Steven Barnes

Evidence suggests supported living can improve functioning and reduce need. However, its lack of a clear definition has presented significant challenges to establishing a definitive evaluation of its efficacy. The present study evaluated the efficacy of a defined model of supported living using in terms of reductions made to aspects of clinical and social recovery.
A naturalistic, non-controlled assessment was conducted using the Camberwell Assessment of Need Clinical Scale (CAN-C) with a sample of adults with severe and enduring mental illness residing with a UK-based mental health company at one of twelve UK locations.
Analysis regarding preliminary outcomes relating to health and social need is presented with comparison between admission and 6-months post-admission (N=90). Additional analysis relating to outcomes at twelve-months is also provided (N=39). Significant outcomes are noted at both timepoints in terms of reducing unmet need and levels of formal and informal help given/required during tenancy.
Our findings support that, even in the absence of clinical recovery, opportunities exist to make meaningful and valuable improvements to unmet need and functional independence, with implications for clinical practice in the context of supported living.
The findings provide encouraging early indications of the benefits of the model in making meaningful reductions to functional and psychological needs in individuals with severe and enduring mental illness.

Purpose- The aim of this paper is to collate and discuss a number of key issues regarding the development, deployment and monitoring of games designed for therapeutic purposes.Design/methodology/approach- The authors collate a number of core areas for consideration and offer suggestions regarding the challenges facing the field of therapeutic gaming.Findings- In this paper, four major areas of interest are presented: ensuring and communicating therapeutic game effectiveness; data-security and management; effective game design; and barriers to therapeutic game uptake and engagement. Present implications of these issues are discussed and suggestions are provided for further research and to help move the field toward establishing consensus regarding standards of practice.Originality/value- This paper represents, to best of the authors' knowledge, the first of its kind in the field of therapeutic games to collate and address the core issues facing the development, deployment and growth of this potentially valuable medium.

Supported living has been shown to improve functioning and social inclusion in people with severe and persistent mental health problems, reduce hospitalisation and provide secure accommodation in a population where housing needs are often unmet. Conversely, living in supported accommodation has been depicted by some as depersonalising, marginalising and an ordeal to survive. Discussions regarding housing and support often lack a thorough consideration of individual experiences, with a reliance on quantitative surveys. The question remains how to assure that supported accommodations actually are supportive of the residents' ongoing recovery process. The present study sought to shed light on the experiences of residents in an enhanced supported living service in the United Kingdom. Semi-structured interviews were conducted with nine residents of the service between July 2020 and February 2021. Transcripts were analysed using thematic analysis and indicated three superordinate themes of experiences considered valuable to residents: (1) support from care staff which was readily available; (2), a sense of community and daily activity offered by the residence and on-site activities; and (3) the experience of supported living as a stepping-stone in an ongoing recovery process. Findings indicate the power of comprehensive care with supportive staff, peer-relations, autonomy and fostering hope in empowering individuals in their ongoing recovery.

Anxiety is a common mental health problem in adolescents with significant short-, medium- and long-term implications if left untreated. Existing therapeutic interventions have proven effective but are associated with a number of barriers to access, engagement and maintenance of gain. Therapeutic games represent an opportunity to address barriers to treatment in a challenging population. This thesis assessed user-perceptions of existing relaxing and informative games to aid the development of a new gamified intervention. This uniquely combines aspects of cognitive-behavioural therapy and attention-bias modification, delivered via mobile devices and utilising remote data-capturing to facilitate access and engagement.
After initial usability and acceptability assessment, followed by game-improvement, a pre- vs post-intervention evaluation with follow-up investigated the anxiolytic capabilities of the new intervention over both a two-week structured intervention and at two-month follow-up. Further investigation during follow-up was conducted to assess the extent and impact of self-directed play. Results revealed that the game made significant improvements to self-reported state- and trait-anxiety as well as threat-detection bias post-intervention which were maintained at follow-up.
Additionally, self-directed play was predictive of outcome at follow-up stage.
Limitations of the findings are discussed in addition to suggestions for future research

The long-term implications of COVID-19 for wellbeing are predicted to be both significant and enduring. Data from previous epidemics indicates long-term detrimental effects are more pronounced among particular demographics, including individuals with pre-existing mental health conditions. The Mental Health Independent Support Team (MhIST) is a charitable organisation offering a range of free-at-the-point-of-contact services via self-referral for a range of mental health and wellbeing concerns, both with and without diagnosis. Since March 2020, the organisation noted significant rises in demand for services. Serious games and their active involvement in eliciting rapid positive behavioural change is associated with their emergence as a key learning tool, with effects transferable to the real world. While a growing number of gamified interventions exist for a range of mental health diagnoses, their presence in the domain of positive psychology is more limited. The chapter reports two studies conducted to enhance the development of an educational game for adult wellbeing.

Anxiety disorders (AD) are the most prevalent of the mental health conditions and are associated with significant and long-lasting burden of disease both for affected individuals and healthcare systems designed to support them. Despite this, barriers to traditional interventions mean less than half of adolescents experiencing ADs seek-treatment, with less than 20% of treatment-seekers ultimately receiving a scientifically validated intervention. Therapeutic games show significant potential to help reduce AD in adolescents, with some concerns remaining over their abilities to engage users, particularly over time. The chapter presents two studies relating to the development of a new mobile gamified intervention for adolescents with AD. This includes a user-feedback study on currently available games for anxiety and depression, followed by a user-feedback, acceptability, and intention-to-use study of a development version of the new intervention.

While the positive relationship between happiness and resilience amongst students is established, diversity in further education (FE) students warrants investigation into potential differences in the strength of this relationship. In respect of the multifaceted definition of the concept, two happiness measures were completed by respondents. This allowed investigation into the potential for the two measures to reflect differing features of happiness and allowed a more specific insight into the role happiness plays in the resilience of FE students. In this study, the predictive relationships of happiness with resilience among three level 3 populations – A-Level, BTEC and Access to HE at a further education college in the UK (N = 443) – are examined by means of self-report. Multiple regression analysis showed that happiness measures correlate with resilience, making independent contributions. Relative importance of happiness measures in predicting resilience also differs across pathways. Findings are discussed in terms of diversity of FE students and diversity of happiness within these populations. This research highlights a variation in significance of different facets of happiness on resilience, with implications for pastoral care in FE.

Background: Extant evidence suggests that the proportion of adolescents suffering from anxiety disorders (ADs) has increased by up to 70% since the mid-1980s, with experience of anxiety at this stage associated with significant negative short- and long-term life outcomes. The existing therapeutic interventions (eg, cognitive behavioral therapy, CBT; attention bias modification, ABM) have proven to have clinically measurable benefits in reducing anxiety, but their efficacy is often compromised by social and practical barriers. The growing discrepancy between demand for, and access to, clinical interventions for anxiety has led to the development of a range of eHealth (health care practice supported by electronic processes and communication) and mHealth (versions of eHealth using mobile devices) interventions. One such protocol is therapeutic games, which aim to provide clinical frameworks in dynamic, adaptable, and personalized virtual environments. Although some evidence exists to suggest therapeutic games are associated with reductions in subjective anxiety and observed stress reactivity, there is currently, to our knowledge, no systematic review of the adherence to, and effectiveness of, therapeutic games for adolescent anxiety.
Objective: The aim of this review was to establish the effectiveness of therapeutic games in making clinically measurable reductions in anxiety symptoms in adolescent samples.
Methods: A systematic search of the existing academic literature published between 1990 and July 2017 was conducted using the databases Journal of Medical Internet Research, Journal Storage, Psychology Articles, Psychology Info, ScienceDIRECT, and Scopus. Records linked to empirical papers on therapeutic games for anxiety using adolescent samples were evaluated.
Results: A total of 5 studies (N=410 participants) met the inclusion criteria, and 3 gamified anxiety interventions for adolescents were identified. The papers included a mixture of randomized controlled trials, quasi-experimental studies, and usability studies comprising quantitative and qualitative measures, with varying degrees of mixed methods. Extant evidence shows potential for therapeutic games to create clinically measurable reductions in symptoms of anxiety in adolescent samples, though findings are complicated in some cases by a low sample size, and in other cases by research design and methodological complications, including anxiety reductions in control groups caused by a control-game selection.
Conclusions: Although research in this field appears to be extremely limited, as demonstrated by the small number of papers meeting the inclusion criteria for this review, early findings suggest that therapeutic games have potential in helping to engage adolescents with anxiety and lead to clinically measurable reductions in symptoms.