“Guilty of Talking Too Much”: How Psychotherapists Gamify Therapy

Title of the Paper

“Guilty of Talking Too Much”: How Psychotherapists Gamify Therapy

Bibliographic Information

• Field of Study: Digital gamification design for psychotherapy
• Keywords: Game design, health games, mental health, anxiety disorders, meta-design, research-through-design, digital psychotherapy
• Authors: Elina Tochilnikova, Amrit Patnaik, Ghada Alsebayel, Uttkarsh Narayan, Andrew Coeytaux, Valeria Ramdin, Miso Kim, Casper Harteveld
• Publication Year: 2022
• Conference: CHI Conference on Human Factors in Computing Systems
• DOI: 10.1145/3491102.3517437

Research Background and Problem Statement

• Problems and Challenges:

  • Mental health issues are increasingly prevalent worldwide, but face-to-face psychotherapy faces challenges such as limited accessibility, high costs, and issues with engagement and acceptance.
  • The COVID-19 pandemic has significantly increased the demand for mental health services, further emphasizing the importance of remote psychotherapy.
  • Current gamified psychotherapy is primarily led by technical experts, with psychotherapists acting as consultants, resulting in a disconnect between design and implementation.
  • Existing psychotherapy games (e.g., SPARX) have limited functionality and lack personalization, requiring further expansion in therapeutic formats and coverage.

• Significance of the Research:

  • Gamified psychotherapy is considered an innovative approach that can enhance patient engagement, reduce stigma associated with therapy, and provide consistent therapeutic experiences.
  • Empowering psychotherapists with design autonomy may introduce new therapeutic models, increasing diversity and specificity in treatment.

• Motivation and Related Work:

  • Investigating the feasibility of psychotherapists independently developing gamified therapy as designers.
  • Exploring the potential of digital psychotherapy to provide personalized and user-friendly solutions.
  • Complementing existing literature focused on collaborative design by emphasizing the potential of therapist-led autonomous design.

Solution

• Proposed Method:

  • Utilizing StudyCrafter, an online creation tool, to organize six psychotherapists in designing gamified prototypes for anxiety treatment.
  • Studying how psychotherapists approach digital game design from both game design and psychotherapy perspectives.
  • Conducting a six-week series of three workshops to guide therapists in familiarizing themselves with StudyCrafter and developing prototypes.

• Innovative Aspects:

  • Employing the Research-Through-Design methodology to observe how psychotherapists without technical backgrounds design digital interventions.
  • Applying the Meta-Design framework to support therapist autonomy in design, avoiding the negative effects of traditional collaborative design.

• Implementation Steps:

  1. Participant Recruitment: Recruiting psychotherapists experienced in treating anxiety through the researchers' professional network.
  2. Guidance and Technical Support:
     • Workshop 1: Introducing the background of gamified psychotherapy and the StudyCrafter tool.
     • Workshop 2: Reviewing prototypes and providing feedback to help therapists refine their designs.
     • Workshop 3: Final discussions and comprehensive reflections on the design process.
  3. Data Collection and Analysis:
     • Collecting prototypes designed by therapists and recording workshop processes.
     • Analyzing prototype content and therapist feedback from both game design and psychotherapy perspectives.

Research Outcomes

• Specific Findings:

  • Identified four types of psychotherapy games:
    • Educational: Providing knowledge and management strategies, such as CBT techniques.
    • Advocacy: Enhancing empathy by simulating the experience of anxiety.
    • Action-Oriented: Incorporating direct practices like breathing exercises and mindfulness training.
    • Hybrid: Combining multiple types mentioned above.
  • Extracted game mechanisms with therapeutic utility:
    • DBT: Using mindfulness breathing techniques.
    • CBT: Cognitive restructuring and behavioral experiments.
    • Reducing uncertainty, redirecting attention, and providing sensory feedback.
  • Found that therapists can reflect deeply on and refine therapeutic methods and processes through game design.

• Comparison with Existing Solutions:

  • Unlike traditional participatory design, this study emphasizes therapist autonomy in creation.
  • Provides strong evidence that therapists, when given technical training, can independently create innovative games.

• Experimental or Evaluation Results:

  • Participants successfully designed six gamified therapy prototypes.
  • Reflected on the support provided by design tools for psychotherapy, noting the need for more user-friendly features (e.g., design templates).
  • Highlighted the potential benefits of therapist and patient involvement in game design for overall therapy.

• Limitations and Future Directions:

  • The study primarily relied on the StudyCrafter platform, leaving the applicability of other design tools untested.
  • The short design process may have limited the complexity and diversity of prototypes.
  • Future research should explore:
    • The potential of therapist and patient co-design.
    • Expansion into more psychotherapy techniques and validation of clinical efficacy.
    • Technical and ethical issues, such as privacy and data protection.