Presentation on theme: "Coaching emotion regulation skills with The SIMS™: Design and development of a computer game based intervention for young people in residential care Áine."— Presentation transcript:
1Coaching emotion regulation skills with The SIMS™: Design and development of a computer game based intervention for young people in residential careÁine Aventin1, Tom Teggart2, Geraldine Macdonald1, Stan Houston11School of Sociology, Social Policy & Social Work2Southern Health & Social Care TrustICL Conference21st February 2014
2Overview Background & Aims Intervention design process The interventionKey FindingsFuture Directions
3Background Mental illness among young people in care Reluctance to engage in traditional therapyA call for engaging interventions delivered in community settingsTherapeutic approaches to social work in children’s homes across Northern IrelandComputer games under-explored
4AimsTo design and develop a therapeutic intervention incorporating a computer game suitable for use by social workers and young people in residential children’s homes;To explore its acceptability and potential therapeutic impact; andTo explore the factors which acted as facilitators of and barriers to engagement and successful implementation.
5Research Design Medical Research Council (2008) II. Feasibility/piloting1 Testing Procedures2 Determining sample size3 Estimating recruitment/retentionIII. Evaluation1 Assessing effectiveness2 Understanding change process3 Assessing cost-effectivenessIV. Implementation1 Dissemination2 Surveillance and monitoring3 Long term follow-upI. Development1 Identifying the evidence base2 Identifying/developing theory3 Modelling process and outcomesMedical Research Council (2008)
6Intervention Design Process Pragmatic, Systematic & IterativeInvolving:- Literature reviews- Consultation with key stakeholders- Preliminary logic modelling- Exploratory research in 3 children’s homesResulting in:- The SIMS intervention & preliminary indications of acceptability- Model of potential barriers and facilitators of implementation effectiveness- Intervention design & implementation logic models
7Emotion Regulation Skills Coaching The InterventionComputer Gameplayed by young person alongside a residential social workerEmotion Regulation Skills Coachingoffered by the social worker to the young person while playing the gameIdentification of emotionsModulation of emotionsExpression of emotions
9The Intervention Riley looks frustrated! Why do you think he got so angry?How do you think Mike is feeling?What might she do to calm down?How would you feel if that happened to you?What would you do in that situation?
11Key Findings A word of caution Acceptability Potential uses The challenges to introducing therapeutic innovations in residential child care contexts
12Acceptability“good” (YP); “really good” (YP); “something different”, “interesting” (RSW); “fun” (RSW)“[The game] was a load of shite” (YP); “It’s nearly too complicated” (RSW); “There was a lot of preparation” (RSW)
13AcceptabilityHe was very keen. [Andy] would be very open to new experiences, meeting new people and trying new things. He likes computers as well. He likes computer games. So there’s an interest there too. (RSW) I identified some concerns about Oliver and his participation before [implementation] and thought that it wouldn’t be right for Oliver’s particular needs. Some aspects of that were wrong and some were right. Oliver did engage with it for a prolonged period, but completely at his own determination. He would only do it on his own and wouldn’t engage in the dialogue that would be associated with a sort of more therapeutic response. (RSW)
14Potential UsesIt sort of gave me an insight to what I needed to actually do and whatever, whenever I go out into the world. (YP)R: What did you like most about it?Sam: The game just. It gave me something to do.R: It gave you something to do of an evening type of thing. Is that what you mean?Sam: Yeah.R: What would you normally be doing if you weren’t playing the game?Sam: Sitting around probably. (YP)
15Potential UsesI mean he’s a high risk taker, major high risk taker. There’d be a lot of concern about his behaviours and potential for misadventure or, you know, even disability or fatality in terms of his behaviours. So at least when he was engaging on a regular basis with the game that did reduce his high risk behaviours. (RSW)When that game was being played he’d be very very focused on it and he was very calm. He wasn’t agitated in any way when he was playing the game. (RSW)
16Challenges to engagement & successful implementation If I’m honest it wouldn’t have been a huge priority. We would have played as much as we could but there was a lot going on for him the last six months. (RSW) [Oliver] is very different from a lot of kids. He’s a real individual when it comes to it. He’s very self-determined. He’s very headstrong. He doesn’t like authority. He doesn’t like therapeutic approaches. I can sort of understand, maybe, where he’s coming from because he’s had therapy to it’s coming out of his ears. (RSW)
17Challenges to engagement & successful implementation I suppose in general there would be staff here who would be into more therapeutic approaches than others and others would have a more practical outlook on residential so there might be some resistance to that. (RSW) You know you’re living with the young person so in one way you’re the person whose imposing sanctions and discipline, you’re sort of a parental figure, so they mightn’t be able to sit down and open up. (RSW)
18Model of Implementation Effectiveness Successful Implementation (Enabling Forces)InterventionResearch ProcessResearcherResidential Social WorkerYoung PersonContextCONSIDERING IMPLEMENTATIONResearch ProcessResidential Social WorkerInterventionResearcherYoung PersonContextImplementation Failure (Constraining Forces)
19Implementation Logic Model 1: InputsCollaborative partnerships with key stakeholders in children's homesParticipants for consultationParticipants for implementationLaptop computers or games consolesGame softwareIdentify evidence base and theory through literature reviews2: ActivitiesDesign research, intervention & implementation protocol in consultation with stakeholdersIdentify intervention 'champion' in the children's homesRecruit participants willing to implement the interventionDesign and deliver training course to residential social workersSecure laptops/consoles and gamesResidential social workers implement interventionConduct pilot studyConduct single-subject evaluation & process evaluation3: OutputsPilot study data indicating the feasibility and acceptability of the intervention in contextSingle-subject evaluation study data indicating efficacy of interventionProcess evaluation data indicating implementation effectivenessIntervention theory of change modelTherapeutic tool suitable for use with young people in residential careImplementation protocolUser manualTraining protocol4: OutcomesIncreased engagement of young people in therapeutic workIncreased involvement of residential care staff in delivery of therapeutic workIncrease in emotion regulation skills among young people5: ImpactImproved mental health outcomes and coping for young people in residential care
20Future Directions Further development work Further exploratory research to examine its potential usesEvaluation research to examine therapeutic impact
21ConclusionYou can discover more about a person in an hour of play than in a year of conversation. – Plato, c. 400 BCE
22Aventin, Á. (2013). The Challenges of Introducing Computer Games for Therapeutic Use in Residential Child Care: An Exploratory Case Study. PhD Thesis. Queen’s University Belfast.