This document describes a proposed app called "Mission: Recovery" designed to help people in eating disorder recovery. The app would send daily messages giving the user permission to enjoy one healthy activity each day without feeling guilty. An early prototype had users enjoying one thing per day over four days. According to one user's story, the app helped take their mind off troubles and allowed them to enjoy activities they normally wouldn't allow. The conclusion is that getting external permission from a tangible source can be key in the early stages of eating disorder recovery.
8. A User’s Story
“I like that it allows me to do
things I don’t allow myself
to do.”
“...took my mind away from
any troubles...”
“Instead of yelling at my
daughter I grabbed the
ball...it’s nice to ground mysel
in something.”
-personally in recovery from an ED….have seen effects when relapse prevention either not done well or doesn’t exist
-our mission throughout
-> relapse prevention for EDs
-> something fun and that excited about b/c relapse prevention tools out there now often as rigid as ED mentality itself
Kat
-initial stressor: adapting to the spontaneity of life outside the rigid structure of treatment is difficult, and often leads to relapse
-initial POV: break the rigidity of relapse prevention plan in a way that makes user feel prepared to adapt to spontaneity of life outside treatment
-gathered from further user interviews that concept of spontaneity not as widely applicable to all ED diagnoses
-also that people who haven’t been in formal treatment don’t necessarily have a plan in the first place to break
-found something even more compelling….concept of giving self permission
-> may sound foreign, but in across all EDs mentality about self-deprication and that don’t deserve
-pinpointing this and flipping it on its head proved very powerful to our users
-new stressor: across all ind w/an ED, allowing oneself/giving self permission to do things is incredibly hard, and if don’t do this, can be road to relapse
-new POV: users need a way to give themselves permission to enjoy everyday activities in a way that doesn’t make them feel guilty
Ji
SBTM
-Once a day, turn a rigid aspect of your relapse prevention plan into something spontaneous.
-Why 1x/day?
-on the motivation vs. implementation (is that the correct other axis?) scale motivation is higher if it’s your ‘mission’ each day
-might forget about it if it’s farther apart than every day
-implementation is too hard if it’s more than 1x/day due to the nature of the tasks as well as where the users are at in phase of recovery
-3 categories:
-> food/meal plan spontaneity
-> social spontaneity
-> somatic spontaneity
Ji
-need to give examples of messages (emphasize that they are actionable) -> we iterated from 3 original groups based on feedback
Kat
Kat
Ji
-2 users in recovery
-1 therapist/clinician, who shared with other therapists and 15-20 clients
-Day 1: “I get to reach out to a friend I haven’t spoken to in a while.”
-Day 2: “I get to do one spontaneous thing that’ll make me laugh.”
-Day 3: “I get to say hello to a random stranger today.”
-Day 4: “I get to treat my body! Think: massages, pedicures, etc.”
Kat
Ji
*overall
-physical prototype
-> loved tactile features, although yarn kept coming apart so wanted it to be more durable
->
User 1
-multiple therapists/clinicians + about 15-20 clients in recovery
-not one of the clients didn’t comment about how much they liked the tactile features (all were constantly playing with the ball)
-all also commented that screen too small (text hard to read)
-really like that the messages are actionable vs. just an inspirational quote that often fails to motivate clients to move forward in recovery
-> kept comparing it to Recovery Record (app that tracks clients progress, but doesn’t have a feature to encourage action, so they really liked this)
-clinicians especially liked that couldn’t skip messages b/c encourages pushing clients slightly out of their comfort zone in a healthy way
-clinicians want the ability to track whether their clients are completing the daily prompts (not sure if we need to mention this?)
User 2 ***can mention quantitative data here***
-(she couldn’t find her charger so she only got messages on 2 of the days, and didn’t do them b/c the wording didn’t speak to her)
-Messages didn’t speak to her
-Didn’t like the phrase “I get to,” suggested changing it to “I deserve to~”/ “I’m worthy enough to” watch the sunset -> we need to personalize based on different stages of recovery
-Felt little uncomfortable carrying around, afraid someone would ask what it is
-Start with simple things, speak straightforward, otherwise felt like another task on top of her regular work
-> even just something like 5 minutes out of her day to take time for herself
-said she would wait for a new message to come (good!!)
-> wanted one in the morning and the evening (needs to be personalized b/c some people get triggered at certain times of the day, and if they can have a message/outside stimulus at that time it will really help
- “I think this will really help people” “There’s nothing else like it out there”
User 3 ***can mention quantitative data here*** (I’m going to say a lot of this in user’s story...so I can cut some later)
-carried the ball on all 4 days and completed all 4 messages
-carried a bigger purse just because she wanted to have the ball with her
-loved that it allowed her to do things she wouldn’t normally do (i.e. get a pedicure, etc.) b/c she feels she doesn’t deserve to do things for herself
-> could do these things without feeling guilty
-liked that it didn’t have any food-related messages so she could still follow her meal plan
-squeezed it in moments when she felt she was losing control (b/c EDs are all about control), but b/c of the physical prototype she was afraid it might fall apart
-> something physical to focus on
- “It’s something physical you can grab for...I punch pillows, but you can’t do that in public!”
-also said screen to small
-would like to have option to skip just 1-2 times
-> in case prompt requires more time than she has but still wants to do one
- “I see it [the loss of control/ED bxs] in my daughter...this would be great for teens”
-also really likes keychain/pillow ideas
Kat
-having something outside the self that can give you permission to do things you wouldn’t otherwise do is key in ED recovery
-something physical that can double as a stress release when feeling out of control
-key = outside the self b/c don’t yet have permission/control to do it themselves
-concept of someone else holding recovery for you in early stages
Kat
1) Larger, longer trial w/more participants
-to see if really is effective in improving outcomes in recovery
-see if still see same general feedback
2) Personalization
-some want different wording on messages
-some get triggered during certain parts of the day and want a message during that time...ability to set that
3) Size
-smaller so it can fit inconspicuously in a purse
-so people don’t ask questions
4) Functionality
-pillow w/a new message every morning when you wake up
-eliminates concerns about other people knowing if aren’t yet ‘out’