European Child & Adolescent Psychiatry

, Volume 28, Issue 3, pp 307–318 | Cite as

Changes in irrational beliefs are responsible for the efficacy of the REThink therapeutic game in preventing emotional disorders in children and adolescents: mechanisms of change analysis of a randomized clinical trial

  • Oana A. David
  • Roxana A. I. CardoșEmail author
  • Silviu Matu
Original Contribution


The mechanisms of change are rarely investigated in the field of gamified interventions for preventing emotional disorders in children and adolescents despite the wide recognition for the advantages they offer as prevention tool. Therefore, the aim of the present study was to investigate the mechanisms of change of a therapeutic game (REThink), specifically mediators and moderators of its efficacy. We conducted a randomized controlled trial, involving 165 children (age range 10–16 years), who were randomly distributed across three groups: the REThink group (N = 54), the Rational Emotive Behavior Education group (N = 55) and the Waitlist condition (N = 56). Results indicated that changes in irrational beliefs were significant mediators for the REThink intervention on depressive mood and overall negative emotions. Age did not moderate the effect of REThink, which indicates that the program was equally effective for children and adolescents.

Trial Registration NCT03308981.


Therapeutic game Prevention Internalizing disorders Randomized controlled trial Rational emotive behavioral therapy 



We thank Carmen Pop, Răzvan Predatu, and Mădălina Sucală for their contribution, without which the present study could not have been completed.


This work was supported by a grant awarded to Oana A. David from the Romanian National Authority for Scientific Research, CNCS—UEFISCDI (Grant number PN-II-PT-PCCA-2013-4-1937).

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Oana A. David
    • 1
  • Roxana A. I. Cardoș
    • 1
    Email author
  • Silviu Matu
    • 1
  1. 1.Department of Clinical Psychology and Psychotherapy, The International Institute for the Advanced Studies of Psychotherapy and Applied Mental HealthBabeş-Bolyai UniversityCluj-NapocaRomania

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