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The player plays one level per therapy session, lasting roughly 20 minutes. The literature provides a very limited description of play.
It does provide a clear translation between the cognitive behavioural concepts and the game metaphors chosen. The paper also stipulates the importance of the guidance of the therapist and that the game is not meant as self-help but must be embedded in therapy.
Ricky and the Spider is a game based on CBT for treating obsessive compulsive disorder OCD amongst children.
The game is a single-player, 3D adventure computer game. In the game the player is confronted by Ricky the Grasshopper and Lisa the Ladybug who without saying it explicitly suffer from OCD and need to confront The Spider who has been making demands that they cannot meet.
They ask Dr. There are eight levels of gameplay in which Dr. The first four levels are all psychoeducational. With the therapist observing, the player plays one level at the beginning of a therapy session, which takes approximately 15 minutes, and recounts the content of the level after which the therapy session continues from there.
The well-established metaphor for OCD is the thought-stream, which is discussed. As well as the four-leaf-clover with strategies for behaviour.
Moodbot is a game for adult psychological patients recovering from conditions such as psychosis and attempts to prevent them from relapsing [ 18 ].
As such the game is not tied to a single form of psychotherapy but is a more general psychotherapeutic aid. As a relapse prevention aid, the game is based on two assumptions.
The game is apparently being trialled in professional psychotherapeutic practice. The game is an online, multiplayer 2D computer game, although the interaction with other players is indirect similar to well-known online, social games such as FarmVille.
In the game the player is on board a highly imaginative ship a large fish and has to help keep it moving and steer it towards certain islands [ 19 ].
The game is played daily for approximately five to ten minutes per day [ 18 ]. After discussion a consensus of four PALOs was reached. It is possible to leave comments tips and advice in these rooms.
SuperBetter is a game or gamified platform that is available as a web-based tool and an app for mobile devices. It appropriates game mechanics in order to provide a new narrative for accomplishing challenging health and wellbeing related goals [ 22 ].
SuperBetter is not specifically designed as a psychotherapeutic game. However, in a random controlled trial SuperBetter proved itself effective in decreasing depressive symptoms in comparison with a waitlist group [ 20 ].
Gameplay ends when the goal is achieved and can be continued by setting new goals. Players can take steps towards achieving their goal by performing Quests: actions that share a common theme.
SuperBetter has predetermined Quests that players can select or design their own or select Quests designed by other players. Players can also undertake mood-enhancing activities power-ups , which are simple and instantly possible actions such as drinking a glass of water or hugging yourself.
The platform provides Bad guys to battle. These Bad guys belong to certain Quests or can be copied from other players or designed by the player. Finally, players gather social support invite allies.
Players can invite friends through the SuperBetter platform to help them. SuperBetter offers a mail contact form and a Facebook plug-in to do this.
After discussion a consensus of nine PALOs was reached: 1 The player is asked to create a superhero identity to play the game with.
The similarity in overall assessment is low. Only one PALO is scored exactly the same by all four coders PALO 4 of Ricky and the Spider and on five PALOs three out of four coders agreed PALOs 1 and 5 from Ricky and the Spider, PALO 1 from Treasure Hunt, PALO 5 from Personal Investigator, and PALO 8 from SuperBetter , twelve PALO showed two coder agreements, and the remaining twenty-one PALOs had no exact agreement between coders.
Concerning the attribution of a Knowledge level, the PALOs of Treasure Hunt, Personal Investigator, and Superbetter were most frequently scored as Conceptual Knowledge.
Ricky and the Spider and MoodBot were most frequently scored as Procedural Knowledge. When looking at the selection within dimensions, Knowledge level had three PALOs for which all four coders chose the same knowledge level PALOs from Ricky and the Spider , fourteen had three coder agreements, twenty-one had two coder agreements, and only one had no agreement PALO 9 from Personal Investigator.
Within the cognitive processing dimension three PALOs PALO 4 from Ricky and the Spider, PALO 5 from Personal Investigator, and PALO 1 from SuperBetter had complete agreement, twelve had three coder agreements, twenty-one had two coder agreements, and three PALO 3 from Treasure Hunt, PALO 4 from Personal Investigator, and PALO 3 from Moodbot had no agreement.
Having arrived at an equal amount of data points, an inference concerning the intercoder reliability could be calculated. This is a statistic that represents the reliability of a variable and its encoding process, which is suitable for cases with any number of coders and variables of all measurement levels nominal in our case [ 25 ].
Running a Krippendorff analysis for intercoder reliability of all the PALOs resulted in a very low alpha see Table 2. This indicates that intercoder reliability is virtually nonexistent as the four observers rarely agree on any exact placement in the Taxonomy Table.
A Krippendorff alpha of exactly zero would mean that there are no differences between the encoding results and attributing random values to the data.
The alpha statistic can also be negative, in which case the encoding results are worse than random and indicate a structural error. Our results indicate a lot of room for subjectivity and interpretation in the placement of our 39 PALOs in the Taxonomy Table.
Agreement on encoding within both dimensions was a little higher than overall agreement but provided no intercoder reliability see Table 2.
All the analyses were rerun while excluding one coder consecutively. Although the Krippendorff alpha does alter slightly by excluding any one coder, there is no indication for a structural error and the reliability remains far below acceptable.
This supports the notion that there is actual disagreement between the encoders and it is distributed equally.
The overall results from the analysis indicate that there is no error in the methodology and that the results are not pure chance but that the encoding by this taxonomy is too subjective to be considered reliable.
In this article we demonstrated the application of the Revised Bloom Taxonomy in the analysis of five psychotherapeutic games. In a two-round process, we managed to come to a consensus on the Player Actions with Learning Objectives PALOs that each game contains in its design.
All four researchers coded each PALO of each game independently and compared the results and an intercoder reliability statistic was subsequently calculated.
The process of assessing game content through the lens of the Revised Bloom Taxonomy turned out to be open to interpretation and resulted in such a great variability in statements after the first round that no sensible comparison of assessment could be made.
However, a consolidated version of what PALOs should be assessed was achieved during discussion. We feel that such discussions would be useful in the design process of psychotherapeutic games.
Describing possible player actions in terms of a PALO provided an interesting perspective on the translation of therapeutic goals into game content.
The intercoder reliability statistic revealed that no consensus could be achieved on how to interpret the game content within the Revised Bloom Taxonomy.
The rating is prone to subjectivity, making it challenging to assign PALOs to appropriate cells in the Taxonomy Table. Accuracy improved Our discussion to formulate PALOs provided a structured way of describing how game design connects player actions to certain objectives and might provide support during the design process of a psychotherapeutic game.
Attempting to place these PALOs in the taxonomy establishes a discussion of the game content on the level of cognition. The low intercoder reliability indicates that applying the Revised Bloom Taxonomy to psychotherapeutic games does not provide a robust structure for objectivity.
The classification of game content remains very open to interpretation and the descriptions it provides should not be used to compare content across different psychotherapeutic games.
In order to be useful as a means of comparison, the taxonomy needs to be further developed into a protocol in which designers, researchers, and therapists need to be involved until the process yields an acceptable intercoder reliability.
By describing content in terms of Player Actions with Learning Objectives, the designers provide a better insight into how their choices relate to the intended processing by the player and the desired overall outcome of gameplay.
This gives any therapist a better insight into the level of cognitive engagement envisioned lower bound for different game content, which would support a more informed choice.
We have found the process of describing Player Actions with Learning Objectives of value, as it forces game designers to formalize their intentions.
We remain confident in the usefulness of trying to find a common language between game designers, researchers, and psychologists to describe the content of psychotherapeutic games beyond the level of any individual game.
One of the limitations of this paper is that we only describe five games. Bloom married her current husband, Braden Pollock, on December 5, A vegetarian since 16, Bloom has been vegan since Bloom has written three books, including Think: Straight Talk for Women to Stay Smart in a Dumbed-Down World , from , and Swagger: 10 Urgent Rules for Raising Boys in an Era of Failing Schools, Mass Joblessness, and Thug Culture , from Lisa Bloom.
For the American cultural critic, see Lisa E. Philadelphia , Pennsylvania , U. University of California, Los Angeles BA Yale University JD.
Attorney author television legal analyst. Jim Wong. Braden Pollock. Gloria Allred mother. Main article: Donald Trump sexual misconduct allegations.
TV Newser. Retrieved October 28, Retrieved November 30, Page Six. May 29, Retrieved March 27, Harper's Bazaar.
Retrieved June 2, Peyton Bray, her blue-blooded husband, became abusive and had a mental breakdown, and by the time Allred was a senior, she was a divorced single mother.
The New Yorker. Los Angeles Times. AEI Speakers Bureau. The Ringer. Retrieved November 21, Retrieved October 24, The Stephanie Miller Show.
April 11, New York Daily News. Retrieved July 30, Bill Cosby". Retrieved September 11, Retrieved October 7, July 10, More Flowers.
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