My Mobile Story was designed to make use of the multimedia capabilities of mobile phones. Teenagers can use their phone to record sounds, pictures, videos, and text between sessions and then construct therapeutically meaningful stories with their therapists. Therapists can incorporate existing paper therapeutic exercises into the system as “therapeutic plans.”
The system was designed to help the client enter into personally meaningful conversations that deal with important issues and identify strengths, ultimately developing the therapeutic relationship. According to one therapist, My Mobile Story “personalizes the content for therapy sessions”. Another therapist who used it with two teenagers reported that “it can serve as a starting point for discussion in subsequent sessions”.
November + December 2009
[ 3] Holloway, D. “Overcoming a Common Help Design Challenge: No Access to Users.” interactions 14, 1 (2007): 32-38.
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some areas, in mental health care this can be genuinely useful. According to one therapist, “A good ice breaker makes therapy a little less threatening.” In some cases, simply using technology as a medium has been effective. Regarding mobile phones, one therapist commented: “I’m 53 and appear old to most clients. For me to have something that they are
comfortable with opened up the conversation—they are comfortable talking about their mobile phones. Clients found it very engaging.”
Outside Sessions. In the services we were involved with, teenagers typically attended one-hour therapy sessions once a week, leaving significant time before the next session. There are significant benefits to involving teenagers in therapeutic activities between sessions. However, engaging teens in activities outside of therapy can be difficult, because many things compete for their attention—television, friends, schoolwork, sports, and computers. Consequently, teenagers may have no time for long and demanding tasks, or may not have sufficient personal space from peers or family to engage in them. Because of this, we have focused on designing systems that are readily available, provide discreet access, and allow multiple short interactions. Stigma is strongest outside a session, so it is also important that systems are flexible and allow discreet and secure access.
Our two mobile systems use a model in which teenagers generate content through a series of brief interactions between sessions, perhaps at times of significant mental health events, and then elaborate, reflect on, and discuss this content with a therapist in a clinical setting.
interactions
Overcoming Lack of Access The lack of access to users means there is a risk of not understanding users’ needs, their cultural context, the practi-
calities of their domestic life, and existence outside or even within the therapeutic environment.
The challenge then is to identify techniques that can provide the designer with feedback on the suitability of designs before clinical use. Other researchers have experienced similar difficulties getting access to end users, and in some cases we can adapt techniques from these cases. Holloway has described competing with other departments in her company to get access to users to evaluate help systems [ 3]. Researchers in “inclusive design” (e.g., technologies to support people with autism) sometimes have to rely on other stakeholders because end users may not be able to provide suitable feedback to designers.
While addressing these issues depended on a number of collaborative design activities with therapists, the use of role play, peer evaluation, and clinical pilots were key in the development process.
Therapist involvement.
Therapists have expert, sometimes tacit, knowledge of their clients and can provide vital information about their needs. Close collaboration with at least one therapist throughout all our projects has been essential. Therapists have been involved as design partners from early requirements and idea generation all the way through to prototyping, clinical protocol development, and reviewing systems right before they were used in clinical settings.
Peer-user evaluations. While therapists can help to provide the designer with insights into clinical situations, there is no
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