A comment on an earlier post expressed the hope that I would at some point talk about the practical ways therapists might use social media with their patients in treatment. I realize that I had not made a connection explicit yet in this blog.
Video games are a form of social media.
When we say social media a lot of us think Facebook or Twitter. But the Web 2.o world is a lot more social and interactive than that. Whenever you play Scrabble with friends on Facebook, post your high score on a leaderboard, help a friend complete something on Farmville, or create a platoon for Call of Duty, you are engaging with social media. Perhaps it is because we have begun to take social media more seriously more quickly than video games that we overlook this. So although I will at some point discuss ways to use Facebook, Twitter, etc. therapeutically, let’s start with video games.
One of the most fun and pervasive parts of various games is “unlocking” an achievement. That usually happens when you complete a task that is spectacular in its rarity, or epically mundane. One example is the fishing achievement in WoW of “Turtles All The Way Down.” This is the achievement of catching a Giant Sea Turtle mount while you are fishing. The chances of doing that on each cast is pretty low, so this usually consists of fishing up hundreds of fish over a long period of time before it happens. Then all of a sudden it there’s a burst of light on your screen, and a little achievement sign pops up with some music to tell you that you’ve accomplished Turtles All The Way Down. You get the reward of a turtle mount, and the achievement goes on your achievement log for all to see. Grats!
Therapists with a pathologizing stance will be inclined to think, “Wow, what a waste of this patient’s time. No wonder they can’t lose that 40 pounds or clean up their laundry or make dinner for their spouse.” At best they’ll hold this judgment in, and at worst they’ll say something like “Do you think that this is the best way to use your time given the problems you’ve mentioned in here.”
A gamer-affirmative therapist, on the other hand, can try this approach:
“Congratulations, that must have taken a lot of time to complete. It also shows us that you have the capacity to stick with tasks that may be pretty boring, let’s see how we could use that to your advantage outside of the game as well.”
Okay, so just how can the therapist do that?
First, you need to acknowledge to yourself and to the patient the reality that real life is often a lot less stimulating than games when it comes to tasks. We all do mundane tasks every day (or avoid them) and no lights or music comes up, and we don’t get a prize. And we live in a very puritanical culture which steps up to the plate and says, “Just so. Virtue is its own reward. Work, for the night is coming. Work, for the end draws nigh.”
I remember working in an urban school district and going into the lunch room, and borrowing a trick I learned from Loretta Laroche. Several of my friends and colleagues were already sitting at the table eating, and I said, “Excuse me please, I have an announcement to make.” (If you have never tried that part, do it! You get to make announcements, you’re allowed. It is SO cool.) They looked up at me.
“I didn’t have to come in today. I could have stayed home instead. But I did, and I worked very hard this morning, and I would like a standing ovation.”
They burst into immediate applause. And that was it, I got my standing ovation, felt great, we all laughed and the day got even better.
You can make real life look more fun and shiny in the mundane spots. And bear in mind that this is for the rough spots. I am NOT saying that I’d rather log on to Second Life and see a simulated version of the Himalayas if I was offered an all-expense paid trip to Tibet. Remember that we’re talking about our patients’ challenges here. Doing laundry IS boring. Exercising or dieting is long and often tedious, and unless you love cooking and have plenty of time, making dinner isn’t always that fun either.
So what does this have to do with social media and using achievements therapeutically?
Well, there is great website to help you do this called the World of Warcraft Achievement Generator. It lets you create your own achievement banners, and gives you the opportunity to send the link, or the actual picture. So for example if you are working with a school-anxiety or absenteeism issue with a middle school child, you can plan out what they need to do for what kind of achievement. Say they are having trouble getting to school on time. You set the goal of getting to school on time once this week. When they do, they or their parent emails you to turn in that quest, and they get an email back from you which says this:
For those of us that recall the gold star on the chart, the principal behind this shouldn’t be revolutionary. But we hesitate to use the technology to gamify therapy. And this is not just behavioral reinforcement, this is social. The child or parent emails us, expressing pride in an accomplishment, and we email something back that hopefully conveys something about who we and they are, and mirrors their achievement.
Therapists who work with adults can use the concept of achievements as well. Patients who are trying to lose weight can engage their partner or a supportive friend to generate the achievement banners that the patient plans out with you in treatment. In the case of weight loss they might have achievements for eating smaller portions, adding veggies, or losing a certain amount of weight. Once they do one they receive this:
Note that you can integrate this with Weight Watchers or other token economies.
Often patients need some help breaking down seemingly insurmountable tasks into manageable chunks. So to win the Title Achievement of Master Launderer you may help them do this in session, and create smaller achievements as they work towards their title, like:
Detractors may think that this is too facile, that life doesn’t work that way.
But it can.
There is no harm in providing enriched stimulation to motivate a patient. Let’s face it, you probably wouldn’t go to work for too long if you never got paid. And you earn those achievement points we call “vacation days” too. We need to get over this puritanical idea that we’re either supposed to love work with all its drudgery, or that having fun is not the point. What if having fun is the point, or at least one of them?
So games are social media, and game concepts can be used therapeutically. One example of using gaming and technology is the achievement generator. Can you think of others?
P.S. Yes, there is a way to gamify the goal of having your partner cook dinner. The non-cooking partner takes a lesson from Iron Chef and picks 2-3 “secret ingredients.” The cooking partner than has to come up with a meal based on those ingredients with what you have in the kitchen. Good Luck!