New E-Therapy Developments Highlight Youth Week

Depression often makes headlines in conjunction with troubling news, but this week is Youth Week; a week in which New Zealanders are asked to confront the causes of depression and explore innovate ways of connecting with the youth.

A valuable tool aiming to increase interaction with youth is the concept of e-therapy.

Robyn Shearer, manager of mental health for the Ministry of Health, says access to care is the major issue within the mental health system.

"Unless it is a 'dire emergency', people are often pushed from pillar to post in seeking assistance," she says.

In 2004, to combat under-resourced child and adolescent mental health services, the mental health commission set a target of reaching three per cent of the population under 20 years of age.

As a result there has been a considerable increase in funding for child and adolescent mental health services.

Two new developments are currently being funded by the Ministry of Health to help young people out of the rut of depression.

The first, a savvy e-therapy game, plans to emulate big production games like Sims and Final Fantasy.

The second, a free online one-to-one counseling service similar to Skype, will be the first of its kind in New Zealand.

Lifeline is developing the online counseling service, and general manager Anil Thapliyal says when support is lacking from family and friends; youth frequently turn to the internet.

"This technology is seductive, and if it can be used properly it will be very helpful," he says.

Dr Sarah Fortune, a clinical psychologist and senior research fellow at Auckland University, says youth connectivity levels are very high, and "mental health services are just starting to catch up”.

E-therapy game

Dr Fortune and Mathijs Lucassen are part of an Auckland University team of research fellows developing content for the e-therapy game.

Mathijs Lucassen, PhD student in the department of psychological medicine says the game will have a sleek and engaging look similar to Grand Theft Auto.

Image: Research fellows: Karolina Stasiak, Dr Sarah Fortune and Mathijs Lucassen.

Mr Lucassen says it's important the game relates to New Zealand; and incorporates Kiwi accents and imagery.

"Resources from overseas never quite sound right for a New Zealand audience,” he says.

It will not be a "game" in the sense of winning or loosing. The aim is for players to learn valuable life skills; such as problem solving and goal setting, through an entertaining medium.

Still pictures from the e-therapy game being developed by Auckland University research fellows.

"We can’t control everything, but we can control how we react to things," says Mr Lucassen.

The games structure is based on cognitive behavior theory; which attempts to map the thought processes and actions of depressed people.

"The link is between how you feel and how you act on those feelings. Those actions often cause the smallest things to blow way out of proportion," says Dr Fortune.

She says although cases of depression have steadily gone down for the past 20 years; New Zealand youth are still having a hard time dealing with depression in comparison with other western nations.

"They are a small sub-group, but they make a big impact," Dr Fortune says.

The games 3D platform will be set on a pan-pacific island, and players will be able to select from different characters and customise their appearance.

"There is nothing commercially available like this,” Mr Lucassen says.

Karolina Stasiak, a psychologist and part of the research team, developed the idea of using a game platform to administer e-therapy during her PhD studies.

Ms Stasiak ran pilot studies of the game in high schools around Auckland, and said reactions from students were encouraging.

"Other types of e-therapy games tend to be basic and a little boring,” says Ms Stasiak.

As work began in February this year the game is still in its early stages, but the team is hoping to have a trail version ready early next year.

Skype-style counseling

Anil Thapliyal, general manager of Lifeline, says what needs to be addressed is whether or not the mental health system is responding.

"We found the John Kirwan media campaign about depression was just not reaching the youth,” says Mr Thapliyal.

Image: Anil Thapliyal.

Six months ago Lifeline launched The Lowdown website; aimed at 14-24 year olds suffering from depression.

The websites interactive, tech savvy interface adds to its success, and attracted over 40,000 hits in its first three months.

"We cannot run a static forum, there needs to be human mitigation behind it,” says Mr Thapliyal.

Dylan Norton, manager of e-therapy services at Lifeline, is working on a new one-to-one counselling service set to be incorporated into The Lowdown within the next few months.

The software will be similar to Skype, but function with an interactive side bar where anything relating to the discussion can be posted; such as links to web pages, inspirational verses and music.

"It’s designed for learning purposes, and to be more interactive than Skype," said Mr Norton.

He says The Lowdown helps normalise depression for young people, and lets them see that others are struggling with issues similar to their own. The website uses modes familiar to youth, such as text messaging, email and social networking.

"The website allows people to get a response instantly, and for them to know someone is concerned for them right now.

"It allows people to post messages of support for each other: thousands of messages. For me it's a real privilege to work with people who open up to it,” says Mr Norton.

Mr Norton has worked with online group counselling before, but the participants were already his clients.

He says in New Zealand one-to-one e-therapy has not been used before.

Dr Fortune says new technologies for therapy have always been put through the grinder.

"When telephone counselling first arrived people were saying it would be dangerous and not helpful, but there are always people who say it can’t be done."

The Lowdown website incorporates guidance from local celebrities who have suffered depression, including C4 presenter Jane Yee, Dave Gibson of Elemeno P, and Awa of Nesian Mystic.

The website is rich with video diaries from local musicians, actors and everyday people who post tales of their struggles with depression. A multimedia section offers songs from Scribe, The Mint Chicks, Pluto and many others.

In one public video posting on The Lowdown, a young woman talks about her battles with depression:

“I couldn’t understand why going to a councillor would help me, you know. I really didn’t think there was anything they knew that was actually going to make my life any better.

“And I found out a lot of the listening your friends and your family offer is sometimes not the listening you need.

“You need somebody who is wise in the area, and can listen and accept your experience for what it is.”

Mr Thapliyal says there is inconsistency in the messages youth get from the media, but that the media has also been positive in engaging with depression issues.

"The thing you have to ask is; without the media how would someone know where to turn to, or direct someone when they need help?”

Lifeline is leading New Zealand's e-therapy services, and employs staff 24/7 to monitor phone lines, text messages and web pages.

Text services to The Lowdown are free (text: 5626), and Lifeline offers a free-call line; 0800 543 354, similar to Youthline: 0800 376 633.

The New Zealand Association for Adolescent Health and Development (NZAAHD) coordinates Youth Week, and this year is advocating a Hoodie Day to show support for youth and challenge stereotypes.

Hoodie Day is on the Friday 30 May, and NZAAHD asks everyone to wear a Hoodie to express support for the youth of New Zealand.

• For further information go to: www.youthweek.co.nz. or www.thelowdown.co.nz.

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