Expressive art therapies for treating online games addiction in COVID-19 outbreak: Why are they important?

Dear Editor,

Despite the fact that COVID-19 is in full swing, most countries throughout the world continue to perform teaching and learning activities from home. Students in many countries experience burnout since they can only spend 24 hours a day away from home. As a result, many of them are seeking methods to pass the time at home by playing free online games, which can be accessible by mobile phone or PC programs [1]. Furthermore, many of them are addicted to online games [2]. If this continues, it may interfere with their daily activities, such as becoming unproductive as a student, procrastinating, and being too lazy to study [3], [4].

According to a study conducted by Lee, Ko, and Lee [5] and Zhou and Leung [6] , an online games addict is someone who feels lonely and disconnected from the real world. Online games addicts believe that by playing games, they might experience what they genuinely desire in the actual world, such as having pals to play with, receiving praises when they win certain games, and delighting in becoming winners among those who others, especially as an achievement [7].

So, one simple technique to help online games addiction is to pay them attention, warmth, and praise in their everyday life, especially at home. The role of parents and family is crucial in this regard. Utilize expressive art treatments such as music, dance, imagery, visual, writing and literature, drama, play and humour, animal-assisted, therapeutic horticulture, and wilderness/nature [8]. These activities are simple to perform when done together at home, and they are, of course, delightful when utilized as an alternative for playing online games, allowing game addicts to feel what they desire so far, namely attention, warmth, and admiration. For example, they may be encouraged to play music and sing along [9], [10], [11]; they may be encouraged to dance together using the TikTok application [12]; they can be welcomed to envision beautiful things [13]; and they may be welcomed to sketch and colour together [14]; they can be encouraged to write and read about topics that interest them via writing and literature [15]; they might be encouraged to play specific dramas with their significant partner at home through drama [16]; they can be encouraged to maintain specific pets, such as dogs, cats, chickens, ducks, birds, and others, with animal-assisted [17]; they can be asked to cultivate vegetables at home via therapeutic horticulture [18], and they can be asked to journey into the wild through wilderness/nature [19], [20].

As supplementary information, the author has a specific case report experience with an online games addict. A 23-year-old male college student from Jakarta – Indonesia with five or more of these clinical signs in one year to have a problem, according to criteria that were proposed in the DSM-5 [21]: (1) being preoccupied with gaming all or most of the time; (2) feeling horrible when he is unable to play; (3) wanting to spend more and more time playing in order to feel good; (4) unable to quit or even play less; (5) not wanting to do other things he used to enjoy; (6) experiencing problems at work, school, or home as a result of his gaming; (7) continuing to play despite these problems; (8) lying to close friends and family about how much time you spend playing; (9) using gaming to alleviate negative emotions and moods. The pathologies experienced by this patient are described as the inability to stop excessive gaming behaviours notwithstanding accompanying social and/or emotional concerns [22]. Based on the information contained in the patient, the precise diagnosis is that he has video games addiction. This patient has been addicted to online games for more than one year since COVID-19 hit Indonesia in early March 2020, so the patient experienced a delay in treatment.

As a follow-up, this patient receives animal-assisted and wilderness/nature therapies from the author. This is incredibly effective and has been shown to lower the amount of time he spends playing video games every day. In his daily life, the author becomes a participant observer, therefore the author always notes and pays attention to each person's behaviours. Initially, he played video games for 12–15 hours per day, but this was gradually decreased to barely one hour per day till now.

According to this explanation, any sort of expressive art therapies can be employed as an alternative treatment for online games addiction. Hopefully, this post will be useful in convincing many individuals across the world to explore expressive art treatments as a viable answer to the issues presented in this letter.

Human and animal rights

The author declares that the work described has involved experimentation on humans.

Informed consent and patient details

The author declares that the work described does involve patients or volunteers.

Disclosure of interest

The author declares that he has no competing interest.

Funding

This work did not receive any grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author contributions

The author attests that he meets the current International Committee of Medical Journal Editors (ICMJE) criteria for Authorship.