Changamoto: a serious game for therapy adherence of youngsters in addiction care.

Each year, Brijder Addiction Care treats hundreds of youngsters (age 12-24) for
cannabis addiction. Cognitive behavioral therapy for cannabis addiction
consists of a face-to-face contact a week and additional homework assignments,
of which registration of triggers for cannabis use is an important aspect. It
is difficult for the youngsters to adhere to therapy: they are absent in one
out of of three face-to-face contacts and the (online) homework is seldom made.
Game designers have expertise in the design of games that invite the player to
keep returning to the game. Can we use their expertise to make therapy more
attractive and enhance therapy adherence of youngsters in youth addiction
care?

In this project, professionals in mental health care, researchers and game
designers collaborate on the design of a serious game that aims to improve
adherence to therapy for cannabis addiction. The design process has resulted in
Changamoto an application for the smartphone. Changamoto consists of two parts:
1) a game in the form of a battle between different types of robots and 2) a
diary in which triggers for cannabis use can be registered. The game enhances
therapy adherence in two ways. 1) Registration of triggers for cannabis use in
the diary is rewarded. 2) The game is more difficult when the player is under
the influence of cannabis because the game targets cognitive functions that are
negatively affected by acute cannabis use. In the planned validation study we
will investigate the hypothesis that the use of Changamoto enhances therapy
adherence of youngsters in treatment for cannabis addiction. Secondary
objective of the research project is to bring forth general knowledge on the
application of serious games for behavioral change.

We will test whether Changamoto enhances therapy adherence in a random
controlled intervention study among 130 youngsters (12-24) that come in
treatment as of april 2014. The researcher will assign the clients of a
therapist ad random to one of two conditions for the first two months of their
treatment. In a game condition, the usual therapy is supplemented with the
Changamoto game and diary. In a control condition, the usual therapy is
supplemented with only the diary from the Changamoto app. Therapist and client
will be allowed to discuss the use of Changamoto openly.

The Changamoto app that we test in this study consists of two parts: a diary
for the registration of triggers for cannabis use and a game in the form of a
strategic battle between different types of robots. For a game group, the usual
therapy is supplemented with the Changamoto game and diary whereas for a
control group the therapy as usual is supplemented with the Changamoto diary
only.

The burden of participating in the study is minimal: Changamoto is used
voluntary next to the usual treatment and the parameters of therapy adherence
are collected without giving the youngsters extra tasks. At the end of the
study, participants will complete an extra substance use questionnaire.