A supermarket of treatments: how the collaboration between Clinical Psychology and Interaction Technology makes you smile

In October 2015, ten Seed Money Grants were awarded to game researchers. One of the Seed Money Grants was awarded to a multidisciplinary project on serious games for the detection of mental health problems. We talked to researchers Claudi Bockting, Ronald Poppe and Alishia Williams about their research question: how can we use technology to enhance our treatments and deliver therapy in a new way?

When she started chairing the Department of Clinical Psychology at Utrecht University in 2014, Claudi Bockting immediately wanted to talk to Ronald Poppe from the Game Research department to check if they could collaborate. Claudi’s aim was to develop serious games for the detection of mental health problems.

In April of this year, Claudi’s research group received reinforcement from Alishia Williams, who had been working on the development and evaluation of internet based cognitive interventions for depressions and anxiety disorders for over 5 years. Alishia had a similar question: how can we use technology to enhance our treatments and deliver therapy in a new way?

Internet in the Sahara

Claudi and Alishia were especially interested in technological innovations that can amplify psychological interventions, like for example a webcam that can interpret facial expressions.

Claudi explains: “Over the past decade, our needs have changed. The Internet is playing an undeniable role in every ones lives. Even Nomads in the Sahara all have mobile phones with a rapidly functioning Internet connection. So with Internet or app-based treatments we could reach a bigger target group for whom digital support could really be helpful. It could also be a good option for people who cannot afford traditional mental health services.”

To the next level

When Claudi contacted Ronald, he was already involved in several projects for which he developed and tested serious games. Just like Claudi and Alishia, he truly believes in multidisciplinary approaches. During their first meeting, the three researchers immediately had a lively discussion on how they could use Ronald’s technology for the research project on facial expressions to detect and tackle depression.

“What’s so nice about our cooperation with Ronald,” says Claudi, “is that despite our completely different backgrounds, he works with the same principles, for example in reinforcing people’s behaviour systematically. Psychologists teach depressed individuals strategies to increase the reward value of daily activities, game developers reward users by giving credits or points, or completing the next level.”

Alishia also highly recommends cooperation between different disciplines: “I’m convinced that true innovation happens when you bring together traditionally separate fields. When you’re only working amongst your own team, you can become too narrowly focused. It’s good to take a step back sometimes and look at it from different perspectives.”

Please smile

The serious game project is a proof-of-concept trial. First, the researchers will develop the face tracking and intervention software. Second, the software will be tested on individuals and evaluated.. The team wants to measure the impact on both emotion and cognition. During the third phase, the feedback from users will be collected to improve and modify the technology.

“It’s very important to develop mental health apps that are scientifically proven,” Alishia emphasizes. “Right now, there are a lot of apps available on iTunes that have not been scientifically tested and therefore do not have the desired effect. As a user, you could get frustrated and start to avoid those options. It’s our duty to create awareness that there are evidence based apps that actually can help you.”

Supermarket of treatments

The researchers aren’t at all afraid that digital treatments will stand in the way of human interaction. Claudi illustrates that a serious game is particularly interesting for people who are wary to go out and visit a therapist, which is a common effect in depression. For them, app-based treatment could be a solution, not a risk.

“With the development of the serious game, we’re not (only) aiming at a replacement for traditional treatments, but at enhancing existing treatments in the best way we can. I like to see this expansion as a supermarket of evidence based treatments, from which you can choose the one that works best for you.”

Virtual life-style coach

Since depression is projected to rank second on a list of 15 major diseases in terms of burden for our society by 2030, early detecting of depression is crucial. A self-empowering tool in the form of a computerized app – like a personal, virtual life-style coach – could become a very interesting product in the future to launch on the mental health market.

“From professional and ethical perspectives, it’s not our goal to commercialise this product,” says Alishia. “But the prevalence is so high, that we sometimes have to be strategic and think: how can we show as many parties as possible that a lot of people could benefit from this approach? Since the existing mental health system places a high demand on limited clinical resources and is also very costly, researchers - who aren’t getting a lot of money either - sometimes need commercialization to make sure that their solution is disseminated throughout society.”

Multi-disciplinary puzzle

Claudi agrees with this point of view: “I see science as a puzzle. Sometimes not all the pieces fit, so you have to find a way to bring more different pieces together. You have to go outside the box to increase your chances of contributing to societal problems. Multi-disciplinarity is also a form of valorisation: in addition to gaining knowledge, we want to get it valorised in practice, preferably with the participation of other important parties. such as policy makers, politicians and funders.”

She concludes with an invitation: “We would also like to invite other disciplines within Utrecht University to share their ideas about supporting people with the help of technical devices. Not only computer scientists, but also researchers who deal with this question from an ethical point of view. Or people who know a lot about privacy, for example about data usage via social media. Or literature scientists who can advise on writing scripts for serious games. We all need each other to have better outcome in the end.”