Implementing nonstigmatized mental health interventions and tools within community programs serving diverse populations may reduce inequities in access to mental health care and preventative emotional learning. One potentially impactful tool is Mightier, a heart rate biofeedback-based videogame that aims to foster emotion regulation skills and practice through game play. In a randomized controlled trial, the present study evaluated the efficacy of Mightier when utilized in a community setting. Seventy-two children (ages 7–12) from a low-cost community summer camp were randomly assigned to play Mightier for 6 weeks or continue camp activities as usual. All campers participated in biweekly social and emotional learning groups. Participants exhibited significantly greater levels of adaptive emotion regulation and lower levels of emotional dysregulation, internalizing symptoms, and externalizing behaviors after the intervention. Caregivers of participants in the intervention group also reported significantly less parenting-related stress after the intervention. When incorporated into community programs, biofeedback-based videogames can foster emotional intelligence competencies in children without access to traditional mental health services.

Biofeedback-based digital games offer an engaging solution to the burgeoning youth mental health crisis. This review identified and evaluated empirical evidence of biofeedback-based digital games in the treatment of youth mental health challenges and the promotion of youth well-being. A systematic search of four electronic databases (CINAHL, PsycInfo, PubMed Central, and Web of Science) was conducted from the publication’s year of inception. We identified 604 unique studies, 16 of which were included in the review based on eligibility criteria. The results of 7 studies were deemed generalizable due to their design. Participants in these 7 studies played Dojo , emWave , Mightier , RAGE-Control , or Wild Divine , all of which utilized a form of cardiac biofeedback. These games proved effective in reducing internalizing symptoms, externalizing behaviors, and general psychopathology, especially within clinical populations. In addition, there is promising evidence of their ability to promote emotion regulation skills as a universal intervention. Future directions include further evaluation of biofeedback-based digital games in school-based settings, as an interim treatment for waitlisted families in outpatient settings, as an add-on to existing evidence-based treatments, and of the cost-benefits to promote insurance coverage of biofeedback-based digital interventions.