Video games are probably kind of bad for you, and they're addictive. And I found a body of research that really pointed to the opposite of that. So I got drawn to the idea, like many people do, is video [00:01:00] games as a therapy delivery mechanism.
And then I started to realize as I looked into it, they weren't just a therapy delivery mechanism, they could be a therapeutic.
Amy: Join us as we explore the intersection of gaming and healing with digital therapeutics pioneer, Ryan Douglas.
Hey everyone, I'm live here with Ryan Douglas. Welcome Ryan.
Ryan: Thank you.
Amy: How is your, you were just traveling. How was your trip?
Ryan: Oh, it was great. I was in Florida for the international VR health association conference. They do a symposium once a year. It was a really great conference. I had a chance to meet up with folks that are more living on the science side of this folks like Walter Greenleaf, who have been foundational in the whole digital therapeutics movement.
And they gave us a keynote and then they really wanted us to talk about what Deepwell was doing. So that was nice. Awesome. It was a great reaction.
Amy: Okay. So that's very exciting. A lot of folks here probably know you, but there's [00:02:00] probably some who don't.
So let's start with some background. First of all, what's a therapy designer? Yeah. How do you define that?
Ryan: Interesting. I think it's a new title that I've been using since I came into doing this work with video games to help people understand that there are these various roles that are maturing or coming into being as we look at the intersection of medicine and media.
So, like a game designer designs your game and has a team of folks from art all the way through production that are doing their work for them. Therapy designers at that intersection of the science, really the engineering and medicine to figure out where the therapeutic aspects are in that game.
And really importantly, the way Deepwell handles this is work in service of the game designer. So, instead of that more reverse thing we saw in Gamification where, you know, the designer was brought in to gamify something that was already maybe sort of pre cooked or pre canned, the therapy designer's job is to look at the therapeutic, present it to the game designer relative to gameplay, and then if that isn't working for the [00:03:00] game designer, if it is not, you know, fitting in the play loops, if it's not fun, it's to go out and find more.
So it's about finding that confluence between what's fun, which is really up to the game designer and how they can use the mechanic and which mechanics are out there, which therapeutics will fit into a game scenario,
Amy: right? So that's a pretty interesting and unique point of view. How did you come up with that?
It's probably the results of what decades of experience working in digital therapeutics.
Ryan: It's funny, I didn't get it defined until about three years ago. It's not until we tried this confluence with medicine and media that I really maybe even understood what I'd been doing for over 20 years. But sitting at the intersection between medicine, engineering, and the market was where I always was.
That, I got all sorts of titles for that, chief technical officer, CEO at various points and times and stuff like that. But I always stayed really resident or close to the products. No [00:04:00] matter what role I had, I was about getting things in people's hands that, that could make a difference. That's I think it was really interesting for us to try to merge medicine and media.
There's a lot of learnings in the last three, four years for DeepWell. I mean, very symbiotic from the ability to help people and really codependent on one another to make a digital therapeutic work. But such different industries, everything had a different term. We, you know, we were looking for who's the project manager.
People are pointing at somebody called the line producer and every one of us in medicine is going, well, what is a line producer? Like these sorts of things. facilitated a whole new language for us to figure out how to cooperate and work together. Very different development cycles, very different cultures.
And so that's, you know, kind of that title as long as, and many other things are kind of lessons learned as we try to find this intersection between media and medicine.
Amy: Give us a helicopter view of your background so folks can appreciate where this is coming from. Now you're a serial entrepreneur.
Ryan: Yeah, I've got four exits. I started, interestingly [00:05:00] enough, the first notable thing was in media. So I started as part of a team that, that figured out how to make audio work in a product called Macromedia Flash. So for a lot of folks, they don't really know what this is anymore, but back in the day, this was really the first multimedia online tool that we had.
The player or plugin was 99 percent propagated around the world. So it was very ubiquitous, but it had a problem. They had figured out how to vectorize graphics, which was really important back then because we didn't have. Broadband connection, this is slow, 28k, 56k kind of stuff. So it was load once, use many on the graphics, but the audio was just a stream.
And so you couldn't get anything to sync. Like you were never going to get dialogue to work, that was not going to happen at all. But you even couldn't get this sort of emotional response that you would plan in a game or in a sort of multimedia presentation or media presentation where you want that, you know, crescendo to happen right as there's a visual expression that wasn't there.
So we figured out how to vectorize, if you will, the audio. compress it and have it load once and use many as well, which [00:06:00] allowed it to sync up to the visuals. And that was kind of my introduction into media. That company, like I said, rolled up into what Macromedia was doing. And I moved on very quickly and ended up in a series of technical roles that kind of went from a big data sort of situation before big data was called big data.
So we were on the back end of Kelly Blue Book becoming digital, Kelly Blue Book becoming auto trader and all of that. Huge data being collected right around 2005 when there wasn't much else you could actually do effectively on the internet. Moved on from that and ended up in a series of things that landed at Defense Robotics and really starting to bring the software to the hardware.
I was part of a company that did the Throbot, which was deployed in theater 2008 2009 in Iraq. It was a very simple, very smart robot, small sensor work, just something you could, size of a pop can, pull the pin, you throw it in there, And it could get a look at, you know, I, you know, explosive devices, it could look at bad guys, it can help you figure out situational analysis.
And that was, you know, kind of a big part of [00:07:00] getting this company called Manufacturing Solutions going. We were also working at the sort of this intersection between design in the U. S., manufacture abroad for cost effective natures. And then we had sort of this pinnacle event happen. The robot was deployed thousands and thousands of them in field.
We were getting all of this feedback back that we were saving lives and that was something that was really connecting with us and then we were asked to weaponize it. And this core group, um, that I'm still working with part of them today, we put our stock on the table and we walked away and we restarted under the name Nextern and really focused on health, wellness, and safety and um, started driving more and more towards what folks had asked us to do because we had this background in big data.
We had this background in media, so understanding, if you will, sort of interface and that kind of stuff. And we had this background in robotics, and we were in Minneapolis, St. Paul, where all of the big medtech was happening. So we were asked to get involved, and ended up commercializing 27 medical devices over a span of 17 years.
[00:08:00] Everything from home based therapies for folks with survivors from breast cancer, Um, you know, from, you know, kids with cystic fibrosis to, you know, ablation based surgical devices, vapor based of ablation for women's health. Just a wide range of things in a period of time that really resonated with us as a technical group of people was the things we wanted to be doing and probably most importantly, it was the group of people that wanted to be together to do it.
Amy: So, I'm really curious, what did you study in school?
Ryan: I am what you would expect for a serial entrepreneur. I studied everything in school. I've got seven and a half years of post secondary without a degree.
I went, I have one diploma, which was in aviation. So I started out as an airline pilot, um, but really a bush pilot way up north in Canada, went back to school for medicine and did not complete that as well. And along the way, started companies. Started with the simplest idea. Manufacturing computers is a way to stay alive.
I had moved from Canada to the States and did not have a lot of money. So, myself and a couple people literally in a garage were putting computers together, [00:09:00] you know, and just kind of doing that sort of thing, while moving all the way through medicine and all these various groups I studied. But it never quite resonated.
I mean, I would often get drawn back into doing a thing that, you know, that was more live, if you will, or more connected to people than just the educational part of it.
Amy: How did you come to focus on this intersection of games and medicine and get like all in on immersive therapy from the whole background that you have?
You're all in on this.
Ryan: I'm definitely all in on it and I was not planning on being all in on it at all. How did that happen? Yeah, well we got those devices sold or in the market. Every one of them went profitable, Amy Jo. So that was catching a lot of attention and there was an opportunity to sell next time and This was the, you know, this was the opportunity of kind of that exit of a lifetime.
It's a five times or five lifetimes of money sort of thing. And I was at the place of, you know, really happy with what we had [00:10:00] done, but had thought a lot about this intersection of why we'd been successful. And we always looked for things that were affordable. That meant they would reach a reimbursement or an audience in a way that they could pay for it.
They were accessible. That meant they did things that were required within the field. So, They solve problems that needed to be solved in a way that the market would allow them to be solved, which includes affordability and there was compliance. It was this idea that people would do it, especially in the home based arena.
We worked a lot to simplify therapies, get them in the home, move away from pharmaceutical solutions when we could, the things that would more induce the body to respond naturally to the effects of the device. And so it was really important for us to have this accessibility and affordability to care.
And as this really big check was getting written, and those of us that had done this from the beginning were getting a chance to move on, I was questioning about that, really, compliance of care. Had, once we got these things in people's homes, were they really using them? And I had evidence that they weren't.
That there was times where we would get these things [00:11:00] in home, and they just were ending up more like a treadmill, right, where it was a great idea, and people wanted it, but when it came down to doing it, it wasn't happy, happening. So I was worried about the compliance, and I was thinking a lot about that.
Right around that time, a friend of mine was exiting from a company as well in video games and going through, I'd say, sort of a similar sort of situation. We're wondering whether the video games that this company had built and the things that they had done, if there was real super value in what they had done and started passing me a lot of studies.
One of the games was Fall Guys. Fall Guys was an amazing success during the pandemic and I was watching this mental health emergency get rolling. And concerned about that, and Fall Guys was really getting the sort of feedback that we used to get off some of our devices, that people were using this as a lifeline.
So, it caused me to dig in deep. I didn't have the Nextern team anymore, so I used my family and started digging into the research that had already been done. I started with the mentality that most people have. Video games are probably kind of bad for you, and they're addictive, [00:12:00] and how could this possibly be?
And I found a body of research, and I mean a significant body, 800 to 1, 000 studies that had been done over 20 years, that really pointed to the opposite of that. And, unfortunately, sometimes it looked like they had been sponsored or built in a way to suggest that video games were potentially not useful, or potentially even harmful, or sometimes the cause of certain societal issues, or violence issues, and things like that.
But the results just weren't bearing out that way. So What really caught my attention was this intersection between how therapeutic they could be and it wasn't compliance, it was compelling, people wanted to do it. So I got drawn to the idea, like many people do, is video games as a therapy delivery mechanism, maybe a way to make what I'd done better.
And then I started to realize as I looked into it, they weren't just a therapy delivery mechanism, they could be a therapeutic. And that drew me in considerably. As did I mean, I reached out to the gaming community and the folks that responded back folks. Now there are many of which are [00:13:00] tied to deep. Well, I mean, we're kind of at the top of their game, how much they had always kind of felt and known this, but hadn't been able to represent it.
Maybe as scientifically that just drew me right in, you know, and staring at the mental health crisis, watching what was going on with covid and knowing that it was going to get a lot worse before it got better that, you know, the mental health crisis we worked on. Um, White therapy and really won that market in North America.
So we understood where depression was at in North America. 20 years ago, worked on neural stimulators that would have had a lot to do with mental health as well as management of pain. And so we knew the climate we were looking at and you know, here you are with a 50 year medical emergency or if you will, mental health emergency and then covid starts.
A lot of people think that's the start of the mental health emergency. It wasn't. It was really the fastest accelerant to a thing that had been causing problems for almost 50 years. The World Health Organization was telling us if we don't get control of this situation by 2030, this is going to be the leading cause of morbidity and mortality.
[00:14:00] Meanwhile, on an international level, 2 percent of our health spend was on mental health. And it just, and we weren't even able to talk about it. So, this just was so compelling to get drawn in and to think, we might have something here that is that Venn diagram, that affordability of care, that accessibility to care, and, you know, compliance taken all up to the level of compelling.
It was just something that I needed to see through, see how far we could take.
Amy: Awesome. So one of the things you and I talked about a few weeks ago was the problems that you've seen so far with mental health games, treatment games, et cetera. So digital therapeutics is very exciting. It's clearly changing a lot.
The dynamics you just outlined with the pandemic, mental health. Clearly driving a lot of change, but people have been attempting to do digital therapeutics for a long time, you know, [00:15:00] decades, including brain games and, you know, Achille and various other games.
Ryan: Absolutely. And I'd really like your way back counting, trying to make things in the games that weren't games to start with.
Amy: Well, some of you know, to be fair. There are some games out there that started as games. They didn't, you know, start as therapy. They started as games. Not every game is a good game. I mean, so, I'm sure this is part of your journey in terms of discovering games, discovering the magic of games, and then as you get deeper and deeper, and you become sophisticated, you start to look at games with a different eye.
So what lens do you see that?
Ryan: Yeah, I mean there's so many learnings there I mean backing up when I was saying like it mean just taking games off the board because remember from my world They weren't really seen as therapeutic, right? I mean if you live in the medical device world in the farmer world I mean even when I started working on this I mean we have a venture studio that sits [00:16:00] above this that does, you know, new generation or Our next generation neurological care and while I was working on the games I was working on implants for the brain and Spinal surgery, robotics and stuff like that.
And when I was in the med crowd, a lot of people would almost chuckle and be like, Hey, you know, how's your games company over there? And they weren't hearing me early on that. I thought it could be the most significant intervention that I'd been involved with. So yeah, there was this background. I think that video games have suffered from this thing for a very long time.
And so as medical device, and this is what's really led to a gamification challenge for me, which is from the games perspective, people want this attraction that we've seen over 50 years of games. But they don't really have respect or knowledge, or can't, or tend to even want to get the respect or knowledge for what it takes to make a good video game.
That it is both art and science. That the highest likelihood is that the best game designers in this world are probably the best behavioral scientists or observational behavioral scientists we have in the 21st century. They have a process and they have a way of doing it, and it's not [00:17:00] gamification. It starts at this kernel of play that is It's worked and worked until it feels like it's, you know, something that is really attractive, often outside of the digital environment, then put into the digital environment where it becomes not very fun.
And the finding fun process, the being at 90 percent in a game and having to work all the way through that being, you know, an amazingly attractive game loop or a series of game loops. I mean, I don't think there was a lot of tolerance for coming to understand that. I don't think that the experts were consulted.
And I saw that really in digital therapy was a little bit too. From the medical device standpoint, we saw folks rush in early on with gamification, with digitalization of therapies, many of which really didn't kind of take lessons back from med device either, or come and find people like me, talk about how reimbursement might actually work, talk about what it might look like to truly be therapeutic for somebody.
We saw a lot of early plays for, you know, that were based in cornering a market, and medicine is a market that is hard to corner. And when you look at what's really [00:18:00] powerful about media and games in particular, is that they're ubiquitous. There's so many of them that there's attachment points for many different people.
And in that way, a chance for them to see themselves in a narrative, in a story, in a character, and potentially then progress through something that could be very therapeutic for them. And that doesn't happen well if you're trying to build a single game to corner a market or something like that. So You know, I saw a lot of misunderstanding about what a secondary game mechanic was, that badging, scoring, and social was the way to enhance good gameplay.
It wasn't gameplay. And so I think we saw a lot of that in the gamification side. So, it feels to me like Amy Jo, that we saw folks maybe more from the media or tech side trying to grab a hold of medicine without a lot of knowledge. Folks from the scientific and medical side trying to grab a hold of gaming and gamification without a lot of knowledge, and not a true intersection between these two disciplines.
in a way that we could get the best out of both of
them.
Amy: I'd love to pick up the thread on the [00:19:00] regulatory environment and how important it is to, um, validate these therapies and get them not just prescribed, but covered by insurance. It's one of the things that everyone in digital therapeutics is aiming at, wrestling with, confronting, and you've definitely wrestled with this as well.
Ryan: Yeah. We've cleared a lot of devices and we're working on this right now, deep well. I think the first thing that happens is people get confused between the clearance that the FDA gives you and getting a reimbursement code and being able to get that paid for as a therapeutic. And we've seen that happen with several companies right now, some of which have gone public, have gone out and pushed this idea, the build it and they will come sort of model.
The thing I talk a lot about is paratherapeutics after 11 years, you know, as they were closing their doors, Their CEO put out a statement saying, did you know that you can have a very viable therapeutic, and insurers don't have to pay and I say in some talks, a little bit tongue in cheek, yeah, Corey, I [00:20:00] did know, and so should you, before you take 140 million dollars, because that really slows down an industry.
So we see this big disconnect between, first of all, understanding what does it mean to get cleared by the FDA, what does it mean to get reimbursed, and what levels of reimbursement you're going after, and we also see that the market is upside down. So today the FDA is. Only really willing to clear a video game as a prescriptive device.
We've seen that happen a couple times, but there is no reimbursement for it. So that puts a real disconnect on the care. What we're working with the agency to do is clear it as an over the counter device, so folks can choose to get a hold of it themselves. And that greatly actually can, even though it's a more sophisticated approval, it can reduce the cost of sustaining those games in the market.
And we have to do that level of innovation. We have to drop the cost. of these being medical devices because there isn't reimbursement today and that's going to come next over a period of time. I was just meeting with somebody while I was at IVRHA and he's a wonderful individual, works at United Healthcare and was very clear, right?
He was talking specifically about [00:21:00] ADHD and he was just very clear about their position which they had for years before, you know, a company took this public and pushed this along. He advised that company and said, Ritalin is nine cents a day. It's nine cents a day. Right. And so if you're going to come up with a digital therapeutic that's 1, 000 a month, we're probably not going to talk to you at UnitedHealthcare.
That's not how we work. So, understanding that, we have to get the FDA to agree to these things, agree that they're available publicly, and that we can use the words, what the FDA really gives us is the permission to use the words like stress, anxiety, and depression. And then we got to get busy working with, Reimbursement to show them value and that's how you get things reimbursed you show them that what you've come up with Costs less and is more effective not the other way around is more effective and potentially cost less That's not how insurance works.
You can dislike it. I do But it is the reality
Amy: that's really interesting. So what about therapies that are meant to [00:22:00] work congruently with drugs
Ryan: Yeah, so that is just You've just jumped to what I think is the most interesting thing I'm seeing as we are, you know, studying these games right now. It looks to me now, I'm going to tell you theoretically about a mechanism of action because this is all about the brain and if anybody tries to tell you that they know how the brain works, right away you know you're talking to someone who's not coming to the level because whether we're talking about some of the most sophisticated pharmaceuticals that we take today for mental health or therapies, we don't know exactly what's going on.
We have theories, we have theoretical mechanisms of action. What it looks to me is happening in some of these games is we're able to literally settle people down and that means more than just relieve their stress on a moment to moment level, but I mean systemic stress. This thing that is really, you know, has, stress has like a 57 percent negative impact on the people.
So if you were truly a chronically stressed person, you could expect more than half the time that you're going to get physically sick as well. It's a big deal and we don't talk a lot about it. Games have this ability to bring [00:23:00] that stress level down, specifically certain types of games that are designed in a certain way.
What seems to be happening when we're doing that is that we down regulate immune function as well. We don't build so many of those killer T cells that are out there looking to attack anything, and they will attack our own bodies as well. We see that in all sorts of different conditions. Eczema and arthritis and, you know, various bowel diseases and these sorts of things.
It's our own immune system coming after us. So we can down regulate that and that puts us in a place where we're more available for therapy. So what it looks like we can do is reduce the dosage of drugs. This is super important because a lot of those drugs, especially the new things that are coming out, the biologics that are solving a lot of these problems for us in immunotherapies, for instance, they have a carcinogenic component to them.
And so if we can get them down in dosage with the same level of effect, we can have a much more robust treatment.
Amy: You're talking about the U shaped curve, right?
Ryan: Exactly.
Amy: About how a little bit of something can be very good for you and more of [00:24:00] it can be not good for you at all. Could you explain that to our listeners?
It's such an important concept from science and in what you're doing and what we're talking about, it's very grounding to understand that.
Ryan: I think that's, you know, I think, I mean, it's been said in the common way to say it is everything in moderation, right? That's the point is that we find that. And what I noticed as a therapy designer, I'll explain it this way on the boundary conditions of anything therapeutic, right?
If I'm trying to figure out if something is therapeutic, when I was working on light therapies, exactly. I'd look at the boundary conditions. So the extremes, what's it like to have no light in your life? What's it like to have constant light in your life on those boundary conditions of anything therapeutic, you will find harm.
And so. That gives you a u shape response and curve as well where harm at the top here and as we come into the middle We find more and more of a therapeutic situation the more or the lesser of the angle that you shape the more therapeutic Opportunity we have when something's very tight like fentanyl for instance That's an important [00:25:00] therapeutic, but you cannot be messing around with it I mean just a grain of it can go in the wrong direction So, when we see a nice, wide open U, that's an opportunity for treatment in therapeutics.
And what we see that games do is they come in and they make that U wider for other therapeutics. A
Amy: really good way of thinking about it. So, you are setting up studios, you're set, you know, you're co creating these teams, and you've got this idea that therapy should report into games. ,
Ryan: I mean, that is how deep well is set up all the way to, you'll notice.
I'm not the CEO of deep. Well, our CEO is a career CEO. I have a chairman role that sits over the whole venture studio, but in deep well, I am the therapy designer and I report to some amazing people who have been like Jeffrey saying, who you've worked with before. I mean, he's our product officer. He is, I mean, a top level game designer.
And. He's out there. I mean, we've got a new build today. I'm going to see it. People have been testing for a couple of days. I'm going to see it next. I am not the first [00:26:00] in the door. I am not the answer about how this will play out. I'm the answer about whether or not the last mechanics I provided him have been appropriately put into the game in a way that they'll be therapeutic, right?
And we've been working on this. This one little game that should have been six to eight months has also been this intersection of learning where we've been at it for a couple of years because we're finding that balance back and forth between And we've had to, you know, move the teams around and get folks that were really truly wanting to work on this as well, right?
It's, this is not using medicine or potentially positioning medicine as a way to sell more games. It's going to do that. It's going to cut through the noise. It definitely helps with the discoverability. You know, we're sitting on the precipice of the first ever over the counter treatment for mental health ever.
There's never been one approved and it won't be amazing if the first one's a video game. So we're right there, but to get it right, we've had to go back and forth many times to try to find. A mechanic that the agency understands a therapeutic that really is effective for people, and gameplay that can support it, right, [00:27:00] in a way that folks feel like they're playing.
Because if you're not playing, the formula's not working. If you can feel like you're deeply involved in therapy at that moment, it's rocket math, right? And, you know, this is the dream of 25 years ago, we'll make it look like a video game, and therefore you'll learn faster, do more, and we already know that's not working.
So it's been a, it's been a lot of work. And I, as far as we can tell, the only way it's going to work, if your therapeutic delivery mechanism is the game, and your game is itself primarily therapeutic, and the only way that happens is if somebody is heavily involved to a flow state, engaged in those game loops in a way that they are heavily attracted, that's gonna have to be led by a game designer.
Amy: So, let's dig into those first two things you said. A mechanic that the agency understands, and a therapy that's truly effective. Okay. That's right. Sound, like, sounds good. There, now, if we pull back a little with our lens and think about how digital [00:28:00] therapeutics worked and has worked, how it's gotten staffed up, you're talking about a different way of staffing it up, setting up leadership, decision making, but one way or another, there's this ongoing collaboration in digital therapeutics between product on the one hand and everything around product and scientists.
So you have your scientists or therapist or domain experts, right? You have your product people, your games, say product slash games. Okay because I work in both so games and then there's your scientists. And I have worked with literally dozens of teams in digital therapeutics and seen scientists interact with games and product people.
And there are many ways to do that. But there's this kind of existential challenge. at the core of this interaction. And I'm trained as a scientist. You have a, I don't know, you're trained, you have an understanding [00:29:00] of it, right? But I have a PhD. I got the whole training. There's a whole nine yards with the scientific method where how far do you extrapolate your results?
You did things, you held a bunch of things constant and changed one thing so you could know what had the impact. There's a lot of simple, basic stuff about the scientific method that if you do it right, you're doing science. Okay, now, we're outside of the lab, right? And people that do science on, like, human perception, which is actually what my PhD was in.
That's what I did research on. You're doing it in a lab, with stimuli, right? Like, it's this thing. And then you go out in the world and you're like, Okay, I'm gonna collaborate with these people that are building this game. As a scientist, there is a whole creative leap and judgment about how much do you stick to the way you did it in the lab?
Because that's the only thing you can trust. And if you don't do it [00:30:00] that way, suddenly it doesn't work. That's like I have seen many scientists wrestle with that in real time.
Ryan: I, I think that's part of it, but here's this interesting barometer we have, this interesting situation that, um, we know without question.
Today, I'm going to talk about mental health only, because I'm not looking at all digital therapeutics, but today, the most wildly successful mental health treatments have been commercially built video games. They were completely accidentally therapeutic. So this is a very Darwinistic approach at the moment.
It's a lot like someone went out in the forest, they found these mushrooms, Some of them killed you, some of them just filled your belly, and in the middle they found this psychedelic effect that we're now figuring out is, has all of these potential therapeutic properties. This is the same thing here.
So, we can have a theory, and we definitely want to go in there, and some of the things you're saying about basic scientific intent, it really is change one thing at a time. If you change everything, there's no way of understanding what did what. And I actually have found that good video game designers know that [00:31:00] too.
They don't come in there and just You know move everything around all at the same time because they also can't figure out how they're getting their best effect And these are the masters i'm talking about that really know to attract an audience, right? So sometimes it happens. It's just like music and it's just like and I think you know this but anything sometimes an indie Sits down and writes a song and every one of us is like what happened there?
And sometimes they got a deep talent. Sometimes there was a little bit of confluence a lot same thing happens in games There's those people that have you know built a game was a smash hit but they were not people that could replicate success Then you've got people like Jeffrey Seng, right? Who, he has a track record of being able to replicate success, and he looks a lot like a scientist to me.
So we, we found a lot of confluence in that situation, but also then coming out and taking a look at it and going, Okay, what's happening here? And what really matters? There's a couple things we know without question that matter. You have to be engaged. We've seen that across the board. We know four ways, yeah, and we know four ways to [00:32:00] really, the easiest ways to get a game to be therapeutic.
You know, are these confluence between a game and it's mechanics in a way that you have motion. So extra games are working really well, right? Distraction. Distraction is working very well at pain management and things like that. Social constructs. Just overcoming loneliness alone changes people's mental health.
And then biofeedback, which we can get you to do a thing that gets vagal nerve stimulation running through your body. Take breaths, you know, and especially while you move and do other things as well. We know these all work. The one that's amazing, that's gonna take more time to understand, is pure play.
Because, I mean, when we look at some of the most remarkable studies, like the one that came out recently on Mario Odyssey, where, you know, it's small sample size, and it's the beginning of days stuff here, so, I mean, I understand there's more to know, but the bottom line is, there was three groups that were given different tasks, one was on drugs and talk therapy, one was doing puzzler games, and one was playing Mario Odyssey for six weeks.
All of this population was diagnosed and had been, Diagnosed for a considerable period of time with [00:33:00] major depressive disorder, a very hard thing to treat. And in the drugs and talk therapy, really your standard kind of almost no change, which is what we expect in people that have already been diagnosed and had the therapeutic response they're going to have.
The brain teaser games, they didn't do anything and that's pretty consistent with a lot of what we've seen about brain teasers. 48 percent of the people who played Mario Odyssey for six weeks were no longer able to score high enough on a personal inventory that they would be considered to have major depressive disorder.
We do not know what all that is now, but that's where we
Amy: think to do a follow up in six months on those people
Ryan: Yeah Yes, but even if but here's the thing that I love about that folks are like it wasn't long enough What have you stayed on? I'm like, I'll can tell you what's interesting if a pharmaceutical had that kind of Response people would be like whoa, but when it's a game, the first thing that comes is skepticism, you know It's like we can look at it.
Well, what if they have to keep playing the game forever? Well, Amy Jo they have to keep taking the medication forever Right? I think the one thing we know about it is sooner or [00:34:00] later they're going to need another game because we need that dopaminergic response, and I don't think you're, once you finish Mario Odyssey, where are you going next?
And that's a lot of what we've been changing that approach as well about, right? It's not how do we build the perfect game, it's how do we build the perfect ecosystem that can keep building these games, where the agency will give us the approvals we want, the developers will understand what it is they're building, And there'll be a reimbursement engine in place where we get compensated for this and we can start to attract who we need to do this work.
And who we need is the best. The other thing you'll find about the most therapeutic video games in the world is they were created by the masters. And the masters get paid for what they do. So, and when you look at also the things that are worst about video games, it's the monetization schedules and that really has caused the biggest problem.
There's nothing really in a gameplay loop that can hurt you. But if you start, you know, using Accessibly using loot boxing, certainly around dopaminergic response. We have free and unmoderated chat going and using energy dynamics that draw people back into the game to preserve the work [00:35:00] and friends and time they've already invested.
Those are the things that make games difficult for vulnerable populations, and they're tied to monetization. So we need to do this work where the agency understands, the game developer understands, and the payer understands, and change the ecosystem so you can get paid for it. To make these things that are really good for folks, keeping new material available all the time because that's going to be an important part of the ongoing therapy.
We're going to need things to keep doing. I think we're going to get better and understand ourselves better through play, especially when you don't have a hunch. Many people use games today to already feel better, but it's a hunch. And, you know, while they're feeling better, they might get a doctor or a parent or a spouse coming at them going, Oh, you're doing this 10 hours a day.
This is really therapeutic for you. I think actually it probably isn't good for you, and then they go off, they go into the drug therapies, they potentially go off into the talk therapies, and they have what I'll call the normal response rates, which aren't amazing. They're better than nothing, but they're not amazing, and for some people, [00:36:00] that's where they actually get worse.
They start to think that they're not really fixable. I was only really good at playing this game. It's only when I felt good, when I actually had to do the real work and did the real medicine, it didn't work on me. I'm not good for anything. And they blame themselves instead of blaming a system where they might have already found their key therapeutic in play.
And the chances that they were going to stay at 10 hours a day if they were getting proper intervention are pretty low. Typically, we have a healing period. We'll see people come back down. If they do, then we're in the place of excessive issues. And the game isn't really curative at that point or solving a problem for them at that point.
They probably have other comorbidities that we've got to look at and see what's going on. Including the idea There's a lot of depressed and anxious people, Amy Jo, that aren't, the core problem's not going away. If you're getting physically or mentally abused on an ongoing basis, and you have other chronic issues like pain, I mean, this idea that there's a magic bullet that's gonna make your life not be the life that's harming you is a different situation.
These are interventions for when [00:37:00] you are in the middle of or have dealt with the core of the issue, and now you're on that recovery path. I don't care what medication you're on, and I don't care what doctor you talk to, If you're being mentally and physically abused, there's only so far they're going to be able to take you until that abuse is stopped.
Amy: Yeah. One of my clients who developed co developed a mental health game as a game from the ground up for teenagers did a project where she took the gameplay to Columbia, the country, and did workshops and worked with kids and caregivers and saw close up close and personal kids in that situation. Um, et cetera, and just game can't solve everything.
So you said the key phrase, which is, there's going to be a segment of the population. It's not going to be everybody. There's a segment of the population for whom this could be the right therapeutic.
Ryan: That's right. And what we see right [00:38:00] now, early data says, this looks more therapeutic than other things we've done.
Like it's going to, it's going to attach itself to a greater level of the population. Right. Right. And have a higher degree of success than some of the things we've seen before, which is, I mean, if you have a new therapeutic or you have a new drug and you come on the market and you show 30 percent improvement on major depressive disorder, they're going to approve that in a heartbeat.
And I think the other really interesting thing is you're not going to know the mechanism of action when you apply for that. You'll have a theoretical mechanism of action. You won't fully know, nor will the agency, but they'll allow us to clear those drugs. And this is the same thing I'm seeing about these games.
We have to get to the place where we identify what's good for you, what's bad for you, make a toolkit of what's good for you, and get comfortable that these are things that deserve a therapeutic label, deserve reimbursement, and really could reduce the cost of healthcare and increase the reach like you can't imagine.
I mean, being successful in medical device, you may know this, but when I say I've had hits, you know, and [00:39:00] I've had hits in the medical device industry enough to retire me, Most of my hits were reaching 100, 000 patients a year or, you know, something like that, you know, maybe in the case of light therapy, we got to a couple million and that was a big deal to have that kind of reach per year, right?
I mean, then you've got 3 billion people already on gaming platform. That's the reach that and that's the reach it's going to take. If you look at globally, what's happening with mental health, it's going to take something like that, right? As an intervention, but it won't if we don't take the other ills out of the, you know, if we don't, you know, If we don't solve the political divide issues, if we don't potentially deal with, you know, the harms that are going on and the disparity of resources and all these sorts of things, it won't completely be this panacea that solves everything, but it can give you coping mechanisms in the beginning, it can restore us to a place where we were a few years ago where we're not right on the brink of, you know, 50, 60 percent of our population being stressed, anxious, depressed.
Some people say those numbers are 80%. Yes, last week at the conference, I heard [00:40:00] someone suggest they're at 90%. So we can tone it down and then we can begin to work on the core issues Which is a lot like any therapeutic and then we got to solve for the core issues And use these also as a way to get to know one another deal with the loneliness epidemic Bring greater levels of connection.
I think media can have a huge part to play I think I don't think anything other than something as powerful as media and story can move the needle
Amy: I hope you're right. I think there's a lot of promise There's one big challenge that I would wager on you're already wrestling with that I just can't help but mention as a game designer, which is the difference between choosing to play a game and the difference between having it prescribed.
Now the Mario Odyssey study is very promising for that reason, right? And but there's a real difference in what you should do and what you choose to do.
Ryan: There's some amazing [00:41:00] psychologically where like professors have said, listen they have said, look, you've got to play Minecraft and you got to build this thing in Minecraft and all of a sudden it became a chore and it broke that whole dopaminergic cycle, that whole, I want to, that sort of thing, I think what we're talking about here is actually not that different than what people have been doing anyways, if we be real about it, there's a lot of people playing games to feel better, they go in there to feel better.
But if they don't just start having fun sometime after they cross the threshold, like pretty darn quickly, if it's not a really good game, it isn't gonna work. And, you know, and I, so I do grapple with it all the time, you know, I say you'll go in for your mental health, but you'll stay because you're having a good time.
That's what makes these are not going to be easy things to produce. I mean, imagine if someone, I mean, I know someone has hired you before, and said, I gotta make a hit video game, and you look at them and say, I'll give you the best team, I'll give you an amazing premise, I'll give you great testing platforms, and I cannot promise you, That I'm going to nail this, because there's no, there's an art and science to it [00:42:00] that is beyond definition.
And now we're adding more components to that. It's the same thing with me. I cannot guarantee you that we'll have high adoption rates on a certain therapeutic. I can do my best, you know, with all the things we have. And there's a magic component in the middle. The further we get to defining that, the better we do.
But that's why it's really going to take, just like it always has, a lot of games. And a lot of media too. I mean this, I don't want to go too far off track, but This does not just apply to video games. Anything that you can become immersed in is something that can get you into this dopaminergic state, can get you a level of visual spatial interference where you're not really cognitively too involved in the moment, and it looks like it starts to heavily accelerate learning and allow you to make memories in a different way, where they become more accessible on a limbic level faster.
So, it's not like a talk therapy sort of thing where, you know, I use this example all the time. Somebody walks into a crowd, and they hate crowds. And they look around and they think, Oh, I suck. This is terrible. And they go running out of there. [00:43:00] They get some talk there, being the talk therapist. Gets them to a place where they understand, Look, you've got to think about that differently.
So the next time they go into the crowd, same stimulus, same response. I suck. And then they start thinking, well, Okay, I mean, maybe I can do this. You know, it's not just me. Other people have a problem with this. And they start using their coping mechanism. When you learn on a limbic level, it's very different than that.
You walk into the crowd, you still don't like it. You get the stimuli, but the first thought in your head isn't I suck, it's this sucks. Now you're in a very, and then you might also have learned to, for instance, take a few breaths. You start having, you know, a very limbic response before you even realizing it, you're taking a couple of deep breaths, you're thinking this sucks.
And then that puts you in a different place, you're at a different set of memories and thoughts. And therefore you're at a different response rate, in which case you might be able to settle yourself down, stay there. But even if you choose to leave, you don't leave because you suck. You leave because this sucks and that's a different perception of yourself and it puts you in a place to be a healthier person.
[00:44:00] That's the kind of changes I see through media, but only if there's a lot of new media that can reach a lot of people in a lot of different ways.
Amy: Beautiful. So, hey everyone, if you have questions for Ryan, write them down, send them to us in the chat. We've already got several queued up. Thank you all for your questions.
So, Tanya Kaelin asks, Can you describe the DeepWell DTx tech stack? Is it web browser or Unity based, for instance? What are your plans to make the tech stack available to other content producers?
Ryan: That is exactly our plan. Maybe if it's okay, Amy, I'll back up and just talk about what DeepWell's doing. Yeah, absolutely.
DeepWell is building content at the moment so that we can get FDA clearance and the FDA to understand what we're doing. But primarily, everything we build, we're not just clearing the games, we're building them as SDKs. Okay. And we're looking to provide those SDKs back to other game developers. We like the idea of supporting indies as well as the [00:45:00] AAA game development in a way that those mechanics can be baked into other games and they allow for a much faster access to being cleared and that allows you to use these actual terms.
My video game is good for stress. My video game is good for anxiety. My video game is good for pain or depression. And so we're building this SDK and we're building it to work with Unity and we're building it to work with Unreal. We're doing a lot of work right now that include audio feedback loops and Unreal's new package is amazing at that.
But both engines are important. The rest of the tech stack is actually really interesting too. On the back end of DeepWell is a quality system that allows a different way of verifying and validating software. Usually the agency wants everything very locked down. But our ability is to separate the therapeutic from the rest of the game and allow those parts that are decorative to the game to be iterative, which is what game developers are very used to doing, in the engines they're used to doing in it, Unity and Unreal, or even if they're [00:46:00] on custom engines, or anything else, a smaller engine that they want to use, and really just managing the therapeutic element of the game as the medical device, which greatly opens up the freedom to design and re change, and change the game, which is not something you can do, The FDA set up their software protocols around things like pacemakers.
They do not want to see iterative change. They want to see it locked down and controlled. So we've managed for that environment in our tech stack. And we're also managing for deployment. So we're getting the agency to understand that this could go out to many mobile devices at many different platforms and not require every hardware platform to be separately validated.
That is a very expensive proposition as well. So a lot of our tech stack is about making the FDA. happy with what we're doing and building an environment where video game developers can be video game developers. The efficacy of the games can be managed. Those things that are therapeutic are controlled in a way that they should be controlled, that the risk is managed for safety and effective effectiveness.
So it's to build this intersection between [00:47:00] media and medicine and provide folks the ability to make a lot of games because that's what it's going to take. It's lots and lots of games that have these labels on them. And then finally, our next trajectory will be to build a referral engine. So when there's enough material out there, we're going to get to know you as a person, a player, your disease state, the equipment at your disposal, and try to find you the best, you know, media, nutritional path for you, which will include, you know, the drugs, so the things that are cleared, as well as we'll call them the vitamins, the things that are just recommendation that are more wellness based, but try to put together for you.
A therapeutic package. And finally, we're working on reimbursement. I'm back into that, which is going to take years. But in the end, we would like to be this epicenter between the tool set the developers can use to build this a set of services that can help people understand how their game is therapeutic and also when it's harmful and a way to get access to reimbursement, a new whole way to get paid, right, which is what will build this immersive medicine environment will change.
[00:48:00] Really, the employment opportunities across the board in both medicine and really an entertainment. I really hope 10 years from now, we'll see the first of a degree, maybe something at Stanford or something like that, where we can work on immersive medicine as a confluence of medicine and media. So people come out capable of doing this in a way that is most effective.
Amy: So Ingrid asks a question and Toby, who's an occupational therapist, has a related question. So I'm going to put these together. And this is about, can you make a living out of developing therapy games? And then Toby asks, what would you recommend for a therapist who wants to get into the gaming space?
Ryan: Yeah, so let me be really clear. At the moment it's very hard to make a living doing it. What I see here is a very big industry that is not ready to pop yet. And the real challenge is the combination of either doing the video game the way the agency wants it today, which is so expensive. That you'd have to sell it for an amount that people can't [00:49:00] buy over the counter and there's no reimbursement.
So that's that misalignment we're talking about. We're working on aligning that by reducing the cost of the development and the management of a cleared game and bringing reimbursement to it over time. So I do see a lot of opportunity here. It feels like we're two to five years away from where this becomes a a large industry.
So that's why a lot of us that are working on this now can afford to. To really not be in a lucrative environment. Most of deep wells, very top people, there's 33 people that sign in every day, do something to deep well, two thirds of them are literally volunteering their time, right? That includes people like Jeffrey saying, you know, who, you know, has come and been successful in the market before he wants this to the level that he's directing all of this work, but he is not taking compensation other than he clearly has ownership.
And we hope that this will grow and do these things. But it's a tough way to make a living so far. I mean, Amy Jo, what would you say about that? You're in here too.
Amy: I am. Yeah, I think it's [00:50:00] interesting. Ingrid also asks, are the experiences Deepwell's developing for use on their own or in conjunction with a therapist?
Ryan: Very cool. So ours are over the counter. So we're looking at Indications like symptoms of stress, anxiety over time with more clinicals, depression, but symptoms of in the mild to moderate, we're reaching the 70 percent of population that can't get access to healthcare that doesn't have the dollars or potentially even really with the dollars may not be able to find that person or that therapeutic that's working for them.
So being said over time, we hope to do more and more of both. We've been approached by a lot of medical device companies. We're looking at some clinicals that would include. pharmaceuticals and we will look to build adjunct therapeutics as well that bring higher accessibility to known care. But our first thing is to get over the counter and be ubiquitous and be as accessible as possible.
Amy: Awesome. So Salty Sea Dog asks, [00:51:00] do you have any advice on how to advocate for games as therapy, maybe resources that might be shared with policymakers?
Ryan: Yeah, I mean the first thing I would suggest. I mean, I put a, I post every day except for Saturdays, that's my one day off, and every day I am sharing the entirety of this.
So there's nothing that Deepwell's doing that isn't completely publicly available. So that's, I mean, getting educated really matters. These studies that are coming out, they really matter. And then, I mean, from a policy perspective, I think that, you know, getting involved and recognizing and rallying for the games that you've already used in the way that they've already been therapeutic for you is very important as well.
We've got to let people know we're not inventing this from scratch. This is not cut out a whole cloth. This is Darwinistic. It's been happening for a long time. And I think that everybody in this current environment is looking for solutions, including the government agencies. I find working with the FDA to be much easier than it was 15 years ago around mental health.
They're trying to, everybody's trying to [00:52:00] find the solution. I mean, we just had a three year regulatory holiday that in a lot of ways made things more complicated. I don't know if folks noticed this, but there was an emergency order. Where if you thought you had something therapeutic the agency as long as you followed their rules But you checked yourself instead of checking them You had the ability to put things in the market and make these stress anxiety and depression claims I think unfortunately that's been a little confusing too because I think we've seen amy joe some of that stuff Probably shouldn't have been making those claims.
Oh, yeah
Amy: i've heard direct stories from clients who are like You know, I got this coverage and I went and I tried a bunch of stuff that was in the portal that You know was covered and it was shit it didn't help me at all
Ryan: I think, sadly, now this is one of those controversial things. I said this at IVRHA, but if we don't talk about it, you know, it might be a bit of a lightning rod, but there's about 20, 000 digital therapeutics out there.
I think it's going to be 001 percent of them that are effective. I really think there's only two paths to being effective at the moment. Either there's something that immediately causes [00:53:00] you to have a shift in body or mind, and mostly it's going to be pain related stuff. Some of those are working really well, but if you don't almost immediately feel the result of it, Then you're going to require this immersive medicine approach, you're going to need game designers because if it needs adherence, you're not getting it without something that is really attractive.
And the only people that know how to do that digitally are media designers. So I think we've got a lot of stuff that was hopeful, you know, it was sort of the build it and they will come do these 20 exercises every day and you'll be better. Well, if that was going to work, digitalizing that wasn't going to change it.
And I think I'll add one other thought to that if you'll let me. I think a lot of folks quickly got confused about what it meant to build something immersive. And I've seen this mostly in VR, where I've seen this mistake every time. Just because something's in VR does not mean it's immersive. It has a higher likelihood of being immersive in VR, but it has to be designed to be immersive.
And again, you're back to your people that know how to do that. Those are the folks in media, [00:54:00] right? They're not the folks in medicine. And so there was this idea that we would, you know, put you in this VR environment as a net result of that. That everything would be better. But a study I published recently on, on LinkedIn, it's not my publication, but I published it on LinkedIn, showed that there was no benefit to being in VR for breath enhancement therapies, for instance.
Now breath is a really strong therapeutic. Vagal nerve stimulation is showing itself to be very therapeutic for us. But if the VR environment doesn't enhance that in any way, now you're just a weight of equipment, a higher potential that people are gonna not feel good or get disorientated while they're doing it, And you haven't enhanced the therapy in any way.
You have probably just deteriorated it and that's what
the studies were showing as
Amy: well. Yeah. It's no small feat. So let's see, we've got a bunch more. So Toby OT asked, what is your take on executive functioning for ADHD clients [00:55:00] with survival games?
Ryan: Well, I mean, first of all, I think survival or what I'm going to say, action games have shown themselves to be the most therapeutic games.
Out there and that's been really controversial when folks are trying to point to the, you know, put violence really at the doorstep of video games. That's not looking to be the case at all. Stanford has done an amazing study showing that's not the case at all. Executive functioning in video games across the board, I think, is a really great intersection.
So I'm a neurodivergent myself, executive functioning and so is my whole family. And executive functioning is where we falter. And I think being able to get into an environment where the stakes are low. But not so low that you don't care, and to have that heavily engaged environment in a way that you become really dopaminergic.
This is a chance to learn to do things that we need to practice as neurodivergents. It's not easy to prioritize tasks, get the right things done at the right time. And whether you're doing that through burger time, or you're doing that through a large adventure game where you need to sequence the work you're doing, it's high enough stakes because you care, but it's not so high enough stakes and [00:56:00] it's not so public that you're falling down in front of people.
Right? Which makes it really hard to practice as a neurodivergent while you're drawing attention to yourself, to your exact challenges. Right? And which, in society often means people start to treat you like you're not intelligent. And that's the worst of it, right? Is to be able to think at or above maybe sometimes in certain subjects above other people's levels while you're, you know, can't find your car keys and get to class on time and don't remember where your homework went and things like that.
Video games, I think, are amazing for this. And they need to be recognized. ADHD, I think they're very useful as well, but I don't think you need a prescription one to do it. It doesn't need to cost a thousand bucks a month or even a hundred dollars a month. There's a lot of games doing everything you need for you right there today.
Anything that has a planful approach, anything strategic, you know, or where you have to order and process and manage your thoughts in a way that if you don't do them in the right and correct order over time, you do not do as well in the game, those are all going to help other people.
Amy: Awesome. So, Dog asks, is there any kind of ongoing database or catalog of [00:57:00] therapeutic games?
Ryan: People do build lists. The problem is they're just folks with opinions at the moment. That really is what Deepwell wants to do eventually, is give you this place where you can come in and know you, because that's also really important when I'm going to sit here. The thing that's therapeutic for me may not be therapeutic for you.
We both, may both have a diagnosis, let's say of depression, but you might be coming this way. from a place of loss, and I might be coming at it from a place of great anxiety. And if we play each other's games, it's gonna literally not work out really well for us. So, there's lists out there, and Deepwell's getting a community together where we're gonna do more recommendations over time, so expect that in the next six months or so.
But I would watch, look at those lists that you can find, and then I would also think a lot about reading the reviews as well. Look for people who sound like you. Those are going to be the games that most likely will do something for you. And don't be afraid to stop something. If it doesn't, if it doesn't feel good, it's not good, right?
It's not supposed to be some sort of hard thing to [00:58:00] overcome or that's, beating you up mentally through it, you know? And certainly, multiplayer games and connection with people matter a lot, but not in environments where folks are not treating you well. One time, somebody says one thing to you that doesn't make sense, you exit that game, be gone of that environment, get away from those people.
Amy: Yeah, and yet multiplayer can be so powerful for learning. You know, I've got a great story that just makes your point about learning new skills in games. Back when I was actively working on MMOs as a system designer, I was working on Ultima Online, a OG MMO, and I interviewed a whole bunch of people that were both in the beta, and it helped us kind of co develop it, and also a bunch of new players.
because we were like six, eight months into after launching. And there was a pattern that emerged out of that, which is a whole bunch of people had [00:59:00] gotten promoted at work into management positions from what they learned running their guild.
Ryan: And a lot
Amy: of them were neurodivergent, you know, me too. It's like, you can learn, right?
You can learn how to role play. And a lot of them had also started to learn that playing D and D. which is there's so many management lessons and group dynamics lessons not to mention explosive creativity that comes out of DND but you know so massive
Ryan: human factors getting everybody arranged agreeing to play the game Setting up a culture where people are comfortable with the level of play that they have.
I mean, are you The folks that really like to act this out, are you gonna, you know, versus the people I'm more of a stoic player when I play D& D. I love it. But I'm not gonna spend 20 minutes acting out a scene. That's just not where my head goes. My boys, they'll act for 20 minutes, and they need to be around people that like that idea.
Right, and so, being able to organize and put yourself together in that way. Clash of [01:00:00] Clans was that for me, which, I mean, Clash of Clans is a lot of things that it needs to apologize for. But the organization of a clan is real work, you know, and if you can do it and you can keep one running and you can be successful with it, you can probably manage a department.
Amy: Exactly. So that's just one example of one kind of game where you can learn transferable skills, right? And that's, it's amazing. I mean, that was one of the experiences I had where I was like, holy camoly, wow, that's very real and I should pay attention to this.
Ryan: But the game companies need to take responsibility for the social environments that are constructed around those games.
So I'll also say, in my clan, in Clash of Clans, I started so I could play with my son, who was 10 at the time. He had a bad attack, and he was lambasted on a level that, that was the end. Like, I pruned all those people out of the clan, I was done, like, what they thought was acceptable. So they said a few things, and I was like, hey, [01:01:00] this is a kid, and my kid, and they didn't stop.
I know exactly who you are, I know exactly what this is. Right. And that's the stuff where I'm saying is a vulnerable population. Not everybody has their dad standing next to them when that stuff is going on. And if you're someone that already has that, I suck mentality running, that's a really difficult place to be when the new peers you have, or maybe the only peers you have are coming at you that way.
So there are wonderful communities online, but you have to find them and you have to have high standards. This is no different than dating or getting married. You know, you get what you tolerate. So do not be in places that don't make sense and don't believe that you can't find it because I mean, there's an amazing study that says almost 50 percent of gamers found their spouse or their best friend through a game.
It's out there, but you got to be choosy about what you do, especially prior to the regulation that you're going to see coming in. The government is going to regulate social media. They are going to think of social media and community tied to games and social media. I think you're going to see a big change in how this happens.
And you're already seeing games like, you know, [01:02:00] call of duty no longer has free and unmoderated chat, right? And that's really important because you're not going to become a first person shooter. Playing Call of Duty. I can guarantee you that. But when you're highly dopaminergic and also fairly isolated, the steady stream of talk going in your head at that moment, it can very much radicalize you or change your perceptions considerably.
So, you know, they now seem to have some filtration they've put on that, and we're going to need to see more and more of that level of control as well. We want to be able to talk to one another freely, right up until the point that it's being used to radicalize folks or harm other people or take from people in some way.
And then there has to be a level of intervention.
Amy: We have time for one more question. And I see there's someone who hasn't asked yet. Todd Smith asks, have you seen much attention or focus on developing therapeutic games for seniors? It's this double design challenge needs to be optimized for older hands and eyes and minds.
I've seen a lot. I can talk about that, you know, in another video. What have you seen? What are you seeing? [01:03:00]
Ryan: I'm seeing a huge demand. I mean, Oh, interesting. From a, from everything from an isolation standpoint, I was just in the Netherlands this year, and, or sorry, late last year, and met with one of the largest elder care facilities in the Netherlands, and they are very much looking for things that they can use to enhance their reach, their quality of care and connect people, all of which I think games are fantastic for.
And there are certain environments, like Animal Crossing is one of these places where this is already happening all day long. My mom's a little bit, you know, she's pretty young actually, but she's got a little bit of pain issues and things like that. And I've, you know, directed her at several different games and suggested that, you know, she progressed from single player.
I'd like to get her into multiplayer environments, but she again has to learn how those worlds work before you go walking in there because usually the first things you find are not the best, but there's very much this level of demand. And we're seeing, I mean, the folks over 60 gaming now, I think the percentage level is up over 30%.
I mean, if you include mobile. The accessibility [01:04:00] is very high and folks are looking for ways to be connected. I like it all the way back to the Wii. I love Wii bowling. I wrote about this about, I don't know, about a month ago. This was like a revolutionary sort of situation in some of the centers that people were in, retirement centers, where they were getting together and doing this Wii bowling.
And it was just, you know, it was a social connection point. It was a level of. Physical exercise that was in, you know, easily enduring and an ability to be good again It's something that you were good at before which is super great for your mental health
Amy: games Give you something fun to do together and that's been throughout history, right?
It's it's a wonderful role they play and it's wonderful that you are tackling This new frontier of bringing games together with medicine in a way that we never could before.
Ryan: Yeah. Thank you I really love all of you The journey has been amazing. I keep bouncing into, I mean, Amy Jo, you're one of those people.
I keep bouncing into amazing folks. I mean, the way we met, you know, being at that round table together and [01:05:00] being a couple voices for sanity in the room that day. You know, there are definitely folks doing things for, we'll call it, not the right reasons. And there's a lot of folks that may be confused about what to do.
But there is a growing group of people that, all of which I find to be just amazing. Just amazing people to be around that are trying to move this medium forward and see just how far we can go. How much therapeutic potential is here. In my whole career. I've not seen anything that has a greater therapeutic potential for mental health that I'm seeing right now with gaming and it's intersection with social components.
Amy: Fantastic. Thank you so much for being here. Thank you so much for all your questions. You made it really fun for us. And I hope your mind was blown as much as mine was.
Outro: Thanks for listening to Getting2Alpha with Amy Jo Kim, the shows that help you innovate faster and smarter. Be sure to check out our website, getting2alpha.com. That's [01:06:00] getting[number]2alpha.com for more great resources and podcast episodes.