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A range of face-to-face therapies and interventions for children and adolescents with mental health problems have been developed over the years and include cognitive-behavioral therapy, play therapy and applied behavior analysis. The popularity of computer games has grown exponentially in the last decade and has been widely accepted by children, adolescents and adults alike. Mental health professionals have therefore been exploring the use of these games to complement traditional treatment methods. To date however, there has been little known concrete evidence of the effectiveness of computer games for the treatment of children and adolescents with mental health conditions. Key to the success of such games is that at the outset, they must be well-designed. This paper reviews extant relevant computer gaming literature to propose a set of guidelines and strategies for the design of psychotherapeutic games targeted at children and adolescents. The issues raised concern both the game player as well as the game itself. As part of this review, limitations of existing work and areas of future research are also discussed.