Presentation of Design
The following is an explanation and presentation of the design of R.I.S.E., consisting of a brief explanation of its origin and an overview of its function, screen shots of the actual interface, a transition diagram of the different screens, and finally the help system for the latest version.
Our initial idea during brainstorming was to create an application that centered on self-help for depression and anxiety and that ran on PDAs to make this information easy to find and to access and available whenever the user had a PDA on hand. We spoke with a few students who closely resembled our intended users: individuals who had suffered from depression and who had used self-help as part of their therapy. From the suggestions given by these students and from looking into other self-help applications available, we brainstormed several different features and functions that we wished our interface to implement:
· Self-help: guided exercises and techniques for mood elevation, relaxation, changing negative attitude and thoughts, including:
o Positive thinking and behavior exercises
o Psychotherapeutic exercises
o Quotes and stories (similar to Chicken Soup for the Soul®)
· Daily journal
o Record days events, particularly those related to mood
o Record specific feelings of depression/anxiety or any acute attack of depression/anxiety
· Medication record: track the kind and dosage of medication to record effectiveness and side effects
· Communication capabilities between user and therapist/therapy group: functionality that encouraged and facilitated communication, keeping several aspects of therapy integrated within the interface
o Instant messaging
o Direct requests from therapists for appointments
· Sound playback for calming and comforting music or affirmations: supplement to self-help and relaxation, acts as an alternate means of mood elevation
· Video playback for calming and comforting video or comedy clips: similar to sound playback for relaxation and mood elevation
· Downloading of new video and sound clips: ability to obtain new video and sound clips so that the features remain effective and do not become monotonous
· Therapist’s report feature that would display or graph levels of depression, list medication dosages, etc. for evaluation of therapist
After preparing this list of possible features, we reviewed the list and tried to determine the relative usefulness and complexity of each task. We agreed that an interface with many different functions would probably be more confusing and put less focus on the self-help functions of the interface. Such an interface would also challenge our ability to create a well-built and complete interface. With that in mind, the list of functions narrowed as we decided to design the interface specifically as a supplement to those already undergoing therapy for depression and anxiety and in particular therapy that involved cognitive and psychotherapy related to self-help exercises.
By refining the function of our interface, we refined our area of research and looked for products or academic research that best modeled what we wished to accomplish. In particular we found a lot of motivation for our interface through several papers co-written by Dr. Michelle G. Newman (Newman, 1996), who has researched the use of palmtop computers in cognitive-behavioral therapy and in particular as part of treatment of social phobia (Newman, 2004). In her research of the latter, Dr. Newman had given examples of different exercises and evaluations and the corresponding screens implemented in the palmtop interface used in her study. We decided to redesign the given screens, add more content, and add different functions appropriate to therapy and group therapy.
After further discussion, we narrowed the available functions down to:
· Self-help exercises
· Daily journal
· Medication records
· Therapist/group communication.
The daily journal would make up part of the therapy, as a way to share thoughts and feelings with the therapist and as its own form of therapy (Wright and Chung, 2001). Since medication often becomes an integral part of therapy for depression, we wanted to keep the medication record as to help facilitate the evaluation of efficacy for different medications that the user may take.
The therapist/group communication was important to maintain as well for several reasons. While many people have problems maintaining face-to-face contact with a therapist, seeking help through an e-mail or online request for help often proves easier, and such online and offline communication is effectively integrated into an individual’s therapy (Fenichel et al, 2001). After further research, we saw that there exists a large community of patient and therapist message boards, newsgroups, and websites. Research has found these modes of communication already provide lots of aid to patients of depression and anxiety (Finfgeld, 2000 and Fenichel et al, 2001). Therefore, we decided not to follow through on our original idea of electronic intra-group communication, since the online groups available seemed to be very effective already. Instant messaging was also considered, but we decided that this function, as well, was already better performed by other messaging clients available. Therefore, we decided to setup a function that was merely an e-mail function that stored group and therapist e-mails, so that the user could easily e-mail their therapist or group within the program to address issues that may arise during his or her self-help exercises, and to keep these e-mails, which can become very personal and private, separate from day-to-day e-mailing. We hoped that the appointment scheduling feature, which would basically consist of a form that sends an electronic message directly to the therapist’s office, would be a convenience that made scheduling appointments an easy process.
As the next step, we created sketches of screens as our low fidelity prototypes. Our intention was to design the basic layout of the interface and find the best way to integrate all of the intended functions into one interface that ran on a considerably small screen. Of the two low fidelity prototypes that we designed, we selected one and evaluated it through a user walkthrough with two subjects. The results basically indicated that the layout of the low fidelity prototypes spread the functions out too much. The different features and self-help resources were divided into many categories and the naming of the categories confused the subjects, who had trouble locating different features when given a task list.
After deciding on the functions of our interface, we decided that we would build it using Visual Studio .NET due to its Compact Framework package for developing mobile device applications and the fact that all of us had some experience with Visual Basic.
Designing an interface using the .NET Compact Framework presented many different challenges. The primary challenge in designing the interface for a PDA lay in trying to efficiently use the limited space of a PDA’s small resolution screen (about 240 by 300) without having cluttered screens and without making the fonts and controls so small that it decreased legibility and increased errors. We also found that the Compact Framework only offered a subset of the available tools, controls, and options that Visual Basic .NET offered. It did not allow modifications of the appearance and style of many of the controls either, which we had not anticipated, and so we had to further re-design the screens, a lot of which we accomplished while actually building the prototype and encountering these limitations of the Compact Framework.
Our high fidelity prototypes up to our latest version consist of a multiple-function interface that contains pre-installed self-help information, exercises, sound, video and images. The interface contains several different functions, all accessible by a main menu screen, and each of which have their own set of screens dealing with related tasks. Functions that contain more than one task have their own submenus. Navigation between screens takes place mainly through the menu bar at the bottom of the screen. The user can also navigate using icons located in different parts of the screen. The icons have images appropriate to the functions which they represent.
The input to the interface occurs mostly through touches to the PDA screen, presumably from a stylus or similar tool, for buttons and menu selection and through text input. The user may enter text using the tools provided on most PDA’s, which include an on-screen keyboard or a handwriting recognition area. Some users may even have external keyboards which allow for easy typing of text input.
The interface stores the logs and medication records as text files stored on the device. R.I.S.E allows several different users to use the same PDA and so handles creation of different user names and stores each user’s information separately. The user can bypass logging in if needed and proceed directly to self-help exercises. This feature we included because we wanted a user suffering from an anxiety attack or a severe bout of depression could start the program and immediately access self-help.
Screenshots of R.I.S.E.
Each screen of R.I.S.E. has help screens available, accessible by different tools depending on the location or type of screen from which the user invokes help. The user may always look for help on the current task through the menu bar at the bottom of all the main task screens:
Figure 2.21: Help Menu on Email Form
Each help sub-menu contains a list of topics relevant to the current task. The user may select any item in this sub-menu to view the help text on that particular task. On the help menu shown in Figure 2.1, if the user selects “Send Email,” the help screen shown in Figure 2.2 appears.
Figure 2.22: Send an Email Help Screen
Figure 2.23: Help Button on Add Address Screen
Smaller, dialog style screens have their own help buttons that display help files specific to the particular task with which the dialog screens deals. For example, on the “Add New Address” dialog style screen, the help button at the bottom left, as seen in Figure 24, allows the user to receive help on the task, the help screen shown in Figure 25.
Figure 2.24: Add New Address Help Screen
All help screens can be closed with the “Close” button at the button of the help screens. Each function of R.I.S.E. has such help screens through the interface.