JMIR Publications

ABSTRACT

Background:

We developed Street Temptations (ST) as an add-on intervention to increase the treatment responsivity of adolescents with disruptive behavior problems. ST’s primary aim is to improve adolescents’ mentalizing abilities in order to help them engage in and benefit from psychotherapy. Additionally, virtual reality (VR) is used to work in a more visual, less verbal, fashion.

Objective:

By recapping the lessons learnt while developing ST so far, we aim to design a following study on ST. Furthermore, we aim to enhance the development and studying of new healthcare interventions in clinical practice, together with adolescents as their end-users.

Methods:

We followed an iterative co-creation process to develop a prototype of ST, in collaboration with adolescents and professionals from a secured residential facility in Amsterdam, the Netherlands. The prototype was tested during a pilot phase, involving two test runs, in which four adolescents and four professionals participated. Qualitative data was collected through interviews with the adolescents and by conducting a group interview with the professionals, in order to gain first insights into ST’s usability, feasibility, and its added value to clinical practice. In between the first and second test run, the prototype was enhanced. Based on the complete pilot phase, we reflected on the future development and implementation of ST in order to design a subsequent study.

Results:

Over the course of six months, ST’s first prototype was developed during multiple creative sessions. Included was the development of a short 360-degree VR-video, to serve as a base for the mentalization exercises. The final version of ST consisted of 7 individual therapy sessions, incorporating both the VR-video and a VR street view application. Based on the qualitative data collected during the pilot phase, we found preliminary signs of ST’s potential to support adolescents’ perspective-taking abilities specifically. Additionally, using VR to focus on real-life situations that adolescents encounter in their daily lives, possibly helps to facilitate communication. However, several challenges and requests concerning the VR hard- and software and the implementation of ST emerged, pointing towards further development of ST as an add-on intervention. These challenges currently limit large-scale implementation, resulting in specific requirements regarding a subsequent study.

Conclusions:

In order to gather more extensive information to shape further development and study treatment effects, a small-scale and individually oriented research design seems currently more suitable than a more standard between-subjects design. Using the reflection on the lessons learnt described in the current report, a research protocol for a forthcoming study on ST has been developed. By presenting our co-creation journey thus far, we hope to be of inspiration for a more co-creative mindset, and in that way contribute to the mutual reinforcement of science and clinical practice. Clinical Trial: NA