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Cognitive reappraisal (CR) is a critical emotion regulation skill that is strongly associated with mental well-being outcomes. While CR has been well theorized psychologically and many therapeutic approaches exist, CR remains one of the toughest skills to learn and develop. We explore the design space of using technologically-mediated CR supports through a dual approach. First, we draw on a content analysis of 30 therapeutic manuals combined with five clinician interviews to understand existing CR processes and challenges in therapeutic settings. Second, we compare the identified challenges with a scoping review of 42 HCI papers on technologically-mediated CR interventions. This allowed us to identify trends and gaps in a field where digital health innovations are critically needed; and suggest four design opportunities that warrant further exploration. Together, our work contributes theoretically-derived future research opportunities, and provides researchers with concrete guidance to explore these important design spaces.
Pediatric mental health is a growing concern around the world, affecting children's social-emotional development and increasing the risk of poor behavioral outcomes later in life. However, obtaining a behavioral diagnosis in early childhood is challenging due to lack of access to resources, low parental mental health literacy, and children's dependence on several stakeholders to coordinate care for them. While app-based, at-home screening tools could offer a scalable and convenient diagnostic solution for families, stakeholder perspectives on their utility and usability remain to be examined. This work reports on a survey of child mental health practitioners and interviews with parents to illustrate existing barriers to care that stakeholders encounter, the perceived benefits of app-based screening tools in meeting their needs, and the challenges in scaling up these tools. We identify where stakeholders agree or disagree, delineate key design tensions, and provide recommendations for the development of future screening technologies.
Many people prefer psychosocial interventions for mental health care or other concerns, but these interventions are often complex and unavailable in settings where people seek care. Intervention designers use technology to improve user experience or reach of interventions, and HCI researchers have made many contributions toward this goal. Both HCI and mental health researchers must navigate tensions between innovating on and adhering to the theories of change that guide intervention design. In this paper, we propose a framework that describes design briefs and evaluation approaches for HCI contributions at the scopes of capabilities, components, intervention systems, and intervention implementations. We show how theories of change (from mental health) can be translated into design briefs (in HCI), and that these translations can bridge and coordinate efforts across fields. It is our hope that this framework can support researchers in motivating, planning, conducting, and communicating work that advances psychosocial intervention design.
Awareness of internal sensations, or interoceptive awareness (IA) is a topic of interest spanning multiple disciplines. In psychology, several therapeutic frameworks which cultivate IA have emerged. Meanwhile, HCI designers have developed novel approaches to IA across diverse contexts and design goals. These HCI strategies may hold value for mental health, however, it's unclear to what degree designerly IA techniques match or contrast with those used in therapeutic settings. We seek to address this gap in two parts. First, we offer a set of design opportunities based on IA practices used in HCI and findings from interviews with 22 counselors. Second, we share context-specific insights from a 5-week probe study involving 24 young women with nonclinical disordered eating behaviors, which are linked to interoceptive deficits. Together, the design opportunities and probe study findings provide guidance and highlight open questions regarding the design of technology-mediated IA support for mental health.
Virtual reality (VR) offers great promise to expand delivery models for therapeutic interventions to help adolescents develop adaptive emotion regulation skills. Cognitive reappraisal (CR) is an emotion regulation skill that involves changing your thinking to improve your emotional state. However, adolescents face developmental and implementation barriers to do CR successfully. To better understand adolescents' (15-18 years) lived experience of CR challenges and how they envision VR could support their skills learning and transfer to everyday life, we ran three co-design workshops (N=69). Our research weaves together the workshop findings with prior literature to identify directions for future VR-based CR interventions. From our study results, we generated design strategies leveraging best practices of existing research: embedded and embodied scaffolds, providing different points of view, and externalizing the inner self. To illustrate these strategies in practice, we show how each would work in a challenging emotional scenario identified by adolescents.