game design meets therapy
DESCRIPTION
presented at Games for Health conference 2010; Talk on collaboration between Doris C. Rusch, game design researcher at MIT and Atilla Ceranoglu, psychiatrist at Massachusetts General Hospital.TRANSCRIPT
Game Design Meets Psychotherapy
...how they hit it off and conceived the “depression game”
Doris C. Rusch, Dr.MIT GAMBIT Game [email protected]
T. Atilla Ceranoglu, M.D.Mass. General Hospital
games tackling the human condition
+
our concept of choice
Facts on Depression
Facts on Depression5 or more criteria, during the same 2-week period
Facts on Depression5 or more criteria, during the same 2-week period
Depressed mood and SIG: E CAPS
Facts on Depression5 or more criteria, during the same 2-week period
Depressed mood and SIG: E CAPS
Suicide: recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation
Facts on Depression5 or more criteria, during the same 2-week period
Depressed mood and SIG: E CAPS
Suicide: recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation
Interest changes: markedly diminished interest or pleasure in activities
Facts on Depression5 or more criteria, during the same 2-week period
Depressed mood and SIG: E CAPS
Suicide: recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation
Interest changes: markedly diminished interest or pleasure in activities
Guilt: feelings of worthlessness or excessive or inappropriate guilt
Facts on Depression5 or more criteria, during the same 2-week period
Depressed mood and SIG: E CAPS
Suicide: recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation
Interest changes: markedly diminished interest or pleasure in activities
Guilt: feelings of worthlessness or excessive or inappropriate guilt
Energy: fatigue or loss of energy
Facts on Depression5 or more criteria, during the same 2-week period
Depressed mood and SIG: E CAPS
Suicide: recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation
Interest changes: markedly diminished interest or pleasure in activities
Guilt: feelings of worthlessness or excessive or inappropriate guilt
Energy: fatigue or loss of energy
Concentration changes: diminished ability, or indecisiveness
Facts on Depression5 or more criteria, during the same 2-week period
Depressed mood and SIG: E CAPS
Suicide: recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation
Interest changes: markedly diminished interest or pleasure in activities
Guilt: feelings of worthlessness or excessive or inappropriate guilt
Energy: fatigue or loss of energy
Concentration changes: diminished ability, or indecisiveness
Appetite changes: significant weight loss or appetite changes
Facts on Depression5 or more criteria, during the same 2-week period
Depressed mood and SIG: E CAPS
Suicide: recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation
Interest changes: markedly diminished interest or pleasure in activities
Guilt: feelings of worthlessness or excessive or inappropriate guilt
Energy: fatigue or loss of energy
Concentration changes: diminished ability, or indecisiveness
Appetite changes: significant weight loss or appetite changes
Psychomotor changes: psychomotor agitation or retardation
Facts on Depression5 or more criteria, during the same 2-week period
Depressed mood and SIG: E CAPS
Suicide: recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation
Interest changes: markedly diminished interest or pleasure in activities
Guilt: feelings of worthlessness or excessive or inappropriate guilt
Energy: fatigue or loss of energy
Concentration changes: diminished ability, or indecisiveness
Appetite changes: significant weight loss or appetite changes
Psychomotor changes: psychomotor agitation or retardation
Sleep changes: insomnia or hypersomnia nearly every day
Facts on Depression
Facts on Depression
• 2.2 million depressed adolescents in 2004
Facts on Depression
• 2.2 million depressed adolescents in 2004
• More than twice likely to use drugs
Facts on Depression
• 2.2 million depressed adolescents in 2004
• More than twice likely to use drugs
• 7% may commit suicide
Facts on Depression
• 2.2 million depressed adolescents in 2004
• More than twice likely to use drugs
• 7% may commit suicide
• Less than half (40%) received treatment
Facts on Depression
• 2.2 million depressed adolescents in 2004
• More than twice likely to use drugs
• 7% may commit suicide
• Less than half (40%) received treatment
...Under-response!
Step 1:
defining the purpose of the game
Response to Depression
Response to Depression
Reasons for under-response...
Response to Depression
Reasons for under-response...
• Limited services or number of providers
Response to Depression
Reasons for under-response...
• Limited services or number of providers
• Lack of funds for effective outreach
Response to Depression
Reasons for under-response...
• Limited services or number of providers
• Lack of funds for effective outreach
• Attitude towards mental illness
Course of Depression
Course of Depression
Consequences of depression
Course of Depression
Consequences of depression
• Noncompliance with treatment
Course of Depression
Consequences of depression
• Noncompliance with treatment
• Estrangement
Course of Depression
Consequences of depression
• Noncompliance with treatment
• Estrangement
• Frustration among caregivers
Course of Depression
Consequences of depression
• Noncompliance with treatment
• Estrangement
Course of Depression
Consequences of depression
• Noncompliance with treatment
• Estrangement
• Frustration among caregivers
the purpose of our game is not to cure depression!
Taking on Depression
Public education aims
• Inform friends and families of depressed
• Increase understanding of how depression manifests
Gaming for Depression
Videogame as a tool
• 97% of all teenagers play a VG
• 1 of 2 played a VG yesterday
• Best tool to reach the Digital Native
Step II:
defining the design approach to inform and raise awareness.
• embracing subjectivity
• modeling “what it feels like”
• not preachy!
• playing to the strengths of the medium
depression is about loss:
loss of meaningloss of goals
loss of control loss of agency
loss of playfulnessloss of sense of self
loss of focus loss of energyloss of voice
games are about play
play is a state of mind
freedom
expansiveness
depression is the opposite of play
In order to make “loss” tangible, the game will also model that which is lost.
It aims to show the contrast between playfulness / agency and depression / loss of agency
and the transition between the two in an experiential way.
Step III:
translating high level ideas into concrete design:procedural metaphors
Gameworld = Emotional Landscape
objective: tap happiness potential
conflict: mood struggle
one has to fight the downward tendency of one’s mood to experience joy and escape
the doldrums of depression.
“passion” as power up; “hum” to identify emotional resonance!
happy state
happy state
depression state
depression state
potential structure:
n
h
t
d
t
n
d d
normal = nhappy = h
transition = tdepression = d
n
t
d
t
h h
n
h
t
d
Check your experiences. How happy were you? How sad? Want to try again?
end screen that shows how you did in terms of potential happiness / sadness:
main collaboration points:
• define purpose of the game: understanding depression and contextual problems
• inspiration for design through clinical accounts on depression
• reality check: does the design adequately represent experiences of depression? Are new features consistent with the concept?
• sharing excitement for the project, mutual motivation, encouragement and fun! :-)
