Pseudo-Counselling Interviews and “Area-of-Effect” Healing: A Thematic Analysis of Healthy Gamer Interviews as a Form of Mental Health Intervention (Interview Mechanisms)
CITATION: Lee, G. (2025), ‘Pseudo-Counselling Interviews and “Area-of-Effect” Healing: A Thematic Analysis of Healthy Gamer Interviews as a Form of Mental Health Intervention (Interview Mechanisms), Journal of Social Science Student Research, Volume 3, DOI:
Abstract: Despite increasing awareness of the negative impacts that poor mental health can have on individuals and society, demand for psychotherapeutic services vastly outstrips provision. Digital-interventions may be one way to help meet demand through offering increased accessibility, and lower-cost solutions. For example, HealthyGamerGG is an online organisation produces pseudo-counselling interviews i.e., long-format discussions between a trained-psychiatrist and interviewee using therapeutic methods on popular video-streaming platforms (Twitch, YouTube). Using data collected from HealthyGamerGG’s platforms on Reddit and YouTube, this study takes a critical-realist, inductive thematic-analysis approach to investigate viewers’ perceptions of potential mechanisms for change in pseudo-counselling interviews. This study found that viewers, through resonance with the content, experienced personal transformation and psychotherapeutic effects, acting as a supplement, alternative or catalyst for therapy. This study is the first to investigate this format of intervention by HealthyGamerGG and suggests a fuller evaluation is warranted, given the apparent therapeutic benefit and large population utilising these videos. The effectiveness of internet-mediated research compared to interviews/focus-groups for producing high-quality responses is also examined.
Key words: Digital Intervention, Mental Health, Psychotherapy
1. Introduction
Despite attempts to increase access to mental health services, a substantial gap remains between demand and treatment (Chen & Cardinal, 2021). Recent polling of 535 British-adults diagnosed with mental illness has found 78% of people on waiting lists, reported resorting to emergency services in absence of mental health support (Royal College of Psychiatrists, 2022). Financial constraints also make psychotherapy widely inaccessible, both in the UK (Clark, 2018) and globally (Keynejad et al., 2018). Furthermore, there is evidence that the mental health needs of diverse populations are not being met effectively nor efficiently by traditional models of healthcare (Clark, 2018; Knaak, 2017). This suggests that there is an urgent need for low cost, scalable mental health support. Digital interventions may offer cost-effective alternatives (Zheng, 2022) to traditional therapies which may improve mental healthcare access and quality.
1.1 Digital Interventions
Due to these impediments surrounding traditional psychotherapeutic treatments, more readily accessible interventions, utilising digital platforms have become increasingly widespread (Langarizadeh et al., 2017; Bhugra et al., 2017). With platforms providing pathways to healthcare or psychoeducational content (Garrido et al., 2019). Here, psychoeducation describes interventions focused on enhancing participants’ education, coping skills and development (Walsh, 2013). Digital innovations can be a particularly effective medium for psychoeducation as low-distribution costs provide easy access to material with low logistical or financial burden (Lal and Adair, 2014; Torous et al., 2021). Research has previously validated the usage of popular platforms such as YouTube for disseminating psychoeducation with positive results (Lam et al., 2017) and that it is increasingly being used to disseminate healthcare information (Madathil et al., 2015). This article uses digital interventions as an umbrella-term for interventions empowered by technology, often the internet, as commonly used in the literature (Liu et al., 2023).
Given the rapid advancements of digital interventions for providing psychotherapeutic support, newer models are emerging which appear incredibly promising. Nevertheless, the recent development of such models means that sometimes academic or regulatory scrutiny falls behind in the process of evaluating and validating outcomes. One such example arises in HealthyGamerGG.
1.2 HealthyGamerGG
Originally developed by Dr Kanojia, HealthyGamerGG -a mental wellness company- provides a system of interventions including online videos and coaching. Whilst its original population focused on persons with gaming/online addictions, both the content produced and the population accessing the content has grown beyond its target audience. With limited resources, the interventions appear to have an outsized-positive effect upon its community suggested by its impact report (Kanojia, 2021b). Healthy GamerGG has an active network across multiple platforms (YouTube: 880,000 subscribers, Reddit: 59,000, Twitch: 581,000 followers, Discord: 55,000 members). Users view diverse videos on mental health and can actively engage through commenting and liking.
1.3 Pseudo-Counselling Interviews
HealthyGamerGG offers a wide range of psychoeducational content (Kanojia, 2019b), including peer-coaching, both one-to-one and in groups. The most novel intervention HealthyGamerGG provides is the use of live, long-form interviews, which often take a psychotherapeutic approach. Over the course of two hours, individuals with differing backgrounds undergo a process with many similarities to what typically occurs in closed, one-to-one therapy sessions (e.g. Kanojia, 2019a). These are streamed to audiences live on Twitch, then uploaded to YouTube. These interviews are labelled pseudo-counselling interviews given their similarities to counselling, but explicitly stated not to be an example of formal counselling. Whilst the individuals (both public figures and private persons) interviewed appear to benefit from sessions, so too, do the audience, with viewers reporting deep resonance with the content and reporting benefits exceeding personal therapy sessions. However, unlike one-to-one psychotherapy, this model reaches large audiences, is infinitely replicable and free-to-access, thus lacking traditional personnel and cost constraints.
This indicates that recordings of interviews using a psychotherapeutic approach may have great value as an intervention to support a wide variety of populations desiring access to mental health support but unable to access it through conventional means. Service-users watching the videos appear able to follow and undergo similar processes as the interviewee in a way that emulates the one-to-one experience of counselling sessions. Within the community, this is described as AoE (Area-of-Effect) Healing (Kanojia, 2019a).
In summary, this intervention may offer a scalable solution to increasing access to mental-health resources which is greatly needed in the current climate. However, no pre-existing literature explores this format of intervention. Therefore, this study investigates the perceived effects of pseudo-counselling interviews through a thematic analysis of YouTube and Reddit comments by viewers.
1.4 Mechanisms in Literature
Bandura’s (1977) Social Learning Theory (SLT) provides a basis for how watching pseudo-counselling interviews may enable behavioural change in viewers. This paradigm asserts that behaviour can be learned through the observation and imitation of others without motor reproduction or traditional Skinnerian reinforcement (Baer and Bandura., 1963). This appears to apply in these interviews, where viewers, empathising with interviewees, seem to learn through their experiences and receive vicarious benefits from observing interviewees’ change. SLT also provides insights into what forms of pseudo-counselling interviews may be more effective as it has been long established that observing models who are more similar to the learner leads to a greater level of learning (Bandura et al., 1963; Bilias-Lolis et al., 2012).
2. Methodology
This study took a critical-realist approach to thematic analysis (Wiltshire and Ronkainen, 2021; Braun and Clarke, 2006) to discover what perceptions viewers have of pseudo-counselling interviews to discern potential mechanisms underlying their efficacy. Data from both online forum posts and comments (Reddit) and comment responses (YouTube) was used to explore this. A qualitative approach was determined most effective in answering the research question exploring how the intervention enables change (Skivington et al., 2021). The lack of pre-existing literature suggested that initial exploratory research would provide the best groundwork for future studies (Nowell, 2017; Skivington et al., 2021). This study took an inductive approach given the lack of a pre-existing theoretical framework (Patton, 2015) to develop semantic themes identified explicitly (Braun and Clarke, 2006). Data from both YouTube (Lindgren and Lundström, 2019; Lewis et al., 2012). and Reddit (Boettcher, 2021; Shields et al., 2022) have previously been used to perform thematic analyses on mental health topics, illustrating the strength in this type of data. Both provide expansive datasets, and are naturalistic data, where users are discussing their own views, rather than being led by the researcher. In addition, due to their pseudonymous nature, users may be able to be more honest in their views than they might in a traditional research paradigm (Proferes et al., 2021).
2.1 Corpus Construction
Data was collected from both the subreddit (r/HealthyGamerGG), and comments made on HealthyGamerGG’s YouTube channel in response to the observational counselling videos following Holtz et al.’s (2012) corpus construction methodology. The pseudonymous nature of online spaces further provides a high level of disinhibition enabling a greater level of honesty (Postmes et al., 2001) which is very important in data around mental health. Indeed, some empirical evidence indicates that opinions given online in these spaces are authentic, although potentially hyperbolic (Glaser et al., 2002).
2.2 Sampling and Inclusion
A cross-sectional method was implemented over material collected between 04/12/2019 – 08/07/2022. The platform’s basic search functions enabled effective collection of naturalistic data (Boettcher, 2021). The Reddit corpus produced a dataset of 25 posts, ~40,000 words. The YouTube corpus came from comments on 10 videos, producing ~12,000 words, videos were selected based on number of views (1.6million-250,000). A judgment-based sampling method was used for both datasets to develop a corpus of relevant material. This involves selections based on the researcher’s determination of salience to the research question (Purna et al., 2023). Selection of all comments where users shared perceptions on the intervention were included.
2.3 Analytical Guidelines
This study followed the 6-step procedure developed by Braun and Clarke (2006; 2022) in approaching thematic analysis. 1) Familiarisation with data. 2) Initial coding identifying semantic features. 3) Theme development using a critical-realist approach (Wiltshire and Ronkainen, 2021). 4) Reviewing themes. 5) Defining themes. 6) Report production.
2.4 Ethics
Collection of online data presents some ethical considerations (Convery and Cox, 2012; Vitak et al., 2017). Whilst information provided is publicly available in addition to being pseudonymous, potential issues with identification remain (Elgesem, 2015). To mitigate this, usernames were not collected, distinctive entries have been modified to prevent reverse-searches for originals and references to identifiable names, institutions or places have been omitted. This research received ethical approval from the University of Glasgow, School of Education Research Ethics Committee.
3. Findings & Discussion
The data-analysis developed into four themes: Resonance, Personal Transformation, Psychotherapeutic Effect, Relation to Therapy. The first three themes are a tentatively inferred mechanism given the strength of the excerpts they were developed from (Wiltshire and Ronkainen, 2021). The fourth theme (Relationship to Therapy) is categorized as experiential given the diverse responses within it. Figure 1 summarises these relationships.
Figure 1 Thematic Map; Light Blue- Themes; White- Categories
3.1 Resonance
The first mechanism through which observing the interviews works appears as a high level of resonance/empathy/kinship with the interviewee expressed by a significant portion of comments as captured by this extract:
“I feel connected to [interviewees’] through the same emotional and thought processes”.
More specific references to videos included: “this stream resonated particularly with me as [interviewee] and I share a lot of struggles.” One highly-rated comment, receiving ~2,000 votes states “I can’t even express how much this conversation resonated with me”. These experiences occur both within and throughout the interviews, an overarching comment asserts:
“I see myself in literally almost every one of Dr. K’s guests, there is something to relate to in every interview.”
Some further examples feel as if they themselves are being spoken to personally by the conversation: “I was not expecting this to be relevant in so many areas…I identified with and gained understanding on nearly all areas discussed”, “I feel like he was talking to me”, “this is so me”, or “it’s like Dr K. was talking to me”. An inference arises that high levels of resonance enable a therapeutic effect for viewers.
High levels of emotional-salience also appear to influence positive change. Substantial portions of comments describe the interviews as “inspiring, or “meaningful”, one respondent indicated “I’m literally pausing this every 20 mins just bursting into tears”. The considerable number of these extracts suggests a high level of transferability from this research to the wider population (Wiltshire and Ronkainen, 2021). It may be correlated to Bandura’s theory that higher correlation between model and learner increases learning under SLT (Bandura et al., 1963).
However, although the interviewees are diverse (background, difficulties) in conjunction with how systemic reports of resonance are across interviews indicates resonance may be a universal process not requiring highly similar models to produce effects as seen in the SLT literature (Horsburgh and Ippolito, 2018). Therefore, resonance can occur even where models and viewers are dissimilar assuming the concepts discussed in the videos are relevant.
3.2 Personal Transformation
Resonance enables personal transformation. This theme is characterized by the interview causing internal changes within viewers enabling new perspectives, increased motivation, empathy for self and others, developing skills and support with mental health issues. Participants responded to videos expressing that they were given “a whole new perspective to view myself and my problems,” “helped open my eyes to my struggles”. Prominent levels of thankfulness occur throughout the data, one example includes:
“these videos have helped me a ton, gained a lot of insight and knowledge about myself and life” … “watching these videos for a few hours helped me understand myself more than two years of seeing a therapist”.
Others suggest that through watching they “found many solutions for my own issues,” the videos “make me ask questions about my own life and then find solutions” indicating increased active open-mindedness. Another extract states:
“Watching the interviews shifted my worldview so much. I learned so much about myself that I became a different person. Being able to connect empathetically with people through conversation opened up my mind. My emotions connected with theirs and realisations made connected for me as well.”
Through observing the videos, viewers can develop meaningful solutions for personal problems. Viewers also indicate that watching the videos increases motivation in their personal lives. Viewers come back to interviews’ to “help me push through” personal difficulties. Another account further indicates that “after listening to this, I was motivated to clean up messes in my room that hadn’t been moved for weeks.”
There is some evidence that interviews are also used to help cope with personal difficulties which may fall into the field of mental illnesses. One person indicates “I have body dysphoria and have tried professional help…I didn’t benefit from two years of therapy as much as I did from this.” Illustrating both the powerful impact of the videos and the potential issues which can be supported. Other clinical difficulties mentioned include “panic attacks” and “abuse”. Whilst only a minority of commenters indicate having existing mental illnesses, these comments indicate that they also perceived a benefit from watching the interviews. One comment explicitly states this: “I’ve gone through several interviews in the past month in learning to deal with my own traumas…all were enlightening”.
Viewers also describe gaining new skills and increased levels of empathy through engaging with the interviews. One viewer expresses learning “better communications skills with people” and that “you can’t hate anyone if you know their story” in response to an interview with a controversial figure. Another comment states:
“I learned how to be better at listening and constructive ways to point out negative patterns in speech and behaviour.”
Throughout the material, participants’ express a personal transformation occurring within their worldviews, thought patterns and emotions. The systematic nature of these experiential extracts may infer an overarching process of personal transformation akin to what occurs in psychotherapy (Locher et al., 2019).
The core mechanism of change in psychotherapy is best conceptualised as the transformation of meaning attributed to experiences and symptoms enabling better functioning on the part of patients (Frank, 1986). The responses of viewers described in the analysis similarly reflects personal transformations of beliefs, emotions, and experiences akin to what occurs in traditional therapy sessions (Locher et al., 2019), developing this theme. The videos appear able to help viewers process their problems, develop insight, personal fulfilment, and self-actualisation to experience their lives more adaptively (Krause et al., 2015).
Observing pseudo-counselling interviews appears to enable transformation within viewers according to qualitative analysis of their accounts. This transformation seems beneficial to their lives, supporting them with difficulties including mental illnesses and skill development. Although further research is required to quantify the extent to which transformation is enabled through these interviews, the emphatic nature of responses indicates an effect is taking place (Nowell et al., 2017).
3.3 Psychotherapeutic Effect
Within the community, the term Area-of-Affect (AoE) Healing is commonly used to describe how through watching interviews, viewers vicariously gaining psychotherapeutic effects which characterises this theme. Viewers emphasize this through statements including: “I feel like I got a really needed counselling session for me”, “this is basically a free therapy session haha”, “it’s like getting second hand therapy”. Other statements include:
“Watching a few hours of interviews helped me understand more things than two years of seeing a therapist.”, “I didn’t benefit from the year of therapy as much as I benefited from this interview”, “I got more out of watching Dr. K than I did out of multiple weeks of therapy”.
This further illustrates the strong impact of these interviews, and the possibility that watching well-executed pseudo-counselling interviews may have greater impact than psychotherapy for at least some participants. Suggesting that this format of intervention may enable far greater access to effective mental healthcare. Comments illustrating this include:
“there are hundreds of comments thanking Dr K. for what is essentially helping them overcome issues in their lives, some of which are rooted in mental illness”…“I returned to therapy recently but found it thoroughly unhelpful. What I really want is a conversation like in this video”…“This helped me more than any couple hours of my life ever did.”
In some comments, viewers also relate this to the broader world of psychotherapy, stating “these conversations help people beyond the often-insufficient realms of therapy”. A comment by a therapist asserts:
“I absolutely love these talks…I think society SHOULD move closer to using the digital space…I think public therapy between consenting parties CAN be useful.”
In conclusion, this theme is characterised by overwhelmingly positive experiences of viewers. Indicating that these interviews have a powerful psychotherapeutic effect, often greater to what they receive in their own therapy session. Whilst the consensus of these experiences infers a therapeutic effect, these claims require further empirical research to be established.
This theme emphasised the strength of therapeutic effect received from the intervention. Participants often indicated receiving greater benefits than from traditional psychotherapy. These points indicate that observing a highly-skilled therapeutic relationship may be more effective at achieving successful outcomes than seeing a less-skilled therapist. This replicates findings that therapists with higher scores on measures including the Therapy-Related-Interpersonal-Behaviours measure produce better patient outcomes (Schöttke et al., 2017). Potentially suggesting that the positive-effects of the most effective psychotherapists can be replicated for third-parties online.
Given psychotherapy’s well-established effectiveness (Munder et al., 2019), these comments suggest this format of digital intervention could support diverse populations, with reduced cost and increased access (Leung et al., 2022). In addition, it may also enable broader groups to benefit from higher-quality psychotherapy than is readily-accessible through traditional services (Chen and Cardinal, 2021).
3.4 Relationship to Therapy
The data also indicates how the usage of pseudo-counselling interviews relates to receiving psychotherapy in their own lives. Comments indicate that it may supplement therapy, act as an alternative if unable to access or be a catalyst to go to therapy.
Participants’ regularly expressed that watching the interviews “gave me a lot to bring to my therapy sessions”, “has taught me that therapists can help with [issue]. Statements also include: “it’s great to increase your knowledge so you can go to your therapist with better information”. Indicating that these sessions provide information which can be further developed within people’s own therapy sessions.
Some comments suggest that HealthyGamerGG is used as an alternative to therapy due to expense. This includes “I can’t afford therapy, so this helps me get answers. I know therapy is very different to watching a video, but this also helps”; “everyone could benefit from therapy. I know it’s not possible for loads of people so these videos are great in realising you’re not alone”; “I’d love to book a therapist, sadly I don’t have the money so these videos will do for now”. Throughout these comments, the pattern remains that the videos have a strong positive effect, but that therapy remains unavailable due to cost.
Some participants’ further indicate that observing videos provide a catalyst for going to therapy, including: “Dr. K encouraged me to keep looking for a new therapist”, “He helped me become comfortable with the idea of going to therapy”, “without HG-GG, I wouldn’t have searched for further help”; “this conversation motivated me to get back into therapy.” Suggesting that viewing pseudo-counselling interviews may reduce stigma or increase belief in therapy’s efficacy. Overall, this theme indicates that these interviews are used as a supplement to therapy, or an alternative where other factors may be prohibitive.
Comments related pseudo-counselling interviews to therapy in three separate ways. As a supplement to therapy, an alternative where it is inaccessible for financial concerns, or a catalyst encouraging viewers to seek therapy. The interviews were viewed as doing this by providing content and information which could be brought to therapy sessions, akin to psychoeducation-based interventions increasing adherence to psychotherapy (Motlova et al., 2017).
Contributors suggest interviews provide a useful alternative due to the cost and waiting times involved in psychotherapy. Even in cases of mental illness, only 10-50% of individuals receive evidence-based treatment in an adequate and timely manner (Patel et al., 2010). Moreover, large segments of the population without clinical issues still want to engage in psychotherapeutic processes as evidenced by the growth of coaching as an alternative (Aboujaoude, 2020). This indicates that immediately accessible resources that emulate psychotherapeutic processes would be beneficial for far greater groups of people than is possible to provide through 1-1 counselling due to cost and personnel constraints. It may be particularly efficacious as an alternative in the least resourced countries, where there is a 90% treatment-gap for mental disorders (Patel et al., 2010).
4.0 Strengths and Limitations
Taken together, there was a broad consensus of accounts underlying the interview mechanism of resonance leading to personal transformation and creating a psychotherapeutic effect, used either as a supplement or alternative to therapy in addition to encouraging viewers to seek-out psychotherapy. Suggesting that these findings are generalisable to the wider population of viewers, or at least a significant portion of them (Tobin and Begley, 2004).
Usage of different data collection models enabled better triangulation of data (Nowell et al., 2017). However, YouTube comments predominantly discussed how viewers were affected by the intervention as they are responding directly to the stimulus. These comments provided much of the data for the ‘interview mechanisms’ theme. Comments from a wide range of videos were taken ensuring responses were not idiosyncratic to specific videos.
However, the nature of internet-mediated research (Lindgren and Lundström, 2019) produced difficulty in contextualising some responses, meaning it is impossible to know whose voices we are hearing in this research for example, their mental health, SES etc. For example, some viewers claimed subject-matter-expertise as therapists or that they were suffering from mental illnesses. These comments were selected in this analysis as being representative of people whose opinions were most pertinent in this research. However, it was impossible to confirm if these people were being honest about their roles and experiences. Furthermore, no demographic information was collected on the participants, whilst HealthyGamerGG advertises itself as being aimed at a young audience (~16-25), it is difficult to know it’s true reach and who it is benefitting the most. Therefore future research is needed in this area.
Reflexivity occurred throughout the process (Braun and Clarke, 2006; 2019) to ensure my personal experiences of HGGG did not bias my account. This took place in keeping a reflexive journal (Excerpts in Annexure) and discussions with my supervisor. These processes helped me reduce potential positive biases arising from my pre-existing experiences with HealthyGamerGG. Furthermore, using secondary data may also reduce response-bias as the researcher is not leading participants (Smith et al., 2017).
5.0 Implications
No pre-existing literature was found using pseudo-counselling interviews as a format of mental health intervention. This study aims to provide a basis from which future research may develop, giving indicators of the extent to which people can have powerful, vicarious therapeutic effects through the process of observing others undergoing therapy. This preliminary evidence suggests it could be a high-impact intervention helping meet societal needs for greater mental health support discussed in the introduction.
6. Conclusions
This study concludes that HealthyGamerGG’s usage of pseudo-counselling interviews enables a process of resonance and personal transformation producing a therapeutic effect for a significant portion of viewers. Given the inaccessibility of mental healthcare, it is a potentially high-impact intervention with the potential to benefit diverse populations. A full evaluation of this format of intervention is recommended to determine effects, refine the intervention, develop a programme theory, and engage stakeholders moving forward.
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