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Issue 108 | April 7th 2011 Contact the Editor | How to Contribute

Therapy 2.0 - Computer Based Self Help
The role of LiveCode in modern psychiatric therapy

Interview by Mark Taoilinn

Did you know that virtual applications are increasingly being used to treat patients with mental health issues?  Virtual reality is being used to treat phobias, addiction and post-traumatic stress disorders.  Text messaging is giving patients real time counselling when their problems hit hardest. And tech savvy therapists are even starting to use mobile apps to connect with their patients in the real world, or to offer patients an alternative to traditional therapeutic techniques.
I spoke with Dr. Christopher Woelk of the University of Osnabrueck, Germany who believes in more than just pen, paper and a comfortable couch.  Dr. Woelk is using LiveCode to make computer based self help programs to reach out to his patients and to interact with them beyond the safe confines of the therapist’s office.

“Therapists and patients, speaking to each other in therapy - that’s the old way” Dr. Woelk insists, reminding me that therapy has moved on since the time of Sigmund Freud. “These days it’s about behaviour, about getting the patients to do something to change their behaviors.” This is a theme that is clearly close to his heart - getting the patients to do the work to bring about their own recovery.  Good therapy, he tells me, is not about the therapist telling the patient what they need to change, but is rather a journey where the patients discover their own route to recovery. Crucially, it’s the patient who has to do the work. 

A vital element of this, as Dr. Woelk sees it, is embracing modern technologies to complement the traditional therapeutic method. “Psychotherapists have the responsibility to use contemporary and effective mediums. Firstly more patients can be reached and treated than ever before, secondly mediums such as computers, the Internet or mobile phones broaden the spectrum and treatment options. Why not use what is already available to most of the patients?”

What has he done to date?
For more than the past decade Dr. Woelk has done just that - his range of books, CDs and interactive computer programs use what is already available to connect with his patients in a way that a traditional therapist never could. “Talk to Him”, an interactive PC-Program, gives patients with Obsessive Compulsive Disorders the opportunity to confront their compulsion head on. By encouraging the patients to take on the role of ‘the compulsion’ the program helps them to realize how their ‘unwelcome guest’ repeatedly manages to make their life difficult. The principal concept is: "Only when I have understood my enemy, can I conquer him".

“Psy-Mon”, a mobile phone SMS management system developed with Andreas Seebeck, interacts with patients through their mobile phones. As Dr. Woelk says, ‘why not use what is already available to patients’ to deliver a tailored treatment for their ailments. Pre-scheduled text messages are delivered to patients prompting them to take a snapshot of their emotional mood at that particular time and encouraging them to take any action needed to improve it. 

Dr. Woelk has even gone as far as developing Brainy, a talking computer animated assistant that monitors OCD patients during sessions designed to limit their obsessive behavior. A patient selects a task - for example cleaning - and puts a time limit into the computer. If the patient spends too long on the task Brainy warns them that their time limit is up. Brainy will only stop nagging them when they finish the task and return to the computer. Brainy goes on to prolong the time allowed between repetitive tasks, helping patients disconnect from the trigger that starts the behavior. All of this information is then collated by Brainy and sent to the therapist who can monitor the patient’s progress.

 So successful was Brainy at helping OCD patients to retrain their behaviors that Dr. Woellk and Andreas Seebeck have brought out a version for training elementary school children to do their homework on time. Through games, relaxation instructions and fantasy journeys Brainy helps kids with ADHD to develop new behaviors and promotes concentration and learning.

 

Therapy 2.0 and LiveCode

Until now, Dr. Woelk explained, he’s been using simple multimedia tools to build these interactive programs. However, he started to find these programs limiting and needed something with a lot more functionality. “We needed a tool that could keep up with us, which responded instantly to new ideas and which let us write programs that grow quickly to encompass the full depth of our mental health projects” Dr. Woelk said. That was when a colleague at the University of Osnabrueck, Germany, introduced him to LiveCode. His colleague uses LiveCode to carry EEG experiments (but that’s a whole other story!) so Dr. Woelk was confident that it would be up to the task of making his ‘little helpers’ (this is how Dr. Woelk and the psychotherapist community refer to the programs they use to interact with their patients).

The next ‘little helper’ that Dr. Woelk is working on with LiveCode is called “Family Affair”. This program lets patients visualize the social and family connections in their life. Patients will be able to move representations of their loved ones around on the device - the closer the family member/loved one/friend is to the patient, the closer they are shown to be on the program. Dr. Woelk is really excited about being able to hand a patient an ipad with the program pre-loaded, or email the program to the patient to use on a similar device at home, and get started right away with the patients recovery.

Dr. Woelk and his collaborators are driving progress in the psychotherapy community. He feels that progress could be faster - therapists have been reluctant to embrace new technologies - and points to the USA, the UK and the Netherlands as ‘the promised land’ for the future of Therapy 2.0. “It’s about putting technology into the secret hoard of psychology” he says. With visionaries like Dr. Woelk and his contemporaries leading E-Mental health provision I am sure that soon we will all be leaving the couch behind and sharing our worries and woes via our cell phones and mobile devices!

Congratulations to Christine Woelk, Dr. Woelk’s wife, partner and fellow psychotherapist, who was the lucky winner of the iPad2 in our recent 4.6 launch competition. She plans to use the iPad to test the new programs she and her husband develop in E-Mental Health provision. RunRev are delighted that this prize has gone to such a good cause and I speak for the whole office when I say how proud we are to see LiveCode being put to such a unique and rewarding use. 

Mark Taoilinn

About the Author

Mark Taoilinn is Marketing and Communications Analyst for RunRev Ltd.

 

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