Development and preliminary feasibility of Healing Minds Through Play: a multi-stakeholder-informed CBT–DBT-informed psychoeducational game for early adolescent counselling sessions in Malaysia

Abstract Background Adolescent mental health is increasingly recognised as a critical public health issue, particularly as many mental disorders begin in early adolescence. In Malaysia, findings from the 2023 National Health and Morbidity Survey (NHMS) revealed significant prevalence of depressive and anxiety symptoms among adolescents. Objective Despite the growing need for early intervention, many adolescents struggle to actively engage in their first counselling session due to stigma, fear of being judged, and difficulty expressing emotions. In practice, this often manifests as silence, minimal responses, and prolonged pauses, which delay therapeutic alliance formation and therapeutic engagement. Method This study aimed to develop and assess the early feasibility of Healing Minds Through Play, a CBT–DBT-based psychoeducational Snakes and Ladders game designed to support early engagement and emotional expression among adolescents. The study employed a Research and Development (R&D) approach encompassing needs analysis, prototype development, expert validation, and a pilot feasibility test. The needs analysis involved 101 respondents, while the pilot test was conducted through individual counselling sessions lasting 45–60 minutes with adolescents aged 10 to 19 years in real-world settings. Findings : Preliminary results indicate that the prototype is easy to use, positively received, and demonstrated potential in mitigating communication barriers and enhancing readiness to communicate during early counselling sessions. Future Research : Further studies are recommended to develop a hybrid digital version incorporating interactive boards, DBT audio, CBT animations, and multilingual support to enhance inclusivity. Conclusion The game-based approach creates a clinically-informed, less intimidating medium ,thereby strengthening the foundation for early rapport between adolescents and mental health professionals. As a low-cost, culturally adaptable psychoeducational tool, Healing Minds Through Play has the potential to contribute meaningfully to the achievement of SDG 3 (Good Health and Well-being), SDG 4 (Quality Education), and SDG 10 (Reduced Inequalities) by improving access and early engagement in adolescent mental health services.