VR and games as therapeutic tools

Before the break of summer I attended
Virtual reality and serious gaming for the prevention and treatment of psychological and behavioral disorders
of the EMGO+ E-HealthExcellence network at the VU University. Some of the first clinical trials being run with VR/AR and games as therapeutic tools – in these areas – and their results were presented. Results which are very promising.

One of the ways to treat immobilizing/irrational fear – a phobia – is what is known as In vivo exposure. The patient is exposed to the thing that induces fear, in the safe environment of a therapeutic setting, until the fear diminishes to functional levels or goes away entirely. This kind of therapy, although very effective, is also described as the cruellest cure.  To quote prof. dr. Cristina Botella, it is “quite complicated to face the reality of our fears”. Virtual or Augmented Reality can provide tools to help connect the safe therapeutic environment and the real world, whilst maintaining a level of control that allows the therapeutic environment to be safe.

VR and AR would allow for control of the exposure, both by the therapist and the patient. It allows for a very personalized experience in the sense of exposure hierarchy, placement and content creation. Occurrence and repetition are at will and not bound by practical limitations. For instance, when treating a patient with a phobia of flying you would not have to be in an airplane.

During their research prof. dr. Cristina Botella a.o. have developed a therapeutic lamp – think projection not lightbulb- specifically for In vivo exposure treatment of small animal phobias (please read more here) and have had excellent results.

Prof. dr. Rosa Banos discussed the possibilities of Virtual Reality to induce different moods  by using a VR headset in a lab procedure known as  MIP (Mood Induction Procedure). She has found that VR can most definitely be used as a tool for Mood Induction and that the effect of VR was stronger than that of ‘traditional stimuli’ such as pictures, written narrative or guided imagination exercises. This might be because VR is more of an experience than traditional stimuli, which are more of a confrontation than an experience. In achieving the difference between a confrontation of a stimuli or the experience of a stimuli, a sense of ’presence’ seems to be an important factor. The more we have a sense of presence, the more we are having an experience rather than a confrontation. Experiences build new memories.

One of the presentations focused on a serious game from New Zealand called SPARX. SPARX was developed to help battle depression in adolescents and has proven itself to be effective. Dr. Theresa Flemming has guided the development and the effectiveness study of this particular game. During the presentation she pointed out that often in the making of therapeutic games  – dazzled by this new environment of a game setting- common elements of therapy are lost or hard to translate. Here is definite room for improvement in the next-gen of therapeutic game-development. For instance ; the relationship with the therapist is a cornerstone of any therapeutic interaction, where does this relationship go in a gaming environment? The gaming environment of SPARX proved especially suited to convey the hope that depression is beatable and very suited for practicing skills that would help halt or prevent depression.

It might seem as if the results from the presented research is obvious or even old. And indeed, sadly scientific research is often lagging behind the technical/artistic/social development. But these are not anecdotes, these results are not based on self-report and survey measures, they are not extrapolated form lab-experiments. These are clinical trails – with measurable therapeutic effect. It makes me very happy to see that what we might ‘already know’ minutely dissected, rigorously tested and still standing for all of us to see and build upon.

Welcome to the age of new therapeutic tools.

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Stretching It

Stretching It is a mini-art-game connecting players in Venezia/Amsterdam by stretching towards each other. By physically interacting, people can digitally connect themselves over distant physical locations.
Played and shown in Amsterdam and Venezia during La Biennale 2013.

Artists:
Priscilla Haring – Game director
Sebastian Michialidis – Visual content
Stijn Kuipers – Making it work

Find out more – and see gameplay pictures and video – on the Stretching It page

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8uur overwerken – FairWork

Op 22 maart hebben we heerlijk 8 uur overgewerkt in eetlokaal Moes. Van 18:00 tot 02:00 uur zijn we in vijf teams aan de haal gegaan met communicatieve vragen van vijf goede doelen.

Ons team zette zich in voor Fairwork – een organisatie die zich bezig houdt met moderne slavernij in Nederland (buiten de prostitutie). Fairwork wil  meer bekendheid van dit probleem; 98% van de Nederlandse bevolking weet niet dat er uberhaupt slavernij bestaat in Nederland. Aan ons de taak hier een aanpak voor te verzinnen en Fairwork naar huis te sturen met een middel – voor 02:00 uur s’nachts.

Eerst hebben we de criteria van moderne slavernij vrijer vertaald naar

Wreed werk – No exit – Geen Geld

Vervolgens willen we graag moderne slavernij een gezicht geven. De personen die zelf in deze situatie zitten kunnen/willen natuurlijk niet zelf in een campagne dus namen we onszelf als voorbeeld. Hiermee willen we duidelijk maken dat het niet gaat om zielige Afrikaanse kindertjes maar om (witte) mensen die in een situatie van moderne slavernij zijn geraakt en daar nu in vast zitten. Dit kan dus iedereen zijn.

Ik ben een slaaf in NederlandIk ben een slaaf in Nederland

Om meer bekendheid te geven aan moderne slavernij in Nederland willen wij ‘iets’ maken wat in grove lijnen uitlegt wat moderne slavernij is en dat makkelijk gedeeld kan worden op sociale media. We komen uit op een ‘flow-chart’ waarmee je kunt bepalen of jij in moderne slavernij valt (nee dus). Hierbij hebben we vooral gedacht aan een deelbare visual op Facebook en Boomerang kaarten als uiting.

Fairwork ging tevreden naar huis….

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VU mini-symposium Measuring Causal Relations

There were several speakers that all had new and elegant solutions to the problem of trying to establish causality in their field. The one that most appealed to me was the story of professor Olivers. Possibly because as a Cognitive Psychologist he was closest to my field of expertise and possibly because he entitled his presentation “The case of….” which instantly made me put on my mental Deerstalker and investigate.

Prof. Olivers suffers from the ‘black box’ problem – as does anyone involved in the field of psychology. How do we measure what goes on in someones head? Even you dont know exactly what you know, why you think you know that and so on.
What we can know is what stimulus creates what response (and under which circumstances). Sufficient causality is hard to establish in this way but necessary causility is possible; what Must be present as a stimulus to obtain a certain outcome. In profesor Olivers’ research this involves fMRIs to see what zones are being activated when a person conjures up mental imagery. The research becomes more interesting when you add Transcranial Magnetic Stimulation (TMS) zapping certain areas of the brain into temporary paralysis and then asking participants to evoke the same mental imagery. First map out the zones through fMRI, shut them down with TMS and if the task becomes impossible to perform, one can establish necessary causality between that zone and that mental imagery.

Form the panel-discussion I will take home a shared annoyance at the significance of significance and a Quest to promote the underappreciated correlations metrices. It has started me on the path of Bayesian statistics

An afternoon well spent.

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Gamifeye: Are you present?

Ideally speaking, you should be able to experience entertainment and education within a game-frame – experiencing ‘fun’ and any ‘intentional content’ at the same time, instead of switching between blocks of one or the other.

This takes a creative approach of the intended content combined with a deep understanding of numerous game mechanics. On a more abstract level we (media psychologists) can predict that to facilitate blending, presence is a very important concept. Through a feeling of presence experienced during gameplay, we process the things going on in the game environment, i.e. your intended content (Biocca & Harms, 2002). Presence splits in a self- , spatial- and a social dimension. First I will discuss them as a psychological concept and then apply them to the often used gamification example: Foursquare.

Presence as a whole “can be understood as a psychological state in which the person’s subjective experience is created by some form of media technology with little awareness of the manner in which technology shapes this perception” (Tamborini, 2006, p. 226).

  • Self presence – the idea of “being”- is the presentation of oneself in the virtual world.
  • Spatial presence – the idea of “being in”- is mainly determined by two qualities: involvement and immersion. Involvement relies on mental vigilance and depends on the meaningfulness of an environment, while immersion depends on the environments ability to isolate people from other surrounding stimuli such as temperature or audio (Tamborini, 2006).
  • Social presence – the idea of “being with” – is the sense of being in a social environment. It involves recognising other actors in the game environment as social entities. Of course, the likelihood of inducing a strong sense of social presence is greatest when the other actors are (controlled by) actual humans.

In Foursquare the presence of self is facilitated by you logging in as yourself (possibly through one of your networking sites) and giving yourself a name/face in this shared online environment. Spatial presence is a very important marker in Foursquare as it is the basic game mechanic; the digital translation of where you physically are. This takes the involvement, meaning and attention you experience in the environment you are physically in and piggybacks that into the Foursquare environment. Social presence is high because all the other actors in the environment are representations of actual humans. Humans like yourself.

 

Biocca, F., & Harms, C. (2002) Networked minds social presence inventory; measures of co-presence, social presence, subjective symmetry, and intersubjective symmetry.

Tamborini, R., & Skalski, P. (2006). The role of presence in the experience of electronic games. In P. Vorderer & J. Bryant (Eds.), Playing Video Games; motives, responses and consequences (pp. 225-240). Mahwah, NJ: Lawrence Erlbaum Associates, Inc.

Blog written for Gamifeye – a UK platform – published online 11.03.2013

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Alternate Reality Gaming – Examples

The Beast is said to be the game that successfully introduced ARG’s to a larger public (Baertlein, 2008). This futuristic murder-mystery intrigued one million players for twelve weeks in 2001. It was created as a promotion for the movie A.I.

Another massive ARG was I Love Bees (aka Haunted Apiary) which was designed to support the launch of the video game Halo2 in 2004 (McGonical, 2007). This ARG revolved around an audio-drama broadcasted by public phones, immersing the player base into the world of Halo2. “The distributed fiction of I Love Bees was designed as a kind of investigative playground, in which players could collect, assemble and interpret thousands of different story pieces related to the Halo universe. By reconstructing and making sense of the fragmented fiction, the fans would collaboratively author a narrative bridge between the first Halo video game and its sequel” (McGonigal, 2007).

It had almost 10.000 people participating in real world challenges, and over 3 million players overall. The core website received 80 million hits, of which over 250.000 on the first day it went online. In the four months that the ARG ran, over 40.000 public phones spread over 50 states and 8 countries were answered (Dena, 2008). The players had to learn a fictional program language called Flea++ in order to complete the online challenges (McGonigal, 2004). The game created enormous media coverage with items in the New York Times, CNN, Wired and the London Times to name but a few. It also received the Innovation Award at the Game Developers Choice Awards 2005 (Dena, 2008).

An example of a smaller ARG is Chain Factor (Montola, Stenros & Waern, 2009). This puzzle based ARG started in the Numb3rs episode Primacy (aired first November 9th, 2007) in which players needed to find and crack several codes to stop the world’s economy from being destroyed. The Primacy episode featured short commercials to lure players to www.chainfactor.com and start playing with a fairly simple puzzle-game. Further game play included several clues and codes embedded in the Primacy episode and clues in physical locations (picture). Other codes that unlocked ‘cheats’ could be found on billboards throughout the country. On December 12, 2007 the game was successfully ended by entering all ‘ShutdownKeys’ simultaneously on twelve s computers in twelve different (physical) locations (Dena, 2008).

An ARG can be more than just fun. The first large ‘serious’ ARG was the World Without Oil that ran in 2007. The game revolved around the personal experiences of the players in a fictional, but realistic, global oil crisis. More than 1.500 player reports describing how they interacted with this ‘crisis’ were posted online. These reports include blogs, video files, audio files, images and voice mails. Almost 2.000 players registered at the core website www.worldwithoutoil.org, mostly from the United States. The game was played between the April 30th and June 1st 2007. When the game concluded the website had received more than 60.000 unique visitors. The game received several awards and a lesson plan for high school teachers to use the content created by the game (Dena, 2008).

This blog is a shaken but not stirred piece of my thesis “How ARG changes reality” which you can find here

Introducing Alternate Reality Games – blog 1 of 3
Alternate Reality Gaming – Ingredients – blog 2 of 3
Alternate Reality Gaming – Examples – blog 3 of 3

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