Michael’s Game: A Card Game for the Treatment of Psychosis

by Katie Coopersmith © 2017 Gifts for Card Players

We know by now that cards are good for a lot of things besides just entertainment. They can teach kids how to code, form substantial collections that can be traded and catalogued, and so much more. One of the most exciting new uses for cards, however, is one that many of us might not have ever imagined possible: cards as treatment for psychological difficulties.

Michael’s Game is a card game specifically designed to help healthcare professionals and patients understand and apply cognitive therapy for psychotic symptoms such as delusions, hallucinations, and lack of cognitive insight. Over 3% of the population will experience psychotic symptoms at some point in their life – which doesn’t sound like a lot, until you remember that there are about 7.5 billion people in the world right now, and 3% of 7.5 billion is still 225 million people! What’s more, although antipsychotic drugs can be incredibly effective and relieve suffering for a lot of people, many patients still experience residual symptoms that can interfere considerably with their daily lives.Thus, psychosis is pretty darn important for us to continue to try to understand and treat – and creative therapy ideas like this Michael’s Game are really exciting.

The one-to-one talking therapy known as cognitive behavioural therapy (CBT) has been shown to be a particularly effective treatment for psychosis, as it teaches patients to successfully manage their problems by changing their behaviour. “Michael’s game” was developed to help therapists and patients become familiar with CBT. Within the game, participants have to help “Michael”  find alternatives to the wrong conclusions that he draws from the situations described on each card. (Source: ISRCTN)

You might be thinking, “sure, but why a card game?”. It certainly does seem a bit strange at first glance, but if we think about it, Michael’s Game actually sounds pretty similar to most other popular card games. In Michael’s Game, players have to make connections between beliefs, emotions, and behaviours … and other card games certainly also require us to make connections between different concepts!

Using games to treat psychological disorders isn’t a new idea, either. Rather, Michael’s Game stands on the shoulders of a long tradition of exploration into the ways in which gameplay can help change maladaptive thought patterns. For example, games have also been used to treat anorexia and schizophrenia through something called cognitive remediation therapy (CRT).

Michael’s Game isn’t just a potentially cool strategy; its effectiveness is actually backed up by science! Researchers pilot-tested the game and published a paper in 2011 summarizing their findings: Michael’s Game is indeed a useful tool for treating psychotic disorders! Patients who were treated using the game were found to have significantly reduced preoccupation and conviction towards their delusional ideas. They also had improved insight. Overall, approximately 45% of patients saw a clinically significant benefit as a result of playing the game.

One of the neatest things about Michael’s Game is that the people who administer it (generally health professionals) don’t need any prior training in cognitive therapy in order to use the game correctly! This means that the game can be used in a huge array of different contexts, and it could potentially help many, many people.

Aren’t cards amazing?!

Editor’s Note May 2024: “Michael’s Game,” the card game designed for cognitive therapy of psychotic symptoms, is not available for direct purchase online. The game is used in a therapeutic context and typically distributed within clinical or research settings. We have been unable to find specific retailers or online platforms where the game can be purchased by the general public. If you are looking for the game, you’ll need to contact healthcare professionals or organizations that conduct cognitive therapy for psychotic disorders to access the game or find out more about obtaining it.