Taking Part: Role-play in the Design of Therapeutic Systems Mark Matthews Department of Information Science Cornell University Ithaca, NY 14850 USA mark.matthews@cornell.edu Geri Gay Department of Information Science Cornell University Ithaca, NY 14850 USA gkg1@cornell.edu Gavin Doherty Computer Science and Statistics Trinity College Dublin, Dublin 2, Ireland gavin.doherty@tcd.ie ABSTRACT Gaining an understanding of user needs is a central component of HCI design approaches such as user-centred design and participatory design. In some settings, such as mental health care, access to end-users is often constrained. This is a particular difficulty given that the experience of those with mental illness can be difficult for researchers to understand, and is further complicated by its associated stigma. In addition, the therapeutic setting is outside the common experience of most people and protected from outside intrusion. Although role-play has been used in varied ways in HCI, rarely has it been defined with sufficient clarity to enable others to deploy it in a nuanced manner. We argue that role-play is particularly suited for use in mental healthcare settings and, when used judiciously, can address some of the difficulties associated with working in this setting. This paper details a range of role-play formats appropriated from therapeutic role-play, drawing upon the HCI and mental health literature, therapist input and our experience of using role-play for a number of purposes at different stages of the development process. We consider how and why role-play can be used to generate empathy, gain understanding of therapy, provide feedback on designs before clinical use and help train therapists in using technology in the treatment room. Author Keywords Mental health; role-play; therapy; healthcare; design ACM CLASSIFICATION KEYWORDS H.5.2 [Information Interfaces and Presentation]: User Interfaces – Evaluation / Methodology, Prototyping, User-Centred Design INTRODUCTION A central goal of many activities in design is to understand the user, and some would argue to empathise with the user [27]. Role-play is one of several techniques used in HCI to involve the user in the design process. It can be used by researchers to explore interaction scenarios, and attempt to put themselves “in the shoes” of the user. The goal in both cases is to bring a user perspective into the design process. Taking a user-centred approach in mental health care settings presents several challenges [9]. Treatment takes place in a protected setting and involves a person discussing their problems with a therapist in order to achieve “inner comfort, outer competence” [6]. Researchers typically face limitations on the participation of patients and therapists. At the same time, the sensitivity of the setting requires researchers to ensure that systems are suitably refined before clinical deployment. In the face of such restrictions, a particular challenge for the researcher is gaining insight into the end-users’ experience and how it is affected by their illness. A further complication arises when therapists lack confidence using and introducing new technology to their patients, and neither their training nor workspace has taken into consideration the use of technology to support their work. As a technique with an extensive history in both HCI and mental health, role-play is a promising candidate for addressing gaps in design knowledge arising from constrained access to end users, and potential lack of researcher intuition regarding their internal mental processes. Role-play is a highly developed technique with multiple formats and purposes in Psychotherapy. Therapists are particularly comfortable with role-playing; most will have used it in their training, and many in their work with patients. As a result it may be a suitable technique for engaging therapists in evaluations, giving researchers insights into the experience of clinical work, providing contextual training and establishing protocols to be used with new technology. Although ‘role-play’ can refer to a wide range of techniques, all role-plays share an “as if” or “make believe” quality; participants assume characters and participate in simulated situations. We define role-play here as a range of techniques which deliberately create an approximation of real life in controlled conditions [28]. 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