Red Barrels' co-optional horror "therapy" simulator The Outlast Trials leaves early access today. I haven't played an Outlast game since reviewing the second numbered game and having excitable opinions about its portrayal of the moon. I'll be honest, I'd assumed the series had died, but Steam user reviewers seem pretty keen on Trials, which takes the first game's mucky asylum premise and spins it out into a low-key live service game about playing a series of human guinea pigs, trying to escape an experimental brainwashing lab run by the villainous Murkoff Corporation.
Trial objectives include smashing up sex toys and feeding people blood, and there's a lot of backstory to glean from found documents and conversations with side characters. Unlockable tools and gear include slippers, which soften your footsteps when avoiding unkillable opponents, and X-ray goggles, with which to spy people through walls. Maps range from sickly funfairs through abandoned police stations to terrible toy factories.
The 1.0 release introduces a new ending, full controller support and crossplay with the just-launched console versions (though not cross-progression), while making "adjustments in difficulty, Trial structure, and progression to provide a streamlined onboarding for all new and returning players - including those playing solo or as a group." According to VG247, The Outlast Trials stacks up pretty well as a single-player game.
There's a lot more in the full changelog, as ever. Even if you haven't played Trials, it's worth a skim simply to think about/wince at how the developers have cheerily transformed the language of live service updating and weekly/monthly "cadences" into a twisted wellness regimen. Missions are sorted into "programs", respawns are administered by popping pills, and every player has a Therapy level.
Certainly, the idea of a live service roadmap that's also a mental health program is a fine basis for a horror game. Alternatively, you might want to check
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