JOINTS

Addressing Group Psychotherapy Requirements

Luís Duarte, Luís Carriço, Marco de Sá and Diogo Luís

LaSIGE & Department of Informatics, Faculty of Sciences

University of Lisbon

Edifício C6 Campo Grande, Lisboa, Portugal

Keywords: Psychotherapy, CSCW, Mobile Devices, Public Displays.

Abstract: Providing computational support to group meetings is a challenge some applications are now addressing.

Nonetheless, there are specific areas which need special attention by developers to cover all inherent issues,

which can reveal themselves as workflow, interface or context requirements, among other. In the group

psychotherapy field of study it is necessary to be careful with both the therapist’s and the patient’s work,

providing both groups with the necessary mechanisms, interfaces and tools to accomplish their tasks. This

poster presents a project whose main goal is to address all this challenges in group psychotherapy sessions.

1 INTRODUCTION

Activities which require some collaboration are part

of our daily lives. In some cases these can be defined

as mere extensions of their individual counterparts

However, when we dwell into more specific areas,

new challenges can rise which were not foreseen and

therefore need to be accounted for (Brignull, 2004).

JoinTS (Joint psychological Therapy Support) is

a project which addresses the problems and

challenges of group psychotherapy. Individual

psychotherapy, although less challenging than the

group version, already requires different forms of

interaction between therapist and patient. The

therapy process includes a series of meetings in

which both actors exchange information both by

conversations and paper artifacts (Mahoney, 2003).

As other collaborative activities, group

psychotherapy can be defined as an extension of

individual therapy, supporting not only all the

activities performed on the individual counterpart

but also bringing several new issues to the process:

an increased number of participants and consequent

increased amount of exchanged and processed data;

the presence (in some occasions) of a second

therapist; the management of different

communication channels (therapist-therapist and

therapist-patients); easy and quick way to retrieve /

distribute data from / to patients.

Project JoinTS aims at delivering computational

support to all these activities, enhancing the group

therapy process and providing therapists with the

appropriate tools to perform their tasks.

2 JOINTS

The traditional group psychotherapy scenario is

characterized for having a therapist (who leads the

session), a group of patients and, occasionally, a

second therapist (who acts as an observer towards

the group). The main therapist conducts the session

as a facilitator. The other tasks are also his/hers

responsibility, unless a second therapist is present.

Communication between both therapists is avoided,

in order not to create awkward moments for the

patients. Group therapy session occur in a room with

the presence of all the participants. Communication

is mainly oral, except for artifacts and artifact

fulfillment results (written on paper).

JoinTS considers this basic scenario and extends

into several dimensions, taking advantage of

technology. First, incorporating the results from

SCOPE (Carriço, 2003), it substitutes paper by

electronic artifacts, thus facilitating (re)definition,

exchange and filling of artifacts, gathering and

analysis of results and observation of artifact filling

activities. Secondly, it introduces the e-group

dimension, thus facilitating group management and

group distribution and recollection of artifacts and

results, but also the conjunct analysis and collective

synchronized monitoring of results.

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Duarte L., Carriço L., de Sá M. and Luís D. (2007).

JOINTS - Addressing Group Psychotherapy Requirements.

In Proceedings of the Ninth International Conference on Enterprise Information Systems - HCI, pages 306-309

DOI: 10.5220/0002385603060309

 SciTePress

This poster addresses these two contributions,

and in particular the second one, around a single-

room setting with all participants present. Three

different arrangements were identified: a traditional

one, with computational support for patients and

therapists; a similar one, but with the addition of a

Large Public Display (LPD); and finally, one with

an Interactive Large Public Display (I-LPD).

2.1 System’s Architecture

Figure 1 shows JoinTS architecture that deals with a

single room scenario setting. A wireless access point

allows participants to communicate with each other.

Patients use small mobile devices to operate the

form-filling tools, while therapists usually recur to

more powerful devices (Tablet PCs or Laptops. The

communication and database modules are typically

supported by dedicated PCs, though they can operate

in a therapist’s device.

Figure 1: LPD Architecture.

2.1.1 Database Server

The Database Server is responsible for storing

records about therapists, patients and their historical

progress, all artifacts created, to whom they are

assigned and respective results. In the group therapy

scenario, session data is also stored, such as its

attendees, annotations taken and message’s

exchanged.

2.1.2 Communication Server

The Communication Server ensures the flow of

message’s exchanging during a session. Both

therapists and patients must login to the server in

order to be part of the session. All requests and

messages must pass through this component which,

in turn, will forward them to their destinations. The

Communication Server provides a message

subscription mechanism to allow moderators to

configure which types of messages are forwarded to

them.

2.1.3 Public Display Controller

The Public Display Controller is a small component

used in the presence of the LPD (or I-LPD). Its main

purpose is to receive, interpret and present the data

(previously staged in the Session Facilitation Tool)

intended to be shown on the LPD.

In case an I-LPD is used, the Public Display

Controller is also responsible for notifying the

therapists’ monitoring applications about the

changes made directly on the presented data.

2.1.4 Session Manager

This component provides a way to manage a therapy

session, allowing therapists to explicitly start and

finish each session and performing a shallow-

configuration of the communication flow in the

system. The manager provides a message

subscription interface to manage the destinations of

the exchanged messages, enabling the therapist to

explicitly state which type of operations he / she

wants to receive and be notified about.

2.1.5 Session Facilitation Tool

The Session Facilitation Tool is the main monitoring

and analysis component for in-session environments.

The component provides all necessary mechanisms

to have an overall view of what is happening during

a therapy session. It also introduces the virtual space

notion in this system, providing the therapists with

three different areas to work on: the private, shared

and public spaces. Besides these work spaces it also

provides a tool to register quick annotations, an

instant messaging interface to communicate with the

second therapist and the necessary tools to stage the

data which will be presented in the LPD.

2.1.6 Analysis Office

The Analysis Office’s primary goal is to provide a

powerful analysis environment for the therapists in

off-session settings. It is possible for a therapist to

check a patient’s progress during his therapy

sessions or his homework repertoire. However, this

tool can also be extended to group settings,

providing ways to visualize entire group’s

questionnaire-filling results or getting statistics

(tables or graphics) about the latter.

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2.1.7 Patient Tools

In order for the patients to perform their activities

both outside and during sessions, we provide them

with form-filling software for PDAs which can be

used to answer questionnaires delivered to them as

homework or in-session activities. This software is

based on the SCOPE project with a few extensions

to allow for file transferring via wireless

communication (Carriço, 2003).

3 SESSION FACILITATION

The facilitation of the session will be one of the

major activities performed by the therapists.

Therefore, special care must be taken into account

when developing the interfaces to support these

activities. The introduction of easy-to-use interfaces

as well as the notion of virtual spaces to the system

are some of the features presented by JoinTS to help

therapists facilitate group sessions.

3.1 Virtual Workspaces

An important challenge in groupware applications is

how to manage, visualize and share workspaces.

Three different workspaces were identified to stand

up to the therapists’ needs: a Private Space, a Shared

Space and a Public Space (Figure 2).

The Private Space is used to prepare data

visualization layouts and to monitor or analyze

information. A coupled toolbar allows the therapist

to choose which patients he wants to add to the

workspace and which questionnaire will be

distributed to them. The Shared Space serves both

therapists interests by allowing them to exchange or

mix the layouts they prepared in their Private

Spaces. The Public Space acts as a monitoring area

for the patients, corresponding to what is shown on

the LPD (if present).

Figure 2: Virtual Workspace tabs.

3.2 Therapists Group

Communication between therapists is crucial for the

session. Therefore, a communication sub channel for

therapists was created, thus supporting the above

mentioned activity without patient’s perception

(Huang, 2004).

A simple interface (Figure 3) is presented to

support this feature, coupled with the Session

Facilitation Tool. A single chat panel is used to

present both the therapists’ chat log and server’s

notification messages.

Figure 3: Session Facilitator Control Panel.

The shared space can be used by therapists to

exchange data among them, promoting discussion

and data analysis during the session.

The Listing Tool panel is used to prepare

visualization layouts. The therapist can quickly

select which form, group (and respective patients)

will be presented in the layout. The three buttons

below the Listing Tool can be used to transfer the

layouts between the different virtual spaces.

3.3 Therapists-Patients Group

A second communication channel is used to provide

a way to distribute / retrieve artifacts during the

session and to monitor all activities performed by

the patients. The before mentioned message

subscription system reveals its usefulness in this

setting: the main therapist can, for instance, receive

thought registries, while the second therapist can

receive full questionnaire-filling results for

evaluation during the session.

The main activity of the session’s facilitator

towards the therapy group is to monitor the patients’

work (Figure 4). To achieve this task the system

provides a desktop-like interface with the capability

of being populated with replicas of the Patients’

Tools. The therapist can add or remove replicas

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(each representing one participant) as well as freely

move them in the workspace.

Figure 4: Session Facilitation Tool Monitoring Interface.

The patient’s Status can be seen in the Patient

Tools toolbar on top of each replica (Figure 5). The

first two buttons indicate if the patient is present in

the session and if he’s being monitored in the LPD.

The last group of buttons indicates in which of the

virtual spaces the patient is being manipulated.

Therapists can quickly remove or add the patient to /

from any of the spaces through this interface.

Figure 5: Patients Tools toolbar.

4 FUTURE WORK

For the next phase of the project we will direct our

efforts into the development of a Session Facilitation

Tool for small mobile devices counterpart. This

version requires more care when creating the

appropriate interfaces due to the intrinsic constraints

of the target platform. Our second focus is to

understand how the presented architecture scales to

different scenarios, such as multiple room settings

and multiple sub-group support.

5 CONCLUSIONS

Traditional group psychotherapy settings, without

computational support, tend to be time consuming

and consequently, often disregard important aspects

in a group therapy session such as monitoring the

patients’ actions or reviewing their weekly

homework and registries. In addition, therapists

should feel comfortable working with groupware

software, even if they don’t have the necessary

academic qualifications to do so.

In this paper we present JoinTS, a project whose

main goal is to deliver computational support for

psychotherapy activities, both individual (Carriço,

2005) and group variants, while not disrupting the

traditional therapy workflows. Using emerging

mobile technologies and different design

approaches, we grant the users the mobility to try

different therapy scenarios and by adding a Large

Public Display we provide a way to present relevant

information to the audience and promote sharing and

discussion of experiences among the group.

ACKNOWLEDGEMENTS

This work was partially funded by FCT through

project JoinTS and LaSIGE.

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M. Mahoney. Constructive Psychotherapy. The Guilford

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E. M. Huang et al. IM Here: Public Instant Messaging on

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Factors in computing systems, 2004.

H. Brignull et al. The Introduction of a Shared Interactive

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