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Mental health used to almost be taboo to talk about. Today, many people take intentional steps each day to improve and maintain good mental health.

Strategies include the expected—exercise, a healthy diet, plenty of sleep, yoga.

Dr. Stephen Kuniak, a faculty member in CommonwealthU’s online Clinical Mental Health Counseling (CMHC) master’s program has another strategy to add to the toolbox—gaming.

Video games, tabletop games, role playing, and fantasy literature can all help some people through difficult times, says Kuniak, who is based out of the Lock Haven campus.

Kuniak has experienced first-hand the benefits of gaming therapy and has since brought it into his own personal practice as well as his classes, many of which focus on the practical application of the content for the students to use in their future practice working with clients.

The CMHC master’s program is CACREP accredited and offers several concentration and certificate opportunities for students. The program also received the Outstanding Education Program award during the 2023 Pennsylvania Counseling Associations’ annual conference. 

"I really think that we have the best of all worlds. Delivered online, but taught in a way that resembles a traditional on-ground program,” says Kuniak, a professional counselor for nearly 17 years, who has worked in family, substance abuse, and relationship counseling. 

A gamer since childhood, at Saint Vincent College Kuniak conducted undergrad research projects on the benefits of fantasy storytelling.

During his first semester of his Master’s of Counseling program at Duquesne University, Kuniak was involved in a serious car accident in which his car was hit head-on by another vehicle. His right femur was crushed and he had to endure reconstructive surgery involving a titanium rod and pins being placed through what was left of his leg. It was during his recovery when he began to see a clinical application of gaming.

“I found that diving deeply into fantasy stories and particularly deep narratives in the games that I enjoyed playing were a better way to occupy my mind than the pain medication I was given. And though this wasn’t any sort of magic, I realized that there were some practical utilities to games,” says Kuniak.

When he began family-based counseling, an in-home model of treatment where a child is at risk of removal from their home, he found that connecting with his clients quickly was imperative to helping them. Gaming began to be a bridge that made that rapid connection possible.

“Over time, I’ve found more opportunities to incorporate gaming into practice and expanding my repertoire of interventions,” Kuniak says. “I’ve made connections between the interventions and the theories that we use in counseling. I also tend to teach these in specific courses where we learn more about incorporating creative interventions to reach clients in unique and out of the box ways.”

Kuniak has found that integrating gaming into his teaching lessons help him reach students who are also a gamer or are interested in pop culture. “I think it also shows students how to modify theoretical perspectives or specific counseling interventions to better meet the needs of our clients,” he says.

Gaming incorporates itself well into his courses, as it lines up with art and play therapy skills and shows the students how to use other areas of interest to help their clients.

"There is a perspective that gaming is something fringe and that only maladaptive people are engaging in these behaviors, but it’s estimated that more than 60% of the population game at least one hour a week,” explains Kuniak. “There are a lot of reasons why people game,” Kuniak says. “The stories, art, and music can all be very deep and emotionally charged, it’s not just getting high scores and completing mindless tasks. We game to feel something."

According to the Entertainment Software Association, a non-profit organization that gathers trends and usage reports for the games industry, estimates that roughly 190.6 million people between the ages of 5 and 90 game at least 1 hour per week, and of that, 80% game socially.

The stories, art, and music can all be very deep and emotionally charged, it’s not just getting high scores and completing mindless tasks. We game to feel something.
– DR. STEPHEN KUNIAK

In his practice, Kuniak has found that being able to “speak gamer” has helped him connect better with his clients who are members of the culture and using gaming interventions tends to help make the work more palatable for his clients.

“It provides unique metaphors to build upon and clever ways to practice skill areas without putting the client through extra challenges that might make progress as hard. I’ve found that it can help to build our therapeutic relationship more quickly and effectively,” Kuniak says. “Counseling can naturally be rather uncomfortable, and this can remove some of that discomfort for a specific population.”

Kuniak’s practice has evolved. Rather than just focusing on what he could individually do with his clients in a small amount of time, he decided to turn it into a non-profit organization that provides education, outreach, treatment, and gathers research data.

“I call the organization ‘Experience Points,’ a gamer term for the points earned in a game from completing difficult tasks, which are used to level up your character,” Kuniak explains. “It is a really clear metaphor for what we try to do with our clients in mental health counseling. Help them achieve experience points through their treatment goals, in order to help them level up their mental health.”

Kuniak has been interviewed for his work in publications like the Washington Post and Counseling Today, was interviewed on the talk show KDKA “Talk Pittsburgh,” and has had a study on “gamer culture” published in the Journal of Creativity in Mental Health.

“It’s been really exciting to see people’s interest in the gaming culture,” Kuniak says. “It lets me know I’m finding a niche that really deserves to be paid attention to.