When Carly McCullar, 32, was diagnosed with autism spectrum disorder as an adult, she wanted to improve her social and communication skills before heading into the next stage of her life.

Never having received such help before, she volunteered to participate in a unique treatment program: virtual reality. Sitting at a computer that tracked her facial expressions, the game tested her social cognition and provided feedback, McCullar played through various realistic scenarios, including a job interview, a confrontation with a loud neighbor and even dating.

The program, a collaborative effort from gaming technology experts and health researchers at the Center for BrainHealth at the University of Texas at Dallas, simulates everyday experiences and social situations that are typically difficult for those with autism or anxiety disorders. And it’s just one example in a growing trend in which video games are forms of therapy.

“The program starts to not feel like a game … It feels real,” McCullar tells Mashable. “You know it is an alternate reality, but you feel the same emotions you would feel in the actual situation you are practicing.”

That’s the program’s purpose: The immersive experience allows users to train their responses and handle certain scenarios to prepare for everyday life. In McCullar’s case, her confusion transformed into emotional connection. The “social mistakes” she made in the game, she explains, made her rethink actual conversations and situations.

“No matter where individuals fall on the autism spectrum, those diagnosed often struggle to succeed in a world based on human interdependence,” says Dr. Sandra Bond Chapman, founder and chief director of the Center for BrainHealth.

Chapman says the Center for BrainHealth began using a virtual reality platform more than seven years ago to see how leveraging technology in a safe, controlled environment could induce brain, cognitive, social and real-life changes.

Tandra Allen, M.S., head of virtual reality training programs at the Center for BrainHealth, says video games also make it easier to tailor situations to specific patients to increase the scope of treatment.

“The virtual training is meant to offer a program when there is often a gap in traditional therapy, at a critical time in development … as well as provide high-level cognitive training that can continue to foster independent growth and living,” she says.

Designed for people between eight and 40 years old who are developing their frontal lobe reasoning, the Center for BrainHealth currently administers 10 hours of gameplay over the course of five or six weeks.

Two years after completing the program, McCullar is now an elementary school teacher in the Dallas area, and says she has much more confidence.

“When you don’t know what friendship is or what it means, it is hard to understand its importance,” she says. “[Now] I am planning my wedding to the love of my life, and I have made real friends, long-lasting friends whom I know I will maintain relationships with.”

The research team is partnering with Yale University’s Child Study Center to test the feasibility of providing the research-based training program to young adults across the country.

Games, especially analog games, aren’t new to psychology and psychiatry — role playing and psychodrama, for instance, have long been used to help doctors and patients better pinpoint issues, and psychologists often employ board games in family and child therapy.

As gaming technology grows more advanced, so does the use of video games in pyschotherapy — and many researchers are starting to give it the necessary attention.

It’s due, in part, to the high entertainment value of electronic games. In fact, 51% of U.S. households own a dedicated game console, according to the Entertainment Software Association, and those that do own an average of two. Experts believe this presents a great opportunity to tap into that widespread interest to benefit mental health, especially with children.

According to clinical and child psychologists Drew Messer and Brian Moyer, co-directors of Electronic Gaming Therapy, Inc., we can actually trace the use of video games in therapy back to the 1980s, when home video games were first introduced.

Some mental health professionals developed games specifically for therapy, while others used commercial, off-the-shelf games, such as Super Mario Bros. and The Legend of Zelda. Both types of games helped doctors establish relationships with patients, or even soothed their anxiety in the waiting room.

Playmancer was specifically designed to help people with impulse-related disorders, such as bulimia and compulsive gambling.

Messer and Moyer do the same today, just with newer titles, including Minecraft, Mario Kart, Nintendo Land, Halo and Portal 2 (which researchers recently found is excellent in improving cognitive skills).

“For younger kids, a lot of it is motivational … You can [also] set up conditions within a game so a child gets frustrated,” Messer tells Mashable. “That’s a wonderful opportunity to ask, ‘How are you feeling?'”

Moyer adds that they often work with higher functioning kids on the autism spectrum, for whom cooperative, multiplayer games work especially well.

“Sometimes [it] can be as simple as building family relationships and interpersonal skills,” he says. “Getting kids together … with family members or in groups playing different games [can help us see] how they cooperate, how they compete, how they send appropriate signals to each other.”

In the future, we can expect using virtual technology for mental health purposes to become easier, and even more readily available. But the field requires further study — researchers are still finding out what works, and for whom.

Dr. Amit Etkin, assistant professor of psychiatry and behavioral sciences at Stanford Health Care, isn’t officially prescribing games as therapy yet, but he does give interested patients a list of games he’s testing — with caveats about not having attained adequate results just yet.

Stanford has been working with Lumosity and MyBrainSolutions to address depression, which Etkin says involves impairments in thinking — specifically the ability to hold and manipulate information in your mind — and emotion, specifically negative emotional biases even in interpreting neutral information.

“In general, these games look much like tests we run in the lab, but are challenging and adaptive, so that participants continue to ‘work against resistance,’ to use an exercise analogy,” Etkin tells Mashable.

The paper containing results of these tests is currently being reviewed, so Etkin can’t offer specific findings. However, he does say the participants enjoyed the study: “The results are very promising, and fit the idea of needing to target abnormal brain circuits to see clinical change.”

The success in these games may lie in how they can complement existing treatments. For example, Etkin says traditional psychotherapy might be more efficient after a patient’s cognition and biases have improved.

“[These games] have tremendous promise, though as a parallel route, where it is something that people can do at home — getting around issues like stigma associated with mental illness and coming to a psychiatrist for treatment — and places where it is hard to get into treatment,” Etkin says.

Right now, no such games have specific Food and Drug Administration (FDA) regulations for therapy treatment (the FDA has a special division that approves medical devices), though Etkin mentions one company is pursuing approval for schizophrenia. However, since many games are available commercially to begin with, it’s unlikely that the FDA would require regulations.

“It is up to the discretion of each doctor, but the relationship between availability of the training games and knowing what actually works, versus what is just wasting time, is very loose and definitely not well-enough developed yet,” Etkin says.

As researchers continue working to figure that out, they’ll further unlock the potential of using video games for therapeutic purposes.

Until then, Chapman is hopeful.

“We now know that the brain changes in social engagement and that the virtual reality environment is a viable platform for treatment,” she says. “There really are limitless possibilities.”

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