exploring the opportunities of tangibles
in clinical mental health contexts




People with high levels of anxiety experience worrying and rumination, i.e. negative thinking, leading to tiredness and lack of self-esteem, and therefore limits their daily functioning and decreases self-efficacy and social integration. Individuals suffering from anxiety, have therefore a high need for effective pathways to cope with acute phases of negative thinking and allow them to be their ‘best selves in society’. Current approaches to address negative thinking focus primarily on relaxation techniques, such as ‘progressive muscle relaxation’, breathing techniques or mindfulness practice.

However, relaxation techniques are not suitable for everyone and don’t show the same level of effectiveness across individuals. Current digital and soothing interventions and designs for relaxation do not suffice for everyone in the anxiety spectrum to deal with negative thinking. Digital and soothing characteristics namely still allow people to ruminate or experience heavy emotions, cognitions or bodily responses to anxiety.
The potential of multi-sensory stimulation, expression and physicality which are important aspects for deep absorption to prevent rumination and releasing various tensions are overlooked as design opportunities by the most technical innovations and CBT techniques alike. As a result, not everyone with anxiety receives optimal relaxation support to cope with acute phases of anxiety, panic attacks, and/or on-setting negative thoughts.

Therefore, there is a need to develop other pathways to relaxation using the advantages of expression, physicality and multi-sensory stimulation to support absorption and release from negative thinking and various anxiety responses.


The potential of RELAX-CHANGE to be used at home or within therapy was supported by the previous investigation (M1.2 project) and explainable through the underlying psychological principles and engagement potential attributed to the design of RELAX-CHANGE. However, flexibility of the multi-sensory interaction had to be improved to fit a larger variety of anxiety patients. Furthermore, the potential of RELAX-CHANGE in a clinical mental health setting had to be researched to broaden knowledge about the potential for people with elevated anxiety. 

Therefore in my M2.1 project, I collaborated with prof. dr. Rubel, expert in psychotherapy research, from the psychotherapy research department at the Justus-Liebig Universität in Giessen. In collaboration with his network, and the university’s outpatient center (psychotherapy day clinic) I investigated the opportunities, positioning and benefits of the design probe to offer relaxation support in psychotherapy research and practice. Moreover, to address the interaction problems with the low level prototype and to support future clinical experiments to research the efficacy of the probe’s novel pathway to relaxation I also developed a high level prototype of the M1.2 prototype.

Background research & Interview preparations

Introduction to psychotherapy practice and research at the Justus-Liebig Universität in Giessen. Background research was done about ongoing psychotherapy research, and psychotherapy practice through visits to the psychotherapy therapy clinic , multi-stakeholder discussions and low key prototype evaluations. Based on this, semi-structured interviews around the opportunities, positioning and benefits of the design probe within clinical practice and research was prepared. The semi-structured interviews targeted various stakeholders in the context of psychotherapy (research and practice) and were recruited based on convenience and heterogeneity.11 participants were recruited including clinical psychology students (BSc / MSc) (n=7), clinical psychology / psychotherapy researchers (n=3) and therapists (n=1). The interviews were prepared in a way they could be personalized to the stakeholder's interests within the interviews. .

interviews, analysis & clinical + design implications

The first part of the interviews focused on opportunities and positioning of the design probe RELAX-CHANGE regards relaxation support in therapy practice and clinical research around relaxation, anxiety responses and task absorption. The second part centered around shaping general visions around future opportunities of tangibles in general to support clinical practice and research. A ‘design probe video’ was used to create understanding of the details of RELAX-CHANGE. Results were thoroughly analyzed through MAXQDA coding software and turned into a set of speculative ideas of the design probes potential for use in psychotherapy research, practice and as measurement object. These were turned into design and clinical implications around tangibles in mental health.

prototyping preparations, collaborations, developments & assembly

First of all the details and improvements for the new prototype were determined and evaluated in low key interaction evaluations with colleagues and friends in Giessen. These were a basis for 2D and 3D models of the new outside casing. Next to the preparations for the 3D model of the new drum instrument, software models for the prototype’s interaction and measurement modalities were made, just like improved circuit models for the electrical engineering of the prototype. These functioned as the basis for the collaboration with a recruited electrical engineering student who realized the new software and electronic circuit. Together with a recruited 3D modeler and Innovation Space, the new outside casing was 3D printed in which it was focused on its ‘aesthetics’ through color and material choices, and ‘stiffness’ through formgiving, material choice and assembly techniques to prevent difficulties and bias in future clinical experiments. Finally, all has been assembled and turned into the final prototype. Software details were set together with the electrical engineering student to optimize the multi-sensory interaction and usefulness of the prototype’s stored measurements

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Clinical Understanding & Multi-disciplinary Participatory Design Research

Enhanced clinical  understanding, practice interventions and research topics / methodologies / clinical experiment design through investigation of children's play toys in children's therapy rooms

highlights in the design research process


Interaction and Experience Prototyping & Budgeting

Assembly of the high fidelity interactive and experience prototype of RELAX-CHANGE for future clinical experiments. Improved flexible multi-sensory interaction to increase engagement in drum play and enabling a fit with the variety of people present in the anxiety spectrum

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Qualitative Data Analysis, Clinical Recognition, Value Propositions 

Qualitative data analysis of the 11 semi-structured interviews with a variety of stakeholders within clinical psychology research and psychotherapy practice. Done within coding software MAXQDA.

1273 codes were categorized into 48 subthemes and 6 main themes ranging from different stakeholder perspectives, added value & opportunities, tension fields and future visions

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