We designed and implemented a gamified eHealth application for youth mental healthcare, to study how game design techniques could be applied within this context. This resulted in the design of a gamified mobile application aimed at supporting therapeutic goal setting: the ReadySetGoals game. The design process itself involved four key stages: (1) Identifying the transfer effect to be aimed-for, (2) Exploring the user context, (3) Designing the gamification, and (4) Evaluating the gamification. Following a preliminary evaluation, we applied a final design iteration to the app that was implemented in therapeutic practice. However, fewer therapists than expected used the app when given the opportunity and information. In a series of qualitative interviews, we investigated their reasons for not using it. Analysis of the results generated three themes that inhibit eHealth adoption: (1) Fittingness of gamification with individual users, (2) Fittingness of eHealth with face-to-face practice, (3) Distortion of therapeutic alliance by eHealth and gamification. Based on these outcomes and our design process we identified the following three recommendations to enhance implementation and adoption of eHealth in mental healthcare: (1) Align expectations of stakeholders through framing (2) Integrate therapeutic aspects in gamification, and (3) Focus on personalisation.

我们设计并实施了针对青少年心理健康的游戏化eHealth应用程序，以研究如何在这种情况下应用游戏设计技术。这导致了旨在支持治疗目标设定的游戏化移动应用程序的设计：ReadySetGoals游戏。设计过程本身涉及四个关键阶段：（1）确定要达到的转移效果；（2）探索用户上下文；（3）设计游戏化；以及（4）评估游戏化。经过初步评估，我们将最终设计迭代应用于在治疗实践中实现的应用程序。但是，如果有机会和信息，则使用该应用程序的治疗师将少于预期。在一系列定性访谈中，我们调查了他们不使用它的原因。对结果的分析产生了三个阻碍电子卫生保健采用的主题：（1）游戏化与个人用户的适应性；（2）电子卫生保健与面对面的实践的适应性；（3）电子卫生保健和游戏化对治疗联盟的扭曲。根据这些结果和我们的设计过程，我们确定了以下三项建议，以增强精神卫生保健中eHealth的实施和采用：（1）通过制定框架来调整利益相关者的期望（2）将游戏方面的治疗方面整合在一起，以及（3）专注于个性化。