Creating MindGamersTM: Building Communication, Design and Development Process with Clinicians, Game Faculty and Students

Stephen Jacobs, Laurence Sugarman and Robert Rice


In 2010, the authors began to meet to brainstorm design and play concepts for a therapeutic, physiologically controlled videogame intended for use by people diagnosed with anxiety and/or autism spectrum disorder (ASD). The end goal of these explorations would be to create a game that would combine Dry Rice's work (Rice & Williams, 2011) in Cognitive Behavioral Therapy (CBT) and Narrative Therapy and Dr. Sugarman's work (Wester & Sugarman, 2007, Sugarman 2000, Reaney, Sugarman, & Olness 1998) with psychophysiological self-regulation.
In the summer of 2011, the first of two 6-month waves of development began, funded by RIT's Office of Sponsored Research. Professor Jacobs led the recruitment of three student developers working full-time on co-op; Kenneth Stewart II, Ivy Ngo and Jack McDonald. Jacobs designed the production process to leave the first three months almost exclusively to research, conceptual design and physical prototyping. Much of the first six weeks was devoted to ensuring that the clinical team (Sugarman and Rice) and the development team (Stewart, Ngo and McDonald) achieved a common understanding of each other's roles and expertise and achieved a common understanding of the therapeutic and technical needs of the project. Approaches to achieving this shared understanding included clinical readings, team demo and play sessions of games, biofeedback sessions and game prototyping through role-playing.

The game concept that emerged from the initial design phase is "MindGamersTM In School." (MG). Gameplay in MG begins with Avatar creation. Based on Rice's therapeutic approach, three avatars are created. The first represents the player. When this avatar is finalized a duplicate of the avatar is then equipped with armor/costume and weapons or tools in a "utility belt." These represent the therapeutic tools the player is using in their actual day-to-day life to cope with stress, etc. So the "Sword of Sharp Intellect" (thinking through situations) or the "Pocket Watch of Slo Mo" (pausing and counting to five before acting) might be selected, named and then added to the avatar's utility belt by the player. This avatar becomes the "goal-directed imp" (gdimp) and represents the player's idealized self that is in control of their behaviors and thoughts. The third avatar created by the player, the problem-based imp (pbimp) represents their anxiety or compulsive behavior that they are working on with the therapist. In game the imps follow the player's avatar. The pbimp will work to get the player off-track and in-trouble. The gdimp will, under the right conditions, intercede and distract the pbimp from the player, allowing them to continue with their mission (for example, get to class on time) unhindered.

The right conditions are determined by the player's state as read by a NeXus 10 wireless transducer. It reads respiratory rate (RSP), peripheral skin temperature (TEMP), skin conductance (SCR) and blood volume pulse (BVP) as proxies for sympathetic nervous system arousal (SNA), which are then dynamically summed and represented as a Stressmeter on the game's display. The higher the stress, the more influence the pbimp has over the player's Avatar. As the player lowers her or his SNA, the gdimp is more able to intercede. So skills in physiological self-regulation as biofeedback are joined with cognitive behavior therapy in the gameplay.
From this process a first functional prototype emerged and the results of the initial patient usability studies and project timeline has been presented at the American Society of Clinical Hypnosis, Charlotte, March 2012 the International Meeting for Autism Research, Toronto, May 2012 and Games for Health, Boston, June 2012. The second phase of production, to develop a wider and deeper prototype, began in June of 2012 with McDonald staying on as a development team lead in the beginning and three new team members Mark Zimmerman, Bryan Gawinski and Megan Kushner, working on it through November.

Since the beginning of the process the team has been built as a three-legged stool. While it is often typical in university-based projects for one or more faculty to assume a "Sage on the Stage/Game Design Lead" role, in this case Jacobs has been much more of a "Guide on the Side/Game Producer" type of role, allowing the design and development to emerge more organically as a collaborative project between the clinical and development teams.

This paper will focus on the process of the MG's design and development process by looking at how the initial design period brought the game design to its current state and how it has influenced the production process.