The premise at the core of Cognia's invention is that gaming - particularly RPG adventure games - fosters mental health in a holistic, self-directed way. That is to say, gaming is good for us (Johnson et al., 2013). To do so, the goal of Cognia is to provide a narrative - complete with character/identity creation (Przybylski et al., 2011) - and set of play mechanics that put players into situations where pro-social and pro-emotional skills are exercised and rewarded as part of the adventure!
When using Cognia as the setting for an adventure, it should be considered who is crafting the experience. If the DM is a traditional gamer with minimal mental health training, it may be wise to explore the setting and narrative with a simple respect for the mental health theme.
If the DM is a mental health practitioner, it may be useful - by their judgment - that play and narration explore trauma and emotional regulation!
To this end, Cognia's first benefit is that the ecology and narrative of this world are literally an opposition to despair and suffering. This primes practitioners to explore the various emotions in a way akin to: "you are about to defeat a Frighder, that is, about to overcome a great fear. Before your eyes, the Frighder invokes a vision as it dies. What does overcoming fear look like for you? What fear might you like to witness overcome?" Narrating in this way; therefore, compels players to consider the same things they might in traditional therapies, but from an empowered perspective wherein they take on the role of a great vanquisher of fear and despair, and experience the same depressive relief as gaming through other mediums (Durkin & Barber 2002).
Cognia's next boon for mental health practitioners is one it shares with all RPGs, role play! Cognia's character creation includes a focus on mental health resources in the form of skills connected with well-being, flaws to be overcome, a suffering condition, and a new statistic: HOPE. Using these new mechanics gives players an opportunity to create a character - with which they are intended to identify (Bessiere et al., 2007) - that has both the resources and means to develop mental and emotional well-being, and give them an immersive point-of-view with which to explore that identity and the skills that foster it.
During character creation, practitioners are encouraged to ask players how and why they are making their choices, and describe how they might use hope (and their other stats, feats, and abilities) to defend their pool of mental HP. This immediately fosters self-talk that makes players speak to and of themselves as if they are already well-versed in maintaining their mental health (Kross et al., 2014). This self-talk - like the ‘character talk’ we observe in traditional RPG gaming - is maintained throughout play, which encourages not only positive self-talk, but developing self-talk as the character grows and learns more well-being skills in-game.
References
Bessiere, K, Fleming Seay, F & Kiesler, S 2007, ‘The Ideal Elf: Identity Exploration in
World of Warcraft,’ Cyberpsychology & Behavior, vol. 10(4), pp.
Durkin, K & Barber, B 2002, ‘Not so doomed: Computer game play and positive adolescent
development,’ Journal of Applied Developmental Psychology, vol. 23, pp.
Johnson, D., Jones, C, Scholes, L & Carras, M. (2013). Video games and Wellbeing: A
Comprehensive Review.
Kross, E., Bruehlman-Senecal, E., Park, J., Burson, A., Dougherty, A., Shablack, H.,
Bremner, R., Moser, J., & Ayduk, O. (2014). Self-talk as a regulatory mechanism: How
you do it matters. Journal of Personality and Social Psychology, 106(2), 304–324.
Przybylski, A K, Weinstein, N, Murrayama, K, Lynch, M F & Ryan, R M 2011, ‘The ideal self
at play: The appeal of videogames that let you be all you can be,’ Pscyhological
Science, vol. 23, pp. 69-76. 2012_PrzybylskiEtAl_PsychScience.pdf