In this episode, Gary and Nathan continued their conversation with David Brendel, M.D., Ph.D., a psychiatrist, philosophical counselor, and executive coach. In the first interview, David told us that his approach to mental health is inspired more by an existential commitment to “personal agency” than by the biological focus of traditional medical models in the West. He also emphasized that the mental health profession cannot get very far in helping people without a philosophy that people are responsible for their own lives. David explained to us how he and his clients become active participants in a collaborative endeavor to improve their lives.
A challenge in David’s practice, because it is different from the common medical model, is that his clients must overcome preconceptions about the doctor-patient relationship, about treatment as something given to them and for which they have little or no responsibility, and especially about ceding power to the promise of prescription drugs. David described how video games provide a new context within which to interact with patients and to provide therapy, a therapeutic methodology that is relatively free of preconceptions about medical practice. Video games are replete with opportunities to experience personal agency and enhance self-efficacy even if only in small ways, perhaps especially effective because they are small and frequent.
David told us about his involvement with, SPARXTM, a video game that treats depression. Researchers in New Zealand, led by Dr. Sally Merry, developed this award-winning game with funding from the governments of New Zealand and Australia because of large under-served populations with high rates of depression and teen suicide in those countries. David is Chief Medical Officer of Linked Wellness, a company that has licensed SPARXTM for further development and use in the United States. He praised David Burt, CEO of Linked Wellness, and their associates for their passion about novel solutions to mental health. In the initial clinical trials, use of SPARXTM resulted in a remission rate for depression of 43% versus 26% for face-to-face Cognitive Behavior Therapy (CBT). This is especially noteworthy because CBT is one of the most successful therapies for depression.
David believes we are at a tipping point toward widespread community discussion on the benefits of well-designed games. In this respect, the overlap is direct and explicit with the initiatives described by our prior guest, Justin Bastian. It blurs the distinctions between medical treatment and collaboration, between adoption and interest, between adherence and delight, and between consumption and engagement. As David has stressed, language is important in its potential for social contagion, that is, words that both reflect and influence action. In mental health, bold action is needed given, for example, that 80% of teens with depression in the U.S. don't receive treatment and that 50% of population will experience depression, anxiety, or bipolar symptoms at some point in the life span.
Dr. David Brendel, received a Ph.D. in Philosophy from the University of Chicago, M.D. from Harvard University, and B.A. in Philosophy from Yale University. He is the Founder of Leading Minds where he is an executive and personal coach, and he has a private practice in Psychiatry. He also has several other professional affiliations in which he helps individual and organizations cross the divide between science and the humanities. Connect with Dr. Brendel on Twitter
Key Terms and Concepts
- personal agency
- self efficacy
- video games
- Linked Wellness
- Cognitive Behavioral Therapy
- social contagion