Our project will provide the benefits of wraparound mental health support in a virtual environment with access to text-based, audio-based, and face-to-face video therapy options. We will utilize the lessons learned from working in mental health, research into behavior intervention techniques, and research on the use of role playing games such as Dungeons and Dragons for therapeutic purposes to provide an evidence-based model of care across distances.
While the setting of The Grove is a game environment, the activity in The Grove has a very serious purpose and uses evidence based modalities. Skill building is an intregal part of mental health treatment and can be easily adapted in the game setting. In addition, the virtual environment gives users the ability to talk directly with licensed therapists and trained counselors without the need to go into an office, extending the potentials of telehealth provision.
The use of role playing games has been studied and is used today in several mental health agencies that work with adolescents today. Our software takes this to another level by building experiences into the game that can be assigned to users based on their needs and goals. Users can interact with these therapeutic activities on their own, together with a therapist or counselor, or with other supports.
Based on the role that multiplayer open world games play in the lives of their fans, we believe that this environment can also provide needed social interaction with Natural and Informal supports for people in isolation due to distance, illness, or other factors. This social interaction can be free-play or conversational, or can include specific tasks linked to therapeutic goals.
In the User Stories included in this repository, we have explored the potential experience of a scientist who is living in Antarctica who is using this software as part of a wraparound mental health support program. Due to the limited time during the Space Apps Challenge weekend, we chose to create these vignettes to show the full potential of the program rather than focusing on user stories in other therapy contexts. However, the flexibility of the software is such that the multiplayer aspects highlighted in these stories in not necessary if the therapeutic framework of the agency does not involve Natural or Informal supports in their program. In the coming weeks, we will be adding additional scenarios to show how variations in how the software might be used.
Laura Hughes is a LMHCA (Licenced Mental Health Counselor Associate) and MHP (Mental Health Professional) and Lisha Sterling is a CPC (Certified Peer Counselor). They both have worked in wraparound mental health care, supporting families in which one or more members are facing intensive mental health challenges. As both of them worked from home during the first few weeks of the Covid-19 crisis, they experienced many difficulties and advantages attached to providing care through telephone and videoconference. In the week leading up to the Space Apps Challenge, we were discussing our experiences in telehealth. We also shared some of our friends' tweets about interactions on Animal Crossing. That led us to the idea of a HIPAA compliant game environment where individuals could speak with their therapists either as themselves or as an avatar, go through game challenges specifically designed to support their recovery, and invite their natural or informal supports in to support them in their journey.
We have created an architecture for a multi-user game system that is HIPAA compliant and useful in low resource situations.
The research of Noshir Contractor, PhD into creating effective teams and mitigating challenges in those teams can be used both in choosing the correct therapeutic teams for individual clients and their families and for creating mental health support plans for improving effectiveness in a work environment.
https://sonic.northwestern.edu/projects-2/crews/
Lindsay Larson, Harrison Wojcik, Ilya Gokhman, Leslie DeChurch, Suzanne Bell, Noshir Contractor, Team performance in space crews: Houston, we have a teamwork problem, Acta Astronautica, Volume 161, 2019, Pages 108-114,ISSN 0094-5765, https://doi.org/10.1016/j.actaastro.2019.04.052. (http://www.sciencedirect.com/science/article/pii/S0094576519301547)
Specific measures will be taken to reduce the delay in communication across long distances in order to mitigate the effects of communication delay on team dynamics as well as other social dynamics within the program. This is related to research cited in the poster at http://sonic.northwestern.edu/wp-content/uploads/2017/01/Ashley-IWS-2017.v6-SM.pdfunder the heading of "2. Communication Delay".
While full audio and video capabilities are designed into the Program for those situations where users have access to high bandwith connections, fallback options to reduce the bandwith use will take advantage of the abilities of the game engine to make the experience feel as similar to normal realtime communiation as possible.
In addition, the repetetive nature of ongoing appointments and experiences in the game environment will help to mitigate the effects of physical separation leading to different understandings of the tasks at hand. (ibid, Discussion section.)
From https://www.nasa.gov/feature/nasa-studies-team-dynamics-in-antarcticaNASA research, including that mentioned above, has shown that humor and play help increase the resilience and ability of isolated teams to work together. The game developed by the Therapy Crossing team will take advantage of this dynamic by creating fun interactions and utilizing humor as the tools in the serious work of mental and behavioral health support.
Among the assessment tools used by The Grove, we will be using some tools developed by NASA. We have already talked about the CREWS project at HERA, which includes assessment to determine the best combination of participants for a team. We will also be using NASA designed tools for behavioral and emotional assessments.
This tool was created for NASA astronauts, and can be used for other people living and working in isolated situations. https://www.nasa.gov/mission_pages/station/research/experiments/explorer/Investigation.html?#id=7537