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Lessons Learnt from Creating an Anti-Anxiety Game
Doris C. Rusch, PhD, DePaul University, Play 4 Change lab
@D_Carmen
The Problem:
40 Million US adults with
anxiety disorder
we owe it to our children, not to pass on
our anxieties.
research on the problem
• SME Prof. Reid Wilson
• anxieties.com
challenges to treatment
• anxious people’s rigid belief
system
• avoidance and resistance of
fear
• only seek help when cu...
Soteria’s Goal
• Initiate perspective shift
• from avoidance & resistance of fear to
embracing & wanting it
• Leverage the...
Embodied Experience =
learning through acting upon the world and
experiencing consequences of actions 1st hand
(Gee)
Recursive learning
Mitgutsch & Weise
Soteria is designed to disappoint old beliefs through
embodied experience in order to facilitate a perspective shift
Not a CURE!
Soteria is comparable to self help books. The
principles are sound and based on decades of
successful psychoth...
Soteria - development context
& approach
• DPU Play for Change lab
• 4 months concept phase
• 14 months development
• $12....
Design Challenges
1. Game models “anxieties” in a general sense
2. Game overcomes players’ resistance to the
theme
1. not ...
https://vimeo.com/177131253
view Soteria video here
1. Modeling “Anxiety” in a general sense: metaphorical
approach
To model the essence of anxiety
disorder, rather than depi...
2. Overcoming Resistance:
Metaphors =“Magic Door”
• counter resistance to a difficult
theme & learning something
new
• tapp...
Soteria’s core metaphors
gameworld = Ana’s inner world
= harbor town

harbor town = infested by
Shadows = fears

harbor to...
Soteria’s “servants” = aspects of Ana’s anxious self
the town is empty except for a few other
characters - Soteria’s serva...
O’Malley the cat = “Therapist”
The only other character in Soteria is
the alley cat O’Malley, whose
sarcasm is only surpas...
Soteria’s metaphors, cont.
• 3 districts representing 3 salient (general)
aspects of anxiety
• music district: fear of sel...
Music store: Fear of self-expression
Puppet theatre: fear of judgement
Observatory: Fear of Uncertainty
metaphorical core
mechanics
• mechanics model Ana’s
relation to fear
• Part 1: stealth gameplay =
avoidance
• Part 2: safe...
3. From “fearful” to “fierce” -
the role of Game Structure to make “fighting fears” mean
something, and leverage recursive l...
modeling the journey, not
just the solution
• Part 1: models perceived reality of anxiety
patient
• Shadows = insurmountab...
modeling the journey, not
just the solution
• Part 2: impasse
• increase safety measures
through Phobos Suit
• safe & stuc...
modeling the journey, not
just the solution
• Part 3: New Strategy!
• linger & provoke
• emotional challenge
• work throug...
4. Speaking the Mind
the role of Voice Over to promote insight, reflection and real-
life transfer
• Ana’s VO: intended to convey her inner conflict
• Dialogue with Soteria’s “servants”: intended to
reinforce Ana’s doubts
...
Summary
• Soteria allows players to experience the ineffectiveness of common
anxiety strategies
• by way of disappointing ...
Outlook: Soteria goes
thanks, questions?
drusch1@cdm.depaul.edu
@D_Carmen
http://playforchange.cdm.depaul.edu
Doris C. Rusch - Lessons Learnt from Creating an Anti-Anxiety Game
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Doris C. Rusch - Lessons Learnt from Creating an Anti-Anxiety Game

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Doris C. Rusch, Assistant Professor, Game Development School of Design, DePaul University

This presentation was given at the 2016 Serious Play Conference, hosted by the UNC Kenan-Flagler Business School.

This talk addresses how we harnessed rules, mechanics, narrative and metaphor to meet these design challenges and create a transformational experience that teaches players productive strategies to respond to a broad range of anxiety disorders.

Published in: Technology
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Doris C. Rusch - Lessons Learnt from Creating an Anti-Anxiety Game

  1. 1. Lessons Learnt from Creating an Anti-Anxiety Game Doris C. Rusch, PhD, DePaul University, Play 4 Change lab @D_Carmen
  2. 2. The Problem: 40 Million US adults with anxiety disorder
  3. 3. we owe it to our children, not to pass on our anxieties.
  4. 4. research on the problem • SME Prof. Reid Wilson • anxieties.com
  5. 5. challenges to treatment • anxious people’s rigid belief system • avoidance and resistance of fear • only seek help when current strategies produce new set of problems Wilson, R. (2009): “The Art of Persuasion in Anxiety Treatment,” In Kerman, M. [ed.], Clinical P Wisdom: Leading Therapists offer Essential Insights. New York, NY: W.W. Norton.
  6. 6. Soteria’s Goal • Initiate perspective shift • from avoidance & resistance of fear to embracing & wanting it • Leverage the “embodied experience” of games • Design structured after “recursive learning model”
  7. 7. Embodied Experience = learning through acting upon the world and experiencing consequences of actions 1st hand (Gee)
  8. 8. Recursive learning Mitgutsch & Weise
  9. 9. Soteria is designed to disappoint old beliefs through embodied experience in order to facilitate a perspective shift
  10. 10. Not a CURE! Soteria is comparable to self help books. The principles are sound and based on decades of successful psychotherapy. But the game can only get you this far. You have to apply its strategies to real life yourself. It’s not a “What you do is what you get” kinda game - it targets belief systems; it doesn’t train behavior.
  11. 11. Soteria - development context & approach • DPU Play for Change lab • 4 months concept phase • 14 months development • $12.000 funding • students, alumni, professionals, SMEs • “poetry” meets “purpose”
  12. 12. Design Challenges 1. Game models “anxieties” in a general sense 2. Game overcomes players’ resistance to the theme 1. not preachy! 3. “Overcoming fears” must be non-trivial 4. Promoting reflection and insight to facilitate transfer to real life
  13. 13. https://vimeo.com/177131253 view Soteria video here
  14. 14. 1. Modeling “Anxiety” in a general sense: metaphorical approach To model the essence of anxiety disorder, rather than depicting specific surface manifestations of it, we decided to take a metaphorical approach to the design. According to our subject matter expert, Reid Wilson, treating anxiety disorders has little to do with the content of a particular fear (e.g. germs, flying, social judgment.) It is about targeting the motivations behind anxiety patients’ actions: namely to AVOID and REJECT FEAR. These motivations are the INVISIBLE FORCE underlying all anxiety disorders. They are also abstract. We can only see their symptoms, e.g. carefully avoiding the cracks between two cobblestones, not flying. Metaphors are excellent tools to make the abstract concrete. They allow us to get an “inside view”. What is GOING ON UNDERNEATH THE SURFACE?
  15. 15. 2. Overcoming Resistance: Metaphors =“Magic Door” • counter resistance to a difficult theme & learning something new • tapping into fantasy • stimulating curiosity • (inspired by: Ruben Farrus, Vander Caballero, Jesse Schell)
  16. 16. Soteria’s core metaphors gameworld = Ana’s inner world = harbor town harbor town = infested by Shadows = fears harbor town = worships Soteria = goddess of safety Goal: claim your dreams from Oicys = disorder Conflict: Oicys’ minions, the Shadows
  17. 17. Soteria’s “servants” = aspects of Ana’s anxious self the town is empty except for a few other characters - Soteria’s servants - aspects of Ana’s anxious self. They bestow protective items upon Ana: the Soteria token to beam out of danger, a flash bang to stun shadows, a compass and a Phobos suit.
  18. 18. O’Malley the cat = “Therapist” The only other character in Soteria is the alley cat O’Malley, whose sarcasm is only surpassed by his mangy appearance. O’Malley is the counter-voice to Soteria’s servants. To reinforce the recursive learning process, he is designed to raise suspicion and resistance. He pushes you out of your comfort zone, but you are not ready. It makes sense to doubt his trustworthiness at this point.
  19. 19. Soteria’s metaphors, cont. • 3 districts representing 3 salient (general) aspects of anxiety • music district: fear of self-expression • theatre district: fear of judgement • observatory: fear of uncertainty • Each district features one anxiety “challenge” location
  20. 20. Music store: Fear of self-expression
  21. 21. Puppet theatre: fear of judgement
  22. 22. Observatory: Fear of Uncertainty
  23. 23. metaphorical core mechanics • mechanics model Ana’s relation to fear • Part 1: stealth gameplay = avoidance • Part 2: safety at the cost of agency through Phobos Suit • Part 3: provoke and linger through the fear
  24. 24. 3. From “fearful” to “fierce” - the role of Game Structure to make “fighting fears” mean something, and leverage recursive learning
  25. 25. modeling the journey, not just the solution • Part 1: models perceived reality of anxiety patient • Shadows = insurmountable • Increased desire for safety / protection
  26. 26. modeling the journey, not just the solution • Part 2: impasse • increase safety measures through Phobos Suit • safe & stuck • disappointment as basis for new learning
  27. 27. modeling the journey, not just the solution • Part 3: New Strategy! • linger & provoke • emotional challenge • work through it, move towards the fear • gain key to recovery • face Oicys • claim dreams
  28. 28. 4. Speaking the Mind the role of Voice Over to promote insight, reflection and real- life transfer
  29. 29. • Ana’s VO: intended to convey her inner conflict • Dialogue with Soteria’s “servants”: intended to reinforce Ana’s doubts • Dialogue with O’Malley: clarifying metaphors and reflection prompt • “What do you think happened?” 35 pages of dialogue rewritten several times to make Ana seem more hesitant in the beginning Dialogues with O’Malley to talk through the individual stages of the game
  30. 30. Summary • Soteria allows players to experience the ineffectiveness of common anxiety strategies • by way of disappointing these strategies, it prepares the ground for new learning • it uses metaphors to capture the essence of anxiety and to present a “mystery” that incentivizes continued play • the game “works”: you can’t win, without understanding the message / new strategies • it’s not a cure: players still need to do the work in real life • AND: making = more effective than playing
  31. 31. Outlook: Soteria goes
  32. 32. thanks, questions? drusch1@cdm.depaul.edu @D_Carmen http://playforchange.cdm.depaul.edu

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