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RELAX-CHANGE in psychotherapy

The investigation of the values, weaknesses, opportunities, and threats of the design probe RELAX-CHANGE to offer novel relaxation support in psychotherapy research and practice, for people with anxiety disorders and beyond.

Design Research
for clinical mental healthcare

M2.1 Design Research
Abroad (Germany)

Assistant professor dr. Max Birk

prof. dr. Julian Rubel (psychotherapy research JLU Giessen, Germany); Tijmen Tubbing (electrical engineering student); Innovation Space (Edwin van den Einden)

in short

Design research challenge, approach, methods, results & contribution

This design research elicits the potential of the novel design probe to add value in clinical practice and research. In order to support anxiety patients (and beyond) in relaxation; therapists; clinical outcome research and to highlight the boundaries to future implementation of tangibles in psychotherapy.

This was done through two phases 1) background research and semi-structured multi-stakeholder interviews, and 2) evaluation and clinical & design implications, performed in three iterations. 11 semi-structured interviews were done with various participants in the clinical field such as clinical psychology students (BSc / MSc) (n=7), clinical psychology / psychotherapy researchers (n=3) and therapists (n=1). Moreover, a high level prototype of RELAX-CHANGE was developed to support the final master project and future clinical experiments.

Resulting clinical and design implications were presented that contribute to supporting a larger part of the target group in relaxation and beyond; to increasing the intervention space for clinical practitioners / researchers; and to enhancing mutual understanding amongst designers, psychotherapists and researchers. In general it was found that psychotherapists and researchers are open minded towards new technologies and the design probe can even extend horizons, however individual patient’s and therapist’s needs have to be considered. Moreover, design qualities such as ‘accessibility and flexibility’, ‘visible direct feedback’, ‘engagement and absorption potential’ and ‘playful musical approach’ have potential to add value in clinical contexts. Moreover, the probe’s ‘educative and reflective’ qualities, ‘measurement’ qualities, ‘connect therapy with daily life’ quality and quality to ‘fit with the relaxation needs from therapists’ shows its potential to stretch the boundaries of the use of tangible design in mental health.




Why I loved this project?

What I loved about this project was that I finally had the opportunity to go work abroad and do design research within a multi-disciplinary healthcare environment, enabling me to learn from stakeholders from a different discipline & background.
Under the supervision of a highly talented psychotherapy research professor dr. Julian Rubel, I was honored to work so close together with him and his research team. Furthermore, being situated at the Justus-Liebig Universität's psychotherapy department, allowed me to come into contact with various clinical psychology professors and psychotherapy practitioners, and actually look around at the psychotherapy daycare center. That really enriched my understanding of clinical mental health contexts. Next to that, I could have in-depth discussions with multiple psychotherapy stakeholders about the value and boundaries of design, innovation and technology within clinical mental health. I could learn from their clinical knowledge and standpoints, and they learned from me. In that way I was able to create a mutual understanding around potential implementation of the design probe in psychotherapy. Which I was surprised about, but very grateful for.

The experience of living abroad was also very insightful. It was a great social "test" and I learned to be flexible around changing COVID situation, not seeing family for a long while and fix problems on my own.

Finally, in this project I could realize a fully functionable and experiential prototype of RELAX-CHANGE, that I could use within my final master project. I loved the multi-disciplinary collaboration with a hired electrical engineering student (Tijmen Tubbing), Innovation Space and David Staat who supported the creation of 3D models. Working together with them, I learned to communicate and present my prototype ideas and interaction concepts through visuals and technical drawings.



The priority in my goals was development within User & Society, Technology & Realization and Math, Data & Computing with Creativity & Aesthetics unexpectedly developed on the side. Furthermore, being in Germany I highly developed my Professional and Personal Skills. Moreover, researching design opportunities in this complex clinical context, I experienced growth in Design Research Processes and Business & Entrepreneurship.  


To enable people within mental health to be their ‘best self’ in society, I wanted to immerse myself in a psychological context and familiarize myself with it from a multi-stakeholder perspective. Especially since this context consists of so many sub fields (e.g. anxiety, depression, borderline etc.), stakeholders, visions and expectations that determine ‘how to design for it’ and ‘provide the right support’. Therefore, I learned about various mental disorders; empathized with their needs & challenges and discussed the importance of psychotherapy research & practice and the role of design supporting interventions and treatments (with multiple stakeholders in clinical mental health).


Moreover, I learned to personalize the framing, preparation and performance of the interviews within a multi-stakeholder context. I especially learned to make it fit with what clinical psychology students learned and with researcher’s topics such as meditation, absorption traits, and emotional expression or measurements. Moreover, I learned to dig deeper when answers were straightforward (especially with BSc students), improvise, deal with information beyond my knowledge level and to be open to critical opinions, which were most insightful. 


Collaborating with technical experts (electical engineers & mechanical engineers), I improved my technical (visual) communication skills. I learned to define and discuss the feasibility by making interaction models for software programming; circuit designs for prioritization of electronics parts and calculations; and financial models for the parts budgeting (see appendices).  With regards to physical prototyping, I learned to set important decisions in prototype “improvements” with regards to interaction, materials and formgiving through quick evaluations. I got the insight in how to communicate these decisions into a final prototype concept to multiple stakeholders, through 2D drawings. In collaboration with Innovation Space and a 3D modeler with regards to the casing, I learned how to approach 3D printing, aluminum cutting and assembling different materials. Moreover, the final assembly phase of the casing and electronics with the EE student was a super insightful process. I learned to discuss software detailing, measurement details to create real innovation and process information neatly for reproduction and use in experiments.  


Next to that, in order to make my results of value in the psychotherapy research and practice field (implications for tangibles, behavioral data gathering and clinical experiments), I wanted to improve my quantitative research, analysis, and modeling skills. That’s why I learned to use coding software as MAXQDA combined with Excel to quantify qualitative data to support and prioritize claims. Furthermore, from psychotherapy research lectures by prof. Rubel, I got insight into the important role of quantitative analysis and statistics in outcome evaluation and process outcome research. What surprised me about the field of clinical psychology was the immense value and use of self-reported data compared to objective measurements which highly affects the role of tangibles for objective measurements. 


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