We've long been told that science heals and art moves the soul. But if the most effective therapy against depression happens to be a video game, or if a VR painting is more effective than a pill at blocking pain, then the brand labels, on which we have been trained to rely, no longer apply, and the awkward question is raised: is digital therapy a science, or an art?

The scientific foundation of the area is indisputable. In the past several years, many digital therapeutics have gained regulatory clearance, supported by large-scale clinical trials and peer-reviewed data. An example of this is Rejoyn, which has been cleared by the FDA as the first digital therapy for a major depressive disorder, given exclusively on a smartphone. Another is EndeavorRx, which has been called the first “video game” licensed as a medical therapy to treat ADHD. These are proof that digital therapy is not something that has been dressed up as an app, but it is, in fact, a proven product which has been adopted into the practice of medicine.

But it is more than the science that goes into these interventions that makes them successful. Their efficacy depends on the way in which they engage with one’s feelings, on how stimulating the experience can be. Here, design creativity is as important as clinical design. VR relief of pain is an exemplary case; burn patients who were treated with colorful sceneries have experienced up to a 50% reduction of pain; cancer patients who were given short exposures to VR, reduce pain that spills over into the next day. These successes come not by virtue of algorithms, but by sensory engagement, affective resonance, and the imaginations of the artists and designers who created them.

That is where science and art come together. The gray area where the largest promise lies. Some examples illustrate it vividly:

  • SPARX, which is developed by the University of Auckland, places the game mechanics of a fantasy role-playing game into therapy. Instead of sitting in an office room, teenagers learn cognitive-behavioural skills by completing quests, battling obstacles, and defeating “GNATS” (Gloomy Negative Automatic Thoughts). Science is textbook-level CBT, the storytelling component is pure videogaming, and therapy is something that people actually want to do.
     
  • NeuroRacer, one of neuroscientist Adam Gazzaley’s research projects, began as a scientific prototype to quantify the human ability to multitask. It asked players to drive a vehicle and respond to visual stimuli, a challenge that stressed mechanisms of attention inside the brain. Soon, the scientific trial flourished into the game design promise to offer quantifiable enhancements to cognition. The game progressed further into EndeavorRx, the transition from laboratory to living room, where children “play” their therapy on medical prescription.
     
  • Break Times, an experimental VR application, places the user within the confines of an artistic arena where pressure may be released and communicated by drawing. Subjects, during pilot studies, saw pressure decrease by as much as 50% following a single use of the app. It is not the number that makes it remarkable, but that the intervention works because of the artistic nature of the intervention: the drawing, the creating of shape and of color within a digital world, is the therapy itself. Art is the therapy.

These cases demonstrate that therapies can't be simply categorized as “science” or “art.” Their strength is in refusing the dichotomy, revealing that creative design and quantifiable outcomes are connected. It is a challenge to scientists, who construct the clinical world on tidy divisions. It can be a risk to artists, who don't need creativity boiled down to a utility, but the future may be something of an uncomfortable collaboration, where one party doesn't predominate over the other. For the creative community, uncertainty is a problem waiting to be solved. Storytellers, sound designers, animators, and illustrators bring just as much to the health innovation table as clinicians and data scientists do. And the scientist side's lesson is just as clear: if the highest-technology interventions do not collaborate creatively, they do not capture the humans they were placed here to treat. The digital therapy of the future will be found not by the laboratory alone, nor by the gallery, but by the crossroads where evidence confronts empathy face-to-face, where care can be like play.