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With regard to applied game design, the collaboration between game designers, engineers, neuropsychologists and medical doctors has shown that it is important to create interfaces in which the learning process is made enjoyable. Achieving this depends on understanding the limitations of the patients, the hard- and software to hand, and the complexity of therapy from the various disciplinary understandings. The balance between what is ‘fun’ and what are serious needs must not be lost, at the same time, a finely calibrated equilibrium is necessary for developing successful therapeutic tools. Virtual reality games as tools for extended therapy are likely of limited application where the immersive experience cannot be adequately achieved or assessed.