A CBT-Based Serious Game on Social Anxiety: Narrative Design and Validation

Document Type : Original Article

Authors

1 Department of Counseling, Faculty of Education and Psychology, Alzahra University, Tehran, Iran.

2 Department of Electrical and Computer Engineering, University of Tehran, Tehran, Iran.

10.22098/jpc.2025.17602.1330

Abstract

Aim: The aim of this study was to design and validate a serious game-based cognitive behavioral therapy (CBT) for adolescent girls with social anxiety, using a structured scenario-writing protocol based on Hoffman's Social Self-Appraisal Therapy Model.
Method: The research employed a multi-phase approach encompassing scenario preparation, expert evaluation, face validity testing, usability assessment, and pilot implementation. Content validity was evaluated by ten psychologists and counselors utilizing the Content Validity Index (CVI) and Content Validity Ratio (CVR) metrics. Face validity was assessed utilizing the Story World Absorption Scale (SWAS) with a cohort of 10 adolescent participants. A pilot study including an additional cohort of 10 adolescents evaluated alterations in social anxiety utilizing the Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA). Usability and player experience were examined through the MEEGA+ instrument.
 Results: The results demonstrated strong validity and efficacy of the serious game. Content validity was confirmed (overall CVI > 0.79, CVR > 0.62), along with robust face validity - evidenced by attention and transportation scores exceeding 0.81 (Kappa coefficients = 0.85, 0.81) and emotional engagement and mental imagery scores above 0.61 (Kappa coefficients = 0.78, 0.72). Additionally, a significant T-test result (t(9) = 16.74, p < 0.025) further supported these findings. Based on the MEEGA+ evaluation, the game was classified as 'good quality,' with θ scores ranging from 57.5 to 63.5 across usability and player experience subscales
 Conclusion: The results revealed that the CBT-based serious game is both experientially effective and clinically promising. For adolescents with social anxiety, it provides a scalable and entertaining intervention tool, especially in situations where access to conventional therapy is restricted.

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