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Games 4 Therapy

Design a game to support therapy in Early Intervention of Psychoses


Susana Passinhas (PT)
Matias Daporta Gonzalez (ES)
Sebastiaan Broek (NL)
Gerdjan van Hagen (NL)



The final sprint!

Hello dear readers!

Insights co-creation sessions

We have finished our last co-creation sessions, and the results have had a massive impact on our progress. As discussed briefly in our last blog, we decided not to go with the breathing mechanism. The main reason for this is that, according to the insights we have derived from our sessions, using the mechanism in public would be too intrusive for the user, even if the mechanism could be used discretely.

New approach: inspirations of CBT

Instead, our user group proposed to focus on a fully smartphone based solution, that we already mentioned in our last blog as well. The application that we are developing is inspired by a technique that is used by therapists while treating (post-)psychotics. Cognitive behavioral therapy (CBT), as the technique is called, is a form of therapy in which the therapists tries to re-orientate the client on his thoughts. Delusions or negative thought patterns of the client may lead to unwanted behavior, and by asking direct questions to the client, the therapist can revert thought patterns of the client to more positive ones. This does not happen by saying that what the client is experiencing is not true by definition, but more by making him realize that what he is experiencing could be a thought pattern that is constructed inside his own mind, and that does not have to be connected to reality outside.

Our application is inspired by this technique in the way that it asks questions to the user, to make him conscious of the thought patterns that might be constructed in his head, and of their intensity and credibility. The answers to the questions (that can be answered in multiple choice form, or in percentages, and lead to various new questions) construct a mindmap structure, which the user can review and show to his therapist in the actual therapy. This last comment brings us to an important note: the application we are building is not a replacement of professional psychological therapy, but an addition to what is already there. It is a way to directly re-orientate a single thought pattern while experiencing it, instead of making a recap of the situations that have occurred earlier, while being in a professional therapy session.

The interface of the application will look like this: in the center, the questions are presented, which the user can answer. Filling (a part of) the screen, there is a status bar that shows the intensity and mood of the thought the user is experiencing, visualized in respectively size and colour. Basically, the bar serves as a motivator for the user to reach more positive/truthful thoughts. The user can add notes to answers, to make the answers more personal and extended, so that they can be better understood later. He is able to review the whole mindmap afterwards, alone or with a therapist.

Future plans

Currently, we are working a few things. We are taking care of the core programming, and meanwhile the last designs, structures and alternative messages are being finished and are being suited to implement them. We are also finishing the research paper that will accompany the prototype when it will be delivered.

We will keep you posted about our progress!

A last message: on June 25, we will do our FINAL PRESENTATION, in which we will present the prototype to the public. The other three MediaLAB groups will do the same, so it will be an interesting evening! The event will take place here at the MediaLAB studio, and you are welcome to come! If you are coming, please RSVP to this Facebook event.

New ideas and directions!

Hello all!

In this blogpost, we will give you a headup of all the things that have happened last weeks!

After last post weeks, we started developing further our breathing game concept and prototype. While researching and prototyping, we found out that the piezo element microphone that we used for our breathing sensor was fairly unstable and not accurate. Therefore, we decided to focus on a more physical sensor: a band that is tied around the user’s chest and measures its capacity. First we decided to build the construction ourselves, which consists of a piezo element that alters the voltage level when curved. We made a construction that makes the element bend when the chest of the user is increasing in volume.

This construction was not always working properly, so when Loes came up with an electro-conducting fabric, we decided to implement this fabric in our prototype. The fabric was more reliable than the construction mentioned above, but still, we felt we needed a professional sensor or system to capture the breathing of the user accurately. We have been in contact with several innovative companies to talk about implementing their sensor in our project.

In this sprint, we have been doing a series of co-creation sessions with people who have suffered from psychosis. It is very nice and interesting to talk to people who have experienced psychosis in person, because it communicates the idea of psychosis much more vividly and clearly. A few things stood out of these meetings. In the first meeting, we talked about having something (like a digital application) to distract from a stress situation, as well as an app that can give structure to the life of a post-psychotic. The idea of a breathing game also appealed to them. In the second session we learnt the smartphone seemed to be an important object of these people, for different reasons (structuring life, keeping relationships, music, etc.). In the second half of this meeting, they offered some ideas for digital solutions that would improve their daily life. One idea is an application that allows the user to orientate his thoughts. It works as follows: the user can set up thinking paths that occur to him more often (perhaps with a therapist), in order to review the appropriate path in a situation of distress or delusion. Another idea is an application that allows the user to capture moments by photo-/videocamera of the smartphone, or by text, spoken message or even a song that reminds him of a certain situation. The user can review these moments and use them as a distraction, an escape out of the situation in which the user feels uncomfortable or distressed.

After the last meeting, we decided to develop the thought-organizing app. We have to say that the idea of the breathing mechanism is still in our minds, because the people from Arkin were very excited about that as well. At this point, there are a few tasks we are working on. We are going to develop the application for iOS systems, so Gerdjan is learning to program for this operating system. Meanwhile, we are making designs and structures for the app, and to make the application support the thinking patterns of the user optimally, we are interviewing several psychologists.

Keep you posted!


New stuff!

Hello everyone!


Long time no speak, so time to give you an update of what’s happening at Games4Therapy!

Last Monday, we presented the prototypes we have been working on to our commissioner Arkin, and it was very productive to hear their vision on our ideas. We decided to develop our ideas into two directions – being ‘physical/mental games’ and ‘communication/socialization’ – that we shall explain more extensive down below.


Physical/mental games

The last two weeks, we translated a few of our ideas into simple prototypes. The memory game mentioned in the last blog post turned out to be very engaging. We noticed that sound is very important in remembering the sequences correctly. Competition is a huge motivator for playing the game. We finished the multiplayer version we were working on last time and it’s interesting in the sense that it lets player 1 generate the sequence for player 2.



We also further developed the idea game that is influenced by the breath of the user. We made a game in which the user has to operate a helicopter, and by breathing gradually, the screen will stay the same. However, when the player is breathing to fast or heavy, the screen will turn darker gradually. The player has to control his stress levels to complete the game.

A more serious version of this idea is a game that takes place in a virtual street, in which the player needs to make sure not to bump into any people while walking to an object. The breath controls the movement of buildings on the sides of the street. When the player breathes too fast, the buildings will come closer, making it harder to pass all the pedestrians.




We came up with the idea of a stress ball, that lets the user communicate wirelessly with people who also have one. Crucial is that the other people will be friends of family of the user. Communication will take place by vibrations, so the users will have to agree on a certain message a vibration means. We like the idea of giving something completely new to the user, instead of applying something to an object the users already has, say a smartphone. Another prototype is a device that lets the user speak into a microphone, being able to send and receive messages to relatives, or to strangers anonymously. A light will blink when someone has heard the message, another light will blink when another users indicates to empathize with the user.


We decided that we are going to develop the breathing game further now, along with thinking of new directions we can take our concepts in. We’ll keep you posted!


In our new approach, we started to develop simple prototypes to show our ideas. For instance, we want to decrease stress levels of the psychotic, and help them communicate with people as well. We made a stress ball, that relieves the user´s stress by pressing it, but also lets the user communicate with other people, through vibrations and light signals. We built the prototype using LittleBits, LEDs, a bending sensor and a vibration mechanism.

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We also want to explore simple concentration games; they keep the mind occupied and motivate the user to engage in the game. We started by exploring the Simon Says memory game. In this game, the user has to repeat a color sequence that is generated by the game itself. The sequence will get longer and longer, and the longer the user can replicate the sequence, the higher his score will be. We made a version in Scratch and used MakeyMakey to build the interface. Currently, we are working on a multiplayer version of this game.

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More information here:

Another prototype we are working on is a game, in which the difficulty is controlled by the breathing of the user. The game starts normally, but gradually gets harder/more chaotic. In order to control the chaos in the game, the user needs to breathe calmly. The game motivates the player to control his breath and stress level. In the prototype, we shall induce the difficulty of the game by gradually lowering the contrast of the video screen.


See you!

WORKSHOP IDEATION With Charlie Mulholland

Yesterday he had another amazing workshop about Ideation. Now that we have done so much research, we need to start focus our ideas and knowledge.

Psychosis is a very complex subject and thinking about solutions to help people in a post-psychotic phase is very challenging. In Charlie’s workshops we do a lot of brainstorming. This time we all draw how we see the problem individually and then we combine them for a full overview of the problem. Based on that we start thinking about solutions that could be a solution for the problem.

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For now, and after talking to game specialists we decided to narrow our concept, and we prefer to focus on very simple solutions to response to a simple individual need. We also did a selection of our target group and that help us to build some user stories. We found out that some behaviors were a pattern. So we start brainstorming about stress, anxiety, mental training and cognitive tasks. At the same time we also want to connect people and help them to be social.

See you!

Paula Tome, an expert

On monday, february the 17th, Matias and Louis had a skype meeting with Paula Tome. Pauyla Tome is a mental health activist in Spain, she gives lectures on alternative treatments on psychosis from a very personal perspective, since she has been a patient herself. Now she is finishing her master degree in philosophy, writing her thesis about the mental health care from a feminist and political point of view.
First she told her story. Thirteen years ago she got two crises in which she ended up in a hospital. During the paranoias she experienced, she was convinced that people wanted to kill her, so the telephone, the post, TV… everything was used to spy her; fear was the ruling emotion. Fear was defenitely the leading theme in her relation to psychosis.
She was under treatment for 5 months, but then she decided to reduce the medication little by little because she considered that her personality was fading out. Since then she only enterred in four more crises, which lasted about a week.
What she did was to reduce the possible stress generators in her life, as it was: her job, her sexuality, her mental condition… She quitted her job and created her own little business, she came out of the closet and she communicated to all her friends what has happened to her. Doing so, some of the friends decided to support her, so in case of another psychosis they would be prepared, in stead of being surprised or scared, they would adapt it into their routine. This network of close friends and relatives was definitely the biggest support to gain progress and reduction of her fears…
With the group of friends, they made an intense analysis about the four crisis that occurred during those 13 years. For her, it was the only way to feel in control of the delirium. Understanding the political context, the philosophical context, the social relations and repercussions of an episode  empowers her to face the following crises.
She also opened a blog where she keeps posting all the conclusions and information that she started to collect about her and other patients and about alternative treatments. In the blog we could find a lot of lectures with a big variety in points of view…
This is one example:
She is not against pharmacological help, what she claims for is a better information system. For example, from time to time, if she feels that her mind is overloaded, and for a couple of days she could not sleep, she just takes a sleeping pill. But, one sleeping pill form time to time is nothing in comparison with the side effects of the thirteen years of medicaments that where prescribed to her.
One of the main problems and difficulties for the understanding of the mental disorders is the tragedy that it throws up. We have learned to relate with them in a dramatic way; for example, lets look to the representation of it in cinema, these  cases are used to create drama or horror. This drama only keeps the patients in a lower level and weakens them to fight for their rights… Like this they remain  in a position of the victimised and there is a no access to alternative treatments.
We are working on it…
(Written in collaboration with Louis Vanhaberbeke)

Getting in touch with the assigner!

Last week we presented our user scene for the first time. As said in our first post, our task was to explain the problem of the assigner in an understandable way. We decided to make a video, in which we would present psychosis from the psychotic’s perspective. The setting is a job interview, and the nerves that come along with it create an excess of impulses and thoughts for the psychotic. You can watch our user scene below!

Games4Therapy user scene

The voice acting of the candidate is done by Louis, who actually has had psychotic experiences. We are very happy with how it turned out! We certainly couldn’t have done it without the help of Louis.



We also started using the Scrum method this week. For those unfamiliar to the structure of Scrum: it is a working method in which the team works in sprints of four weeks max. After a sprint, a potentially shippable product (a prototype) is presented. In the sprint review that follows, the team examines at what aspects the prototype can be improved and which ones are to be kept. We are planning to do five to six sprints in our project, each one bringing forward a new prototype.



We met our assigner for the first time! At Thursday we had a meeting with Arkin, the company that provides mental health care, re-socialization and reintegration in society. We showed them our user scene and they were very happy and satisfied with the end result. We spoke with them about potential ideas for the initial prototypes, and agreed that we could focus best on developing a solution for a user in the post-psychotic state, which means a person that is making a comeback from the psychotic period.

Next Friday, we will meet with them again to present our first initial prototype. Until then, we are busy doing research, brainstorming ideas and discussing them. For now, we are very happy with how our project has started and the ideas we have already shared and received. We are very looking forward to what time and a lot of work (and fun!) will bring us!


Wednesday the kick-off of the project Games4Therapy started. Games4Therapy is a project aims on designing a game that helps young adults aged around 18-28, who are having symptoms of psychosis.

Our team first met each other on Wednesday and it has been very interesting to hear what everyone does. We are a team of four people. First, there’s Susana Passinhas, an Interaction Designer from Portugal, finishing her Master’s Degree in Design and Multimedia at Coimbra’s University. She has worked as a Web Designer for the past years and enjoys the process of developing new concepts. Not only she likes the technological part of it, but also when it involves working with raw materials.

Then there’s Sebastiaan Broek. Sebastiaan is a 21 year old Media & Culture student from the university of Amsterdam, graduating in Digital Media at the MediaLAB. He is looking for creative solutions for issues concerning media. Sebastiaan likes to work together with – and learn from different cultures and has a wide interest in music and traveling.

Matias Daporta is our creative thinker and conceptionalist. He studied ballet, contemporary dance, theatre and filmmaking and also fashion design in Spain. In his current trajectory at the SNDO, university for choreography, in Amsterdam he tries to combine these realms, with special focus on the one common element they propose: the social encounter, repeated in time. He’s using theatre as a social experiment in which the audience and the performers are being tested, and that gives equal value to the influence of the presence of an audience towards a piece and vice versa.

Last but not least, there’s Gerdjan van Hagen. He’s a 22 year old Game Developer, specializing in Game Technology. Being in his graduation phase, he’s had a lot of experience designing and developing games and has worked as a Software Developer for about two years now. After graduating, he hopes to work in the serious game business.

Together, we hope to provide a solution to young adults who have had psychosis, whether the help will be through social acceptance, early detection, prevention or perhaps through other ways.

If you have any remarks or ideas, please let us know at


Day two 

Kick-off week continued on day two, with insights in the projects and tips and hints from former MediaLAB students. It was really nice to see some designs and applications these students worked at for 20 weeks. The presentation about aspects of design that our coach Marco gave afterwards gave us some really interesting and helpful understandings about (Dutch) design.

Our first assignment for the Games4Therapy projects was to make a user scene, in which we explain the case to for instance our commissioner, in an understandable way. To get a better understanding of psychosis and its boundaries, we invited Louis, who has dealt with psychosis 18 months now. We spoke with him about his problem and his experiences. As a team, we all had a notion of the aspects of psychosis, but Louis was able to explain the effects of the psychosis on him much more clearly. It was really helpful to have him to reflect on our notion of psychosis, and our ideas for the user scene. At the moment, our user scene is in development and will be available this week.

New Insights

Getting closer to the interaction design scene. 

Yesterday we went to see a conference about interaction design and the projects of the designers. It was a really interesting way of understanding the context and research process. In order to design well we should understand the user as well.

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Travelling quicker

The first presentation that we have seen was about improving the human flow at train stops. How can people board their trains faster? In order to understand this process better, Marie de Vos followed the train users’ behavior and their way of getting into the train. The research they did lead them to develop a bright sign in the station that shows green and red areas. The colours differentiate between the wagons of an arriving train that are crowded or empty.


Human Machine Interface

IconMobile presented about design expertise in incar experience. They really show us that they work for the user’s demands, although they have to think about safety. It is a little “tricky” to design an interface when you are in the car, because the driver is supposed to pay attention to the road. They design what we expect in the future, what we as users would like to see, but with safety in mind. Markets, car manufacturers, global trends and markets are influencing factors that affect this area.

No signal

The third presentation was about a project that involves the use of sensors. The aim of the project was to turn off the signal of the mobile phone when the user is in a certain social case. So whenever the sensor detects somebody it turns off the signal, so people could really physically interact. It seems to us that this is a more experimental and artistic project than a really doable one.


Just draw the line

Het Stedelijk museum in Amsterdam asked Luna Maurer to develop a project where people could interact and be a part of something bigger. She developed “Your Line or Mine”. People had a paper with dots that they had to connect. At the end, all papers were placed after one another, which made for a very creative movie. It seemed like a very engaging experience and the visitors loved to participate in a project like this.

See you next week!