material communications a strategy applied in [family therapy] that expands the understanding of the cognitive world for designers, and reveals the value of the material world for cognitive scientists

Parsons The New School for Design | School of Design Strategies MFA Transdisciplinary Design | Thesis 2014 | Doremy Diatta | doremydiatta.com

A C K N O W L E D G M E N T S

I would like to express my thanks and appreciation to my primary advisor Mathan Ratinam for his support, generosity, sincerity, and consistent on-point-edness throughout my master’s thesis process.

In addition, I would like to thank the Child Mind Institute, their fully devoted administrators, clinicians, externs, and program assistants that welcomed me to be involved with Parent-Child Interaction Therapy. The work of this organization is truly valuable and was an honor to be a part of.

I would also like to thank Clive Dilnot, Jamer Hunt, Patricia Beirne, and each one of my colleagues in the third cohort of MFA Transdisciplinary Design and our predecessors.

Lastly, I’d like to thank Daniele Ferraro, my constant source of balance.

To start exploring this, it’s necessary to understand the relationship between the object, its maker, and its user. Elaine Scarry’s a theorist who notes all our made artifacts are projections of the human body. In other words, compassion is built in. In cognitive science, on the other hand, is the ‘relativity of our mind’ which is the notion that the way we interact with our environment shapes the way we think.

This understanding is actually an expanded version of the way I have been using objects and space to cope since I was very young. It’s what led me to study

A B S T R A C T

All of us have a place in our homes where we keep meaningful things. These are things that would be devastating to lose or have destroyed. If we think about where our future is going and how automated society is becoming, what role will simple tangible objects like these play in 10, 20, 100 years? This trajectory, where sentiment is constantly complicated by functionality, makes the role of these kinds of objects become all the more crucial to supporting our emotional and mental health.

interior design and product design. What I see is that lying mostly dormant in both these disciplines is the potential to actively enhance existing methods for managing emotion and behavior.

To what extent can the things around us support what we think, feel, and do? The case study for my thesis is in a family therapy technique called Parent-Child Interaction Therapy (PCIT). Therapists who practice PCIT currently help parents learn 3 primary skills for how to reinforce positive behavior of their children with behavioral disorders.

Material Communications is about materializing these 3 precepts. I’ve aimed to literally change parent’s surroundings by providing supportive, metaphoric, and memory-eliciting objects. This set of special objects have been tested with the goal to help parents remember to use the PCIT skills, increase practice time, and consequently shorten the time and costs needed to complete therapy.

If design begins activating its dormant potential to support mental health now, these kinds of objects could increase the odds of sustaining our innate and unique relationship to artifacts as human beings. It is all the more appropriate time now, to work out ways to embed this relationship and compassion to design.

photo courtesy of freunde von freunden

Abstract

P A R T 1 I N T R O D U C T I O N

The Object, its User, and The Maker 12 Design and the Human Condition 15Material World + Cognitive World 17Material Communications 18

P A R T 2 C A S E S T U D Y

Social, Emotional Engagement Skills 22Materializing 25Integrating 38

P A R T 3 I M P L I C A T I O N S

Assessment 50Reflection 53

P A R T 4 C O N C L U S I O N

Conclusion 58

P A R T 5 A P P E N D I X

Investigating Family Therapy 62Parent Feedback 74Integrating Worksheets 78Future Speculations 82

C O N T E N T S

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P A R T 1 I N T R O D U C T I O N

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PART 1 INTRODUCTION

T H E O B J E C T , I T S U S E R , A N D T H E M A K E R

A French film from 1994 tells the story about a professional assassin named Leon, and a 12 year old girl named Matilda. The two end up joining forces to find revenge for the murder of the girl’s younger brother. ‘Leon: The Professional’ is a movie about this unlikely pair who rescue each other from the violence and loneliness in their lives. This story’s underlined by an unexpected film motif, which turns out to be a simple potted houseplant.

Leon calls this plant his best friend, carefully wipes each of its leaves, and places it on the windowsill every morning. When I watched this film, this is the part I found the most intriguing. How is an object like this able to capture human discontent, and instability?

This is linked to the box of special things we keep on our bookshelves, the nick-nacks that we’ve got sitting on the mantel, and even the piece of jewelry we’ve worn for 7 years straight. All of these things would be devastating to lose, or have destroyed. Not just for an individual but for friends and family as well. Our relationship with these things simply shows us how, in a way, we have a fundamental, innate relationship to the objects around us. This goes back over 30,000 years. Objects are evocative and they’ve repeatedly shown us they have the power to bring about complex thoughts and emotions, and affect our wellbeing.

It’s curious how this works, and how design might play a role here. It’s why my research of Material Communications is focused around exploring this human-to-object interaction and how its related to our ‘mental health.’ I’m defining this term as emotion and behavior management. In psychotherapy, the tactics therapists use to help our emotion and behavior usually involves targeting the thoughts you have, and the actions you take. But over time, what I’ve found is that there’s a contradiction in the field of cognitive science: There’s a theory called ‘Relativity of the Mind’ that says the way we interact with our environment shapes the way we think. The problem is that the existing methods for emotion and behavior management are lacking this significant variable, the environment. This points out a definite gap between the made artifact and a person’s wellbeing.

As a product designer and interior designer, I feel this is a call to design. It has the potential to become an agent to address these concepts. The process of designing products and environments is rich with tactics for making and arranging tangible objects and spaces. Unfortunately, design in its current state is yet to provide a strategy that explicitly addresses this potential.

One could argue that presently, design as a discipline focuses on efficiency and function. Technological advancement, from the first computer in 1951 and even further back to the beginning of the Industrial Revolution in the late 18th century, has focused on applying scientific knowledge for practical purposes. In both these periods, ‘practical purposes’ have centered on extending our human capacities. They are on a particular trajectory and momentum. Good design is often synonymous with design that “moves.” Slow objects, on the contrary, are hardly accepted into mainstream design or society. This impenetrable movement abandons an integral part of our nature. Since these advancements, we have started yearning for reflective experiences and attentiveness. Design will have to find a new paradigm, a different mode of “moving” -one based less on productivity and more on caring for the subtleties of the human condition.

Health services such as mental health are made available during every phase of our lives, and they can be applied at such variance as childhood to the end of life. These services are made to counteract elaborate, fast-moving life by taking out time to slow down and take care.

If we accept that design is a way to slow down to make active the object’s ability to support our thoughts and experiences, then the designed tools

still from ‘Lecon: The Processional’

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used in mental health care are a means to achieve that during critical points of our lives. The design process could provide a strategy to slow down and to nurture our relationships to artifacts.

D E S I G N A N D T H E H U M A N C O N D I T I O N

Objects in general have hundreds and thousands of orientations, functions, implications and cultural significances. Emotion and cognition both as a field of study and in every day life is riddled with even more complexity. Considering this, in what ways might design interpret and influence the vast range of human-to-object relationships?

Weeds Aliens and Other Stories is a project by Dunne and Raby, a critical design studio, that is a set of furniture that plays on the eccentric relationship the English have with the garden and plants in the home. Here, the design process is used as a medium to first, critique existing cultural habits and secondly, to design pieces of home furnishing. They’re objects that are made to encourage a particular behavior and emotional state, and are incorporated into the landscape of a typical household.

While Dunne and Raby’s objects are made to subtly stand out in the environments they are in, the artifacts in Franz Erhard Walther’s Werksatz are considered ‘immaterial art’. In other words, the made the object here is invisible and the change is reflected in the new personal and interpersonal experience of the individual(s) using the object. Each Werksatz, of which there are over 100 made in the span of thirty years, are all primarily made of cotton fabrics. The limitation on the physical material is part of how these participatory art pieces elicit such unique

courtesy of Dunne and Rabycourtesy of Objekte Benutzen

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PART 1 INTRODUCTION

M A T E R I A L W O R L D + C O G N I T I V E W O R L D

Through this thesis, I am asking; How might the process for design be used to bridge the gap between the material world and the cognitive world?

The heart of this thesis is not in the objects, but the process for design that could be used to impact our well-being. Material Communications is one design approach that uses this capacity and begins filling this gap in order to expand the understanding of the cognitive world for designers, and to reveal the value of the material world for cognitive scientists. By tapping into this in-between space we can arrive at a deeper, more mindful understanding and practice that is Transdisciplinary.

MATERIAL WORLD COGNITIVE WORLD

and diverse emotional experiences.

Charles K. Bliss was an Austro-Hungarian chemical engineer and a semiotician who in 1949, designed a new written language system. As a semantographer, he created what is called Blissymbolics. Here, the ‘object’ is not a tangible one, but comes in the form of symbolic, metaphoric representations of abstract concepts. Bliss designed several hundred symbols that could be combined together to represent nearly any concept, and presented them as a kind of alphabet. If these symbols are seen as designed ‘objects’, design is used here to introduce a new kind of language or alternative form of communication. It is made with the intention to eliminate any cultural associations or connotations a person might express through spoken language.

The objects in these three precedents are intentionally positioned in the space between the individual and the object; what is emotional, cultural, and social. Reviewing them is not meant to be a way to find gaps in existing material approaches. What this is meant to do is to begin understanding the array of ways designers and artists are expressing a need for slowness in the design process and to speak to our emotional relationship to one another and to objects.

In what way might this in-between space be defined more specifically, and be further operationalized?

courtesy of blisscanada.wordpress.com

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The Material Communications approach has three phases.

First, it requires an existing situation that involves a person enacting their social and emotional skills.

The second phase is a re-purposing of the processes that interior and product designers are already using, and is called Materializing. Here, social and emotional skills are the agent to incorporate slowness in to designed artifacts.

Once a spatial intervention’s been made, the third phase works to consider a person’s daily life and how this intervention might improve their personal interactions. Integrating is about nurturing our relationship with artifacts.

This document explains in more detail what each one is and how it works, through a case study done over a 17-month period.

M A T E R I A L C O M M U N I C A T I O N SPERSON

SOCIAL EMOTIONALSKILLS

MATERIALIZING INTEGRATING

PERSON

SOCIAL EMOTIONALSKILLS

MATERIALIZING INTEGRATING

PERSON

SOCIAL EMOTIONALSKILLS

MATERIALIZING INTEGRATING

1

2

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S O C I A L , E M O T I O N A L E N G A G E M E N T S K I L L S

The story for my thesis starts at the crux of social and emotional stability or detriment; the family unit. I have partnered with a child mental health organization that offers families in Manhattan with what is called Parent-Child Interaction Therapy. This therapy program acts as the case study to apply the 3 phases of the Material Communications approach.

The Child Mind Institute (CMI) is a New York City-based organization that provides children and families with evidence-based clinical care, engages in research, and provides resources to educate parents. Parent- Child Interaction Therapy (PCIT) is one of the evidence-based treatments CMI provides. This therapy treatment gives support to families with children who have clinical levels of externalizing behavior problems. For me this partnership with CMI involved going to clinician meetings, watching therapists work with families, a feedback session, and one-to-one conversations with parents.1

1 “Find Treatment.” Parent-Child Interaction Therapy Program. N.p., n.d. Web. 08 Apr. 2014. <http://www.childmind.org/en/clinics/programs/parent-child-interaction-therapy-program>.

PERSON

SOCIAL EMOTIONALSKILLS

MATERIALIZING INTEGRATINGThis young boy, above, is Brian’s son. He’s a really bright and loving 4-year old, and he’s been acting out and is aggressive at home. His behavior has started to cause serious problems with his older sister and parents. So because of this, Brian’s family is a great candidate for Parent-Child Interaction Therapy. Brian is beginning to learn new skills so he can have a more positive experience with his son. In this photograph, they’re in the first of more than ten introductory therapy sessions.

Although the child is the vulnerable one, the parent is the key to creating a supportive environment for the child. For this case study, I have chosen to focus on the parent. The main thing these sessions work to do for a parent, is help to avoid feeding attention to negative behavior and punishing for it, and instead acknowledge positive behavior. There are 3 social and emotional skills parents learn to use in order to do this:

1 give the child specific praises for behaviors they want to see more 2 verbally reflect what the child says3 describe the child’s behavior

In combination, these 3 skills lay the foundation for being able to achieve the goals of Parent-Child Interaction Therapy.

Parents learn what Praise, Reflection, and Describing Behavior are, and how to use these skills with the therapist in the clinic. The setting for the room is always designed to be set up for the most favorable interactions; there’s usually just a table, a few chairs, and one set of toys. In contrast, the family’s environment at home can be unpredictable and chaotic with

courtesy of Central Michigan University

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so many variables affecting what happens moment to moment. It’s real life (for a closer examination of in-session versus in-home therapy, see p 62 of appendix).

Then, understandably, parents find it hard to use the skills when they go home. They’ve got to remember to use them, remember what they are, where to best use them, when that’s appropriate, and above all overcome their long-standing habits for interacting with their child.

As a designer you start to wonder how this can become more fluid, especially being that the difference between how successful parents are in using the skills are mainly environmental differences. This thesis applies its methodology to this case study to help parents like Brian remember to practice their skills at home. This kind of support has yet to be made available by Parent-Child Interaction Therapy. So, how might a material, spatial, intervention help ease this gap?

In PCIT, parents need the straightforwardness and solidity they have in therapy and metaphorically ‘bring it home’ with them. What this Materializing phase addresses is, ‘What if this wasn’t just a figure of speech? What if they could literally ‘bring’ their therapy skills home?’

I first thought of a way to take the essence of each skill and represent it visually and symbolically. This way, parents wouldn’t be using their memory skills at home, but their visual skills. This translation is actually a capacity most spatial designers are trained to have early on in their education. By this, I’m referring to the design exercise where you take an abstract concept or term like ‘movement’ for example, and though the basic principles of design come up with several visual forms that represent ‘movement.’ As part of Material Communications, this is how Materializing works.

My very early hunch was for parents to make these visuals themselves or use an object they already own. But, the real question is, “How might a universal representation useful for any parent be determined?” The reason for this is over time, I found people have an ability to attach meanings and

M A T E R I A L I Z I N G

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abstract associations with any object. This is as long as there are somewhat symbolic features to the object that are appropriate for what they are meant to be used for.

By adopting this existing design process, I’ve taken the 3 Parent-Child Interaction Therapy skills and taken them from being ‘complicated concepts’ and made them into ‘simple material symbols’ that represent each skill. Through Materializing, the slow nature of our emotions and intimate social interactions are embedded in to the design process and consequently result in an aesthetic and material form.

MATERIALIZING

labeled praise

reflection

behavior description

courtesy of Daisy Chen

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PART 2 CASE STUDY MATERIALIZING

Praise compliments a child on her or his behavior. Labeled Praise is effective because it lets your child know exactly what you like. Labeled Praise increases the behavior that it describes. Labeled Praise increases your child’s self-esteem. Labeled Praise makes both you and your child feel good. 1

1 Eyberg, Sheila M., and Beverly Funderburk. “Therapy Orientation and CDI Teach Session.” PCIT: Parent-child Interaction Therapy Protocol: 2011. Vol. Therapy Orientation and CDI Teach Session. Gainesville, FL: PCIT International, 2011. 17-24. Print.

photo courtesy of Daisy Chen

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To reflect is to repeat or paraphrase what your child says. Reflection allows your child to lead the conversation. Reflection shows your child you are really listening. Reflection actually helps you learn to listen. Reflection shows you to accept and understand what your child is saying. Reflection improves and increases your child’s speech and language.1

1 Eyberg, Sheila M., and Beverly Funderburk. “Therapy Orientation and CDI Teach Session.” PCIT: Parent-child Interaction Therapy Protocol: 2011. Vol. Therapy Orientation and CDI Teach Session. Gainesville, FL: PCIT International, 2011. 17-24. Print.

photo courtesy of Daisy Chen

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Behavior Descriptions state exactly what your child is doing. Describing behavior lets your child know you’re interested and paying attention to her or him. Describing behavior lets your child know you approve of what he or she is doing. Describing behavior teaches your child how to hold his or her own attention on one activity.1

1 Eyberg, Sheila M., and Beverly Funderburk. “Therapy Orientation and CDI Teach Session.” PCIT: Parent-child Interaction Therapy Protocol: 2011. Vol. Therapy Orientation and CDI Teach Session. Gainesville, FL: PCIT International, 2011. 17-24. Print.

photo courtesy of Daisy Chen

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O B J E C T I T E R A T I O N S

Iteration A This is based on a preliminary PCIT Skill Survey response; “Praise is huge, violet but bright. It’s blinding when seen from below and lifting when seen from above.”

Labeled Praise compliments a child on his or her behavior.

Iteration CThe inner blue mirror may represent the physical praise-worthy action of the child. The exterior transparent sphere may represent the Labeled Praise the parent is enveloping the child in. Material: Plexiglas.

Iteration B Through interviewing parents, it was obvious this skill stands out for them. It is a prominent example of a mutual benefit both for them and their child. This iteration is focused on creating loosely symbolic features that are appropriate for Labeling Praise. Material: glass.

The Parent-Child Interaction Therapy objects are not prescriptive and they’re also not meant to teach parents new information about ‘Praise,’ for example. They are designed to prompt parents to use that skill. They’re designed to elicit memories of the skills they practiced in therapy in the past. The following iterations are the first experimental results of Materializing each of the 3 therapy skills.

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Behavior Descriptions state exactly what your child is doing.

Iteration B The latest iteration of this object is based on observations of parents in-clinic. Behavior Description, successfully executed, is often dependent on the of pace the parent. More specifically, if the parent is slow in pace and is providing a neutral grounds for the child to play, the more effective their Behavior Descriptions.

The subtlety in the two yellow hues and the natural tone of the wood is representative of the slow pace required to identify subtle yet telling behaviors of the child.

Iteration AThis is based on a preliminary PCIT Skill Survey response; “Description is like circles, different bright colors.” Its overall form is made to represent the diversity of characteristics in any action that is to be described.

Iteration A This is based on a preliminary PCIT Skill Survey response; “Reflection is a sort of harmless shape, like a squashed sphere with depressions in the middle. Like a blood cell. It is round and stable, but heavy and somewhat unwieldy.”

Iteration C Keeping the same representational concept, this iteration mimics an object that captures sound; a seashell, a cave, a boom box. Material: Plexiglas and metallic foil

Reflect is to repeat or paraphrase what your child says.

Iteration B This iteration is focused on creating loosely symbolic features that are appropriate for Reflection. This jack shape is intended to represent the very auditory and vocal qualities of this interaction skill; ‘frequencies’ emanating from a central point. Material: zinc with chrome finish.

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I N T E G R A T I N G

PERSON

SOCIAL EMOTIONALSKILLS

MATERIALIZING INTEGRATING

INTEGRATING

Within the case study, integrating is about asking, “How can these objects be made practical in a parent’s life?” In other words, it is about nurturing our relationship with artifacts. For the designer, this phase is centered around the design process being a way to facilitate conversations and encourage reflection to answer this question.

The objects for Parent-Child Interaction Therapy are designed with different kinds of loose symbolic features that leave room for parents to personalize how they associate and what they associate with the object. The question is then, ‘How can you induce, in a relatively short period of time, a similar kind of association we humans have with the nick-nacks sitting on our mantle, or the plant we call our best friend?’

Part of this has to do with designing conversations and dedicating time to reflect and make these connections. The hour-long dialogue I have with parents in Parent-Child Interaction Therapy is made up of 6 smaller, progressive conversations.

Brian and I take a seat together with just a few papers and a pen in front of us. Prompted by a worksheet, Brian shares that ‘Labeling Praise’ is an important skill for him to use. Yet, its the one that’s most challenging to use at home. He shares that its especially the case at the breakfast table right before his son has to run and get on the school bus.

I then place the therapy object assigned to ‘Labeled Praise’ in front of Brian. This next conversation is a period for him to pick apart a few material aspects of the object and reflect on his experience with using Labeled Praise and record on paper exactly how they correlate. (for a transcript of parent feedback on this Integrating dialogue, see appendix)

Once he’s done this, the object carries meaning. He’s ready to take it home, and hang ‘Praise’ over the breakfast table.

Early on in researching and testing this, my thought for integrating the objects into a person’s life was that the object-to-person relationship is a direct exchange. One has a thought, one associates it with an object, that object triggers a thought, that thought evolves, and back and forth. But in fact, I found the true object-person relationship is one that’s ephemeral. The way parents and clinicians use these objects and integrate them embraces this complex nature. The associations and relationship parents have with the object are regulated by the therapy sessions they go to every week that are already working to reinforce their understanding and the effectiveness of the skills.

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I N T E G R A T I N G W O R K S H E E T S

Each of the 6 conversations within the Integrating dialogue are guided by a worksheet where parents take a moment to reflect and write about their experience and tacit knowledge of Parent-Child Interaction Therapy (for the full set of Integrating dialogue worksheets, see p 76 of appendix).

Conversation 4 Therapy Object Worksheet 1 To reveal and introduce the object 2 To review the therapy skill

Above is the CDI skill I am focusing on�is is how I might relate my personal experience to this object

color shape

[ ]

object worksheet

this color relates to CDIgoals and/or my personal experience...

this shape relates to CDIgoals and/or my personal experience...

this relates to CDIgoals and/or my personal experience...

INTEGRATING

C O N V E R S A T I O N S

Below are goals and questions addressed in the Integrating Dialogue. (for parent feedback on this conversation, see p 74 of appendix).

Conversation 1 MapThe goal for this conversation is to jog parents’ memory and to share experience within the culture of PCIT and the Child Mind Institute. Here, I ask what are the parts that make up PCIT? What stands out?

Conversation 2 Therapy Skills: Part AThe goal for this conversation is to reflect on and pinpoint locations and times for therapy skills. Here, I ask when and where at home do/did the skills take place while going through PCIT?

Conversation 3 Therapy Skills: Part BThe goal of this conversation is to focus on one key location and time where a skill is important yet difficult.

Conversation 4 Therapy ObjectThe goal for this conversation first to review the skill chosen. Secondly, the therapy object is revealed and introduced. Thirdly, an exercise is done for parents to form personal associations with the object.

Conversations 5 Take-AwayThe goal here is to prepare parents to be able to take their object home, practice skills, and document this process.

Conversation 6 ReflectionWhat were your main take-aways? This final portion allows for the parent to self-reflect, providing feedback, and re-design their objects.

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P A R E N T I N T E R V I E W SParent A Reflection Object

To whom did you show the object?

I showed it to the kids and said ‘I went to Dr. K and got this to remind me to be a good listener.’ And then I put it on the shelf.

Where is the object now?

On the mantle. That’s where the kids’ toys are. In terms of where I do most of the playing and where I spend most time with the kids, its where we do Special Time so I thought that was a good place.

Were the objects successful?

I definitely say it was successful. My idea of success was to use the skills more, and yes in this way it was. It wasn’t just during special time. Whenever I was using the skills, it reminded me to Reflect more.

INTEGRATING

So if we were going to make another object like this in what ways might you redesign it?

I don’t necessarily think I would. It was less about what the actual object was, and more about that it was a reminder. It was good that the object blended in, but enough that it stood out. The shininess was good because it’s not something that I would normally have in the house.

How might you see the object you interacted with being used in places other than the home?

My kids are small enough where if there was a shelf really high in the two-way mirror room [during therapy], if it the object is on top of it, it might be a good way to say this is Reflection. It was good because there was reflection in that object. Then at home, with the same object is visual reinforcement and consistency.

Would you rent these objects if you could?

I can see that you could borrow it for a while, you would borrow the one that’s most representative of that skill.

Could you imagine this being used for different skills?

Yes, definitely.

If the object was to be passed on to someone else, what advice would you give to the next adopter?

I would advise to put it somewhere where you’re going to see it. That it will be in your line of sight. And that it’s going to be a forced reminder to you of whatever you want to be reinforced of. It’s less about touching it. For me, the ability to just see it was enough.

Would you take a PCIT clinician up on an offer of taking home this object?

I would take them up on it. Why not? There’s no downside. If I had to pay money for it I’d probably say no. Of course I would do it, yeah.

courtesy of PCIT Parent

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Parent B Labeled Praise Object

To whom did you show the object?

I showed my son, and I showed my husband. I don’t think the kids really had a reaction. My husband really not either.

How did you talk to other people about the object?

I explained it the same way to both my son and my husband. I told them, “It’s part of a project; an object that was designed to help mommy use her Labeled Praise.”

Where is the object now?

I thought ahead to make sure my husband wasn’t going to run in to it with his head [with it hanging from the ceiling fan]. It’s still hanging there. We only use the bedroom only for sleeping, it’s not really a play area for the kids. The kitchen was the other place. That was the original place where I thought I would put it, specifically the play where my son eats his breakfast.

INTEGRATING

Were the objects successful?

It was mildly successful in that because I was talking about it and filling out worksheets about it, talking to you on the phone, Labeled Praise was more on the brain. But, would say it was unsuccessful because it didn’t really trigger to use Labeled Praise. Had I been seeing it, it would’ve been great. We live in a pretty tiny house, and considering we have a lot of animals, and the three kids it’s really crowded and cluttered, it’s kind of difficult to put something in a place where I’d be looking at it a bunch and it would still be cluttered.

Even though I used it and hung it up, I couldn’t ever think of a moment where I was actually like, need to use my Labeled Praise when I caught sight of the object. But it’s pretty, so I left it there.

How might you see the object you interacted with being used in places other than the home?

I think if there was an object that was like part of the training, if there was an object that has a presence in the [therapy] room that was described as a CDI Object, that was used when CDI training began.

Would you rent these objects if you could?

I would think of them as something more as what you would buy where they’re permanent. You really want to use the skills forever. Also I have multiple kids. For instance a Praise tee-shirt, they would all 3 be wearing it.

Could you imagine this being used for different interpersonal skills?

Oh! Probably. If I were to go to the steps of the one worksheet we did where I’m naming the reasons that the object makes you think of the skill. I think you could use it for different skills. You could use it for PCIT skills or something like, ‘I’m frustrated, I’m going to use it to count to 10.’ As long as you went through that process and you think of the skills because of this and it’s in your head it’s there.

How might that unfold in various stages of life?

courtesy of PCIT Parent

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You could probably extend it infinitely, because you can apply it to an infinite number of objects. You could put the images on anything, anywhere, and have whatever is the most eye-catching object and use that all day every day for any skills, really.

If the object was to be passed on to someone else, what advice would you give to the next adopter?

Attaching the skill to the object is really important and to think about it deeply when you’re doing that.

How would you feel if more objects in the home had aesthetic or intellectual functions?

That would be great! It kind of reminded me of when you walk in to someone’s cubicle and they have a lot of words on cork-board of those things that say ‘smile,’ ‘breathe,’ ‘relax.’ Haha, It really is an effective technique to usually have reminders of the energy you want to project and the way you want to channel your thoughts and how you behave. The visuals are really helpful.

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A S S E S S M E N T

Material Communications give emotional and social support to individuals by affecting their surrounding environment. What I’ve done is investigated the existing conditions of Parent Child Interaction Therapy, come across a gap in the practice that’s based on environmental factors and built a set of supportive, metaphoric, and memory-eliciting objects specifically around the concerns of the parent.

Implications of Material Communications

What has been tested thus far through this case study are the 3 phases of Material Communications. Here, the process of design is a strategy that addresses a gap in the case of two families being able to engage with their social and emotional skills at home and in therapy. The outcome of this design process is at a small scale, where it results in a set of artifacts for the home. They allow their user to have a kind of clarity that lets them have more positive emotional and social experiences with their family.

Beyond the 3 phases of this research, it can be speculated that a thoughtful research process, well-informed Materializing, and a guided Integrating of the objects in to a parent’s life may increase how frequently parents practice their skills at home, improve their evaluations in therapy, and consequently cut down on the time and finances needed to complete Parent-Child Interaction Therapy.

Assessing the Case Study

There was consensus that for parents who are visually oriented, the object they took home served as a consistent reminder to use the skill. Also, that they could understand the meaning of the object:

I definitely say it was successful. My idea of success was to use the skills more, and yes in this way it was. It wasn’t just during special time. Whenever I was using the skills, it reminded me to Reflect more. (Parent A p 40)

However, there wasn’t consensus that the therapy object is fitting for all parents, nor that when they did take the object home, that they place it somewhere appropriate.

Firstly, it has been very important to be cognizant of how apprehensive or skeptical parents may be of therapy itself, and to avoid inadvertently compounding that by imposing the therapy object.

I did so much research of PCIT before starting therapy, but once I started, it’s totally hard and uncomfortable to have to completely re-learn my habits as a parent. (Parent Interview Feb. 2014)

This requires a questioning of whether or not the objects are necessary or appropriate for a parent at the outset. This is why the decision to incorporate the objects into therapy would vary case to case, and is at both the therapist and the parents’ judgment.

Secondly, its been found that there is a need to determine where the ideal locations for the objects are.

I would say it was unsuccessful because it didn’t really trigger to use Labeled Praise. Had I been seeing it, it would’ve been great. (Parent B p 42)

This insight was followed by refining the Integrating phase, where a more targeted dialogue was designed. This dialogue became about identifying exactly where and when the PCIT skill is most needed and considers that there may be more than one location (for the worksheets designated to this dialogue, see p 77, 78, and 80 of appendix). As a designer, this is a time to guide parents to avoid what seems like a simple error of ‘putting it in the wrong place.’ Over time, parents have found their experience with these objects are always in flux, and take on different meanings related to, as an example ‘Labeled Praise’, depending on where its located and what is happening around it.

Assessing the Design Methodology

Material Communications is a methodology to be applied to several contexts, one of which is Parent-Child Interaction Therapy. This case study is a test of the design methodology of Material Communications. From a design perspective, each phase has elements for a designer to re-assess and customize depending on each case.

The first phase of the process requires a designer to engage with an existing situation that involves a person enacting their social and emotional skills.

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This points to how important it is to be immersed in the organization or institution in question. Group meetings with stakeholders and one-to-one interviewing works to gain a richly subjective account of the context. Yet, this research simultaneously requires a designer to observe objectively just as intently. The design in this phase is achieving this balance. For this case study, I attended clinician meetings and observed therapy sessions for a consecutive 8 weeks. Its implied that any kind of expedited version of research would be inappropriate for working in such an intimate scale. A multi-dimensioned understanding of the setting and the individuals involved is the purpose of the first phase.

These existing conditions and a designer’s nuanced understanding of them are used to Materialize. This understanding acts as the agent for incorporating slowness in to the design process. Slowness can be defined as the particular pace of person’s state of mind or the pace required for a quality interpersonal relationship. Materializing is meant to be enacted by a designer who is well versed in the existing process for abstracting and visually representing a given concept. Hard skills allow a person to put forward these abstractions, but this also requires soft, tacit knowledge. By this, I mean to know the way in which and why, for example, an apple can mean one thing to a teacher, mean another to an anorexic, another to a farmer, another to a Christian, another to one’s sister, and another to oneself. Integrating these forms in to a person’s life requires it to be that much more forgiving and flexible to associations a person might have. In comparison to other design processes, this one isolates the tacit knowledge a designer uses, and dedicates a phase of practice solely to engage with this knowledge, and again, encourages a slowness to designing.

The process of Materializing results in artifacts. Incorporating them in to a person’s daily life is the basis of the Integrating phase. Without orienting a person to the value and intention of the given object, the object cannot fulfill its purpose. This process mirrors the way we are known to nurture our relationship with the objects around us. We associate material artifacts with a moment, it changes meaning constantly, and it can act as an physical and metaphorical anchor for a vast range of ephemeral experiences.

In Material Communications, design is a processor of qualitative and quantitative information, and is a mediator between an individual and an organization or institution.

R E F L E C T I O N

The following are reflections on the research and practice of Material Communications and snapshots in to what future research is called on by this work. (For more speculative future scenarios, see p 82 of appendix)

Design Pedagogy

Currently, educating product and interior designers on how to make things and spaces is directed by things like commercial profit, ergonomics, efficiency, ‘sustainability’, and functionality. In hindsight, Material Communications is yes, a means to a new design practice, but is really more of a pedagogical approach to be used by educators and be the start of an incremental shift that changes our processes and understanding for designing. This movement is about strengthening and grounding our sincerity and ethics as designers through education.

Communications

This research stems from my own idiosyncratic experience and curiosity around how we perceive day to day experiences. I have a tendency to associate moments with more visual and emotive representations as opposed to language-based representations. Material Communications functions as an alternative form of communication. It is indifferent to these language-based representations of an experience, and is a way for the user of the object and the designer enacting the design process to tap in to something that is not limited by syntax.

Education

Applying Material Communications to different contexts becomes a question of where alternative forms of communication could be of use. It also is a means for conversation and organizational change. This method

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allows me to synthesize pedagogies of institutions in order to simplify the content in more digestible forms for their constituents.

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C O N C L U S I O N

The Value of Nurturing Our Relationship to Artifacts

I am bringing to healthcare and educational institutions a capacity that clinicians, teachers, or cognitive science researchers would not necessarily be able to realize or complete independently. As a Transdisciplinary Design approach, Material Communications is a design strategy that embraces the true nature of the human condition that is just as material as it is cognitive. A study of mental health and behavior is an investigation of environmental factors. A conversation about artifacts is a question of the human condition.

The objects in this thesis document are an active contribution for the wellbeing of a family unit, like Brian’s. Yet, they can blend in with the nick-nacks sitting on the mantle. They sit next to the box of special things on the bookshelf. And with time, equally become a sentimental archival piece for he, his family, and future generations.

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PART 5 APPENDIX

I N V E S T I G A T I N G P A R E N T - C H I L D I N T E R A C T I O N T H E R A P Y

This research document elaborates deeply on the Parent-Child Interaction Therapy program and how Material Communications can be applied to this specific context. The following is a scientific paper explaining this process. The process, outcomes, and considerations are further elaborated on and illustrated after this portion.

Abstract

Parent-Child Interaction Therapy (PCIT) is an evidence-based treatment facilitated by a therapist to support families with children who have clinical levels of externalizing behavior problems. A Transdisciplinary research and practice called Material Communications is proposed here in that it transfers findings from cognitive science to design, and back and forth. More specifically, it includes research in interaction therapy, embodied cognition, externalization, and material thinking. This paper first explores the existing clinic-based model for PCIT and raises questions around a study of in-home PCIT. Secondly, an answer is suggested as to how a Transdisciplinary augmentation, called Material Communications, may best leverage the strengths and reinforce the weaknesses of both clinic and home based PCIT in a way that a single disciplinary approach could not. Lastly, some further considerations and sensitivities are addressed. Theimplications of the proposed augmentation creates a link between in-clinic patient experience and in-home patient experience. This is done with the aim to develop cohesiveness in the family’s experience, increase frequency of interaction therapy skill practice, homework completion, and consequently heighten the quality of the relationship parents have with interaction therapy skills.

This paper summarizes various phases of the evidence-based manualized intervention known as Parent Child Interaction Therapy (PCIT), raises questions around at the efficacy of one augmentation of this program, and finally proposes an augmentation that balances the strengths of the two. PCIT is made of a combination of didactic and direct coaching sessions between parents and therapist with the goal to build a positive relationship between caretakers and their children, aged between 2.5 to 7 years of age. The children eligible for the 12 to 16 week PCIT are those with clinical levels of child externalizing behavior problems. The behavior management techniques coached in PCIT are designed to aid children’s emotion regulation by providing parents with developmentally appropriate language and skills11.

Child-led Play Child-led Play is a 25-minute assessment period in PCIT where the therapist identifies the strengths and weaknesses between the parent-child dyad, noting the parents’ skills and how the child responds to parent’s verbal and nonverbal cues. Using the coded observations made during this period, the parent constructs specific goals for themselves and their child.

Child Directed Interaction Following the intake assessment, families begin their PCIT with Child Directed Interaction (CDI). CDIs are interaction sessions that allow the child to take lead in the interactions between them and their caretaker, which gives parents practice in certain skills and points to the skills needed to promote effective behavior management techniques. This is done using a set of parent behavior management skills and communication techniques called CDI Skills or PRIDE skills. PRIDE is an acronym for praise, reflect, imitate, describe, and enthusiasm. The three primary skills used to assess

1 Thomas, R. & Herschell A.D. (2013). Parent-child interaction therapy: A manualized intervention for the therapeutic child welfare sector. Child Abuse and Neglect. 578-584.

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parent’s progress are Labeled Praise, Reflection, and Behavior Description.Labeled Praise is needed to acknowledge a child’s positive behavior to reinforce the behaviors that are desired and are pro-social. Listening skills are facilitated by verbally reflecting a child statements, formally called Reflection. Behavior Descriptions are used to describe the positive things the child is doing in order to hold the child’s attention on the activity and teaches the child how to hold her or his own attention to one activity. Other skills that are taught and measured are for parents to avoid questions, commands and criticisms. Allowing the child to take lead in the interactions naturally manifests cues for the parent in enacting the CDI skills. In CDI, therapists code parents on the number of times they use Neutral Talk, Behavior Descriptions, Reflection, Labeled Praise, and Unlabeled Praise Parents are also evaluated on the number of Questions they ask, Negative Talk, and Commands the give their child.

Parent Directed Interaction Parent Directed Interaction (PDI) sessions follow CDI and is a way for parents to learn to set limits, demonstrate these abilities, start to show consistent and fair discipline strategies, and reduce their child’s non-compliance. Parents are coached in how to effectively use time-out space, and are helped with establishing home and public behavior rules. The goal being to maintain clear and consistent responses to any misbehaviors their child may have. In this portion of PCIT, the therapist, child, and parent have a joint introductory session where families learn the new rules as modeled by the therapist.

1 Augmentations and Modifications

There have been several augmentations and modifications to address some of the points in the base PCIT model that can be further developed. These include moving PCIT out of the clinic and into the home, focusing on motivating parents, and shortening therapy time. The motivations for parents are especially a need with families who are involuntarily referred to PCIT training and are not necessarily incentivized to continue or complete training. This motivation component was tested in six sessions, primarily based on motivational interviewing principles and family testimonials. The expected outcomes are higher retention rates and lower attrition, and the results for the motivation augmentation show that

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attrition was significantly reduced2. For families with more challenging circumstances it would appear to require a longer treatment time for sufficient PCIT benefits, but surprisingly, when compared at just 12 weeks these families had greater improvements in all measures than did longer term PCIT participants3. The total duration of therapy is an important factor that, if minimized, addresses some of the pressures that may be impacting attrition rates. Another augmentation that has been explored and adopted by several PCIT programs across the country is in-home PCIT4. Each of these modifications vary in effectiveness, yet for this paper they are detailed for the purpose of suggesting the weaknesses in PCIT; retention, maintenance of skill use in-clinic to in-home, and therapy duration.

2 Exploring the Efficacy of In-home PCIT

Of the previous augmentations and weaknesses of PCIT, in-home PCIT is one of the most compelling and substantial making it a potential platform for addressing several factors including therapy duration, cost, retention, and maintenance of skill use in-home. Lisa M. Ware studies the efficacy of full in-home PCIT with 5 families using identical criteria and measures as clinic-based PCIT, hypothesizing that this implementation would result in similar observable changes to clinic-based PCIT in caregiver behavior across treatment phases. Some of the questions raised from this study are in regards to details of the conditions of the patient homes, the effects of the therapist and challenges of coding in the home. Though this study’s core purpose is to explore the efficacy of in-home PCIT, some clarification on the distinct qualities of PCIT in the patient’s home could help deepen the value of this study considering the conversation around transportability and generalization it aims to join.

Results

Comparing Results: ECBI Intensity Score

2 Chaffin, M., Funderburk, B., Bard, D., Valle, L. A., & Gurwich, R. (2011). A combined motivation and parent–child interaction therapy package reduces child welfare recidivism in a randomized dismantling field trial. Journal of Consulting and Clinical Psychology. 79, 84–95. 3 Thomas, R. & Herschell A.D. (2013). Parent-child interaction therapy: A manualized intervention for the therapeutic child welfare sector. Child Abuse and Neglect. 578-584.4 Timmer, S. G., Zebell, N. M., Culver, M. A., & Urquiza, A. J. 2010. Efficacy of adjunct in-home coaching to improve outcomes in parent–child interaction therapy. Research on Social Work Practice. 20, 36–45.

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Ware compares results from in-home PCIT to clinic-based PCIT to provide context for the findings in her study. Eyberg Child Behavior Inventory (ECBI) is a 36-item report form completed by parents used to assess the frequency of their child’s disruptive behavior problems using a rating scale that yields an Intensity Score. The intensity score means of this study pre- and post-PCIT was lower than all the means of previous PCIT outcome studies. One of the participant’s ECBI (Eyberg Child Behavior Inventory) Intensity scores were unique in that they began to decline in CDI, increased throughout the end of CDI and beginning of PDI, and finally decreased throughout the rest of PDI. One hypothesis for this pattern Ware suggests is the amount of caregiver contact the child had, considering the child participated in a day camp during the study. Scores appeared to coincide with the amount of daily contact the caregiver had with this child.

Comparing Results: Compliance Rates This study’s pre-treatment compliance rates were lower than all of the compared rates, yet at post-treatment, compliance rates for the present study were 100% for all three families who completed treatment; higher than those of other compared studies.

Comparing Results: Maintenance Rates Families maintained their treatment gains at a rate of 83%, compared to 98% of one other study that reported follow-up compliance rates. This relatively low maintenance rate could be explained by families’ weaker distinctions between therapy and home. After in-home PCIT is completed learned therapy skills and experiences that were once clear in a parent’s memory begins to blend over time and could be more easily suppressed by subsequent daily events in the home resulting in lower maintenance rates. In contrast, families engaged in clinic-based PCIT are able to discriminate their clinic and home environment. This clear environmental and experiential distinction that comes with clinic-based PCIT could explain in-home PCIT’s lower follow-up compliance rate.

Results of Caregiver Behavior The results of this study show that as hypothesized, from beginning Child Directed Interaction (CDI), all caregivers showed a gradual increase in the use of PCIT skills across this phase. Once parents met requirements to transition to Parent Directed Interaction (PDI), their skills sustained near mastery level. The 3 families completing treatment exhibited varying levels of caregiver negative behavior (CNB) during baseline, all of which

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decreased and appeared more stable after CDI. These frequencies remained low during PDI. The proportion of direct commands were somewhat consistent with the proposed hypothesis of this study that the proportion of direct commands would increase during PDI. The proportion of direct commands remained variable during CDI5. All 5 families demonstrated the same pattern of skills acquisition for contingent praise and increased during PDI for those who completed their therapy.

Results of Disruptive Behavior Disorder Criteria All of the participants met criteria for disruptive behavior disorder, and by post-treatment or follow-up, two participants no longer met criteria for their diagnosed behavioral disorder and one participant met criteria for their ADHD - Impulsive Type for post treatment and follow-up assessments. Ware relates the success in therapy of this last family to additional stressors such as depression and self confidence that are independent from the child’s behaviors.

3 Distinctions of In-Home PCIT to Clinic-Based PCIT

Clinicians in this study were able to express a wealth of information in regards to clinical challenges specific to in-home PCIT, reporting that all the challenges could generally be categorized as related to having less environmental control than is possible with clinic-based PCIT. One reported problem was other family members being in the home and creating distractions during sessions. Treatment integrity was affected when therapists were unable to conduct coding during one of their patients’ sessions. Because this study does not elaborate on which case or why this is, it is unclear as to how rare of an occurrence this would generally be for in-home therapy or whether this would ever happen in clinic-based therapy where therapists are behind a one-way mirror. Clinicians conducted sessions in pairs 42.8 percent of the time and also had the support of an advanced undergraduate student who assisted in keeping siblings occupied during the sessions. In addition, in-room coaching was used as opposed to using a bug-in-the-ear device and one-way mirrors. Being evaluated by two therapists and having an assistant present as opposed to the one clinician present in clinic-based PCIT may be an added distraction and stress for children, caretakers, and therapist. This alteration may have caused varying effects for families.

5 Ware, L. M. (2006). Efficacy of In-Home Parent-Child Interaction Therapy. (West Virginia University Department of Psychology). 3276028.

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There are some pieces of patient information missing in this study that could be useful in understanding how in-home might vary from clinic-based PCIT. This study provides rich demographic information from each family including the child’s age, gender, ethnicity, the caregiver’s age, gender, and ethnicity, a list of the child’s siblings and ages, the caregiver’s relationship to the child, the status of the child caregivers, employment status, education level, and income. Beyond this standard quantitative data, detailing the location, environmental details, time, participating caretakers, and noting whether these factors are consistent across treatment periods could be valuable. Studying the effectiveness of in-home PCIT without this information makes comparing the two sites for PCIT impossible. Any difference in effectiveness could be more clearly identified with this kind of supplementary information, especially since these have been identified by clinicians to be the main features distinct to clinic-based PCIT.

Considerations It is suggested by Ware that the kind of implementation of in-home PCIT will likely be costly, based on the time and travel demands on the therapist and that the use of a decision tree may be helpful in establishing which families would benefit most from this modality. While it cannot be expected that in-home PCIT would replace clinic-based PCIT, there may be an option that is a fair compromise between the two that adopts the strengths and leverages the weaknesses of both modalities. As Ware notes, the results of this study are promising, and act as a catalyst for many future research studies.

4 Augmentation Proposal: Clinic-Based PCIT

The differences between in-home PCIT and clinic-based PCIT are significantly characterized by environmental differences. Specifically, these include the complications from multiple evaluators and assistants with in-home PCIT, and the clear environmental and experiential distinction that comes with clinic-based PCIT. The following proposed augmentation bridges the opportunity gap by supporting the experience parents participating in clinic-based PCIT have outside of therapy. I argue that by actively extracting strong points and leveraging the issues raised from Ware’s study on in-home PCIT, an augmentation that introduces a way to bring the focused clinic experience home may help increase frequency of practice and retention of skills. This is based on a notion that if parents participating in clinic-based PCIT were to be

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reminded of and designate space to practice their PCIT skills at home, that progress towards skill mastery would accelerate and be made evident in in-clinic evaluations. If proven effective, the results could consequently address issues of retention, cost, and duration of PCIT. This augmentation would specifically come in the form of a set physical specially designed objects that are associated with PCIT skills (including Behavior Descriptions, Reflection, and Labeled Praise) and are moved from clinic to home. The method for testing and implementing these objects, called Material Communications includes 3 design phases; research, production, and integration that correspond with existing PCIT modalities.

Material Communications at the Child Mind Institute To test this hypothesis, the Child Mind Institute (CMI)’s PCIT program acts as the first case study for Material Communications. CMI is a New York City-based organization that provides accessible evidence-based clinical care for children and their families, engages sciences in collaborative research, provides comprehensive information and resources to educate and empower parents, and focuses on advocacy to destigmatize childhood psychiatric disorders6. This initiative is a retroactive one, testing hypotheses with parents who have graduated from PCIT.

Research How might one create a physical object representing Reflection, for example? Research to determine this consists of two phases. The first phase is called Materialization and is dedicated to determining the physical form of these objects. The second phase requires research around finding precisely where and when objects are to be used. Research: Materialization ‘Materialization’ is an exercise designed to collect tacit knowledge about each skill from PCIT parents and therapists. Participants are asked, ‘What does Reflection sound like (by producing a description), look like (associating color and sculpting form), and feel like (identifying an emotion adjective and any bodily associations)?’ These amalgamated elements, or symbols, collectively represent the visual and experiential essence of Reflection. This project provides universally identifiable objects for each CDI skill by prototyping an iteration of the set of objects. Based on a previous test of this it was found the universality of the objects’ design is 6 ”Find Treatment.” Parent-Child Interaction Therapy Program. N.p., n.d. Web. 08 Apr. 2014. <http://www.childmind.org/en/clinics/programs/parent-child-interaction-therapy-pro-gram>.

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relatively easily obtainable, and is a matter of engaging in dialogue to help a parent associate their knowledge of a skill to the assigned objects. The main challenge is in determining where and when the objects are to be used throughout the day. In terms of future directions, this second research phase will work to explore this and will be in the form of a with caretakers who have completed PCIT. Locating and timing is an important part of research because without this, the objects risk becoming dormant or even damaging to the family’s therapy process. The focus of the Where & When Dialogue provides a way for a parent to selectively share their thoughts about interaction skills, identify obstacles, and determine locations and periods in the day that CDI objects are most needed. This reflective and playful dialogue for parents has 3 parts.

1 Warm-Up Talking about and mapping the connections between elements that make up PCIT. This part will ask questions such as, ‘What are the main parts that make up PCIT for you as a parent?,’ ‘Does each CDI skill feel distinct or are any grouped together?,’ and ‘How do they fit in with the elements of PCIT?’ The Warm-Up is designed to level the playing field and prepare participants for the following portion of the dialogue. As the researcher, this is a way to pick up on the pulse of PCIT for parents.

2 Where & WhenPinpointing specific times and locations where an interaction skill is challenging to practice. The participant chooses one CDI skill. Keeping in mind the discussion from the mapping exercise, the participant elaborates on a moment where and when a skill is typically most challenging to practice.

3 Incorporating ObjectsPersonalization and ownership of your CDI Object. Each person is given one pre-made CDI skill object designed in the previous Materialization research phase. These are three-dimensional representations of each interaction skill. This object corresponds to the skill each parent identified and used in the When and Where exercise. Participants will be challenged to integrate this into their home life by taking it home. Their responses, critiques, attractions, interests will implicitly be revealed though the nature of these activities.

INVESTIGATING PCIT

The method for extracting and applying the findings from the Where & When Dialogue is based on a reflective design practice methodology which allows one to “focus on acts of intelligence within situations of uncertainty, placing technical rationality within a broader context of reflective inquiry”7. These two creative research processes function as a complement to the more traditional cognitive science research methods as illustrated by Ware’s study.

Production & Integration

The locations or ‘homes’ for these objects will determine and reinforce the material, shape, and scale for further iterations. For example, if Labeled Praise is found to be most difficult to practice in the morning at the breakfast table, the object Labeled Praise may need to sit next to the salt and pepper shaker, therefore helping to refine the form, scale, and material. These objects are to be identified to live anywhere; in the child’s room, for bedtime, in the back yard, the dashboard of the car, or over the television but the underlying method for designing the objects lies in product design theory and the theory of place. “Product semantics have been defined as the study of the symbolic qualities of man-made forms in the cognitive and social contexts of their use and application of knowledge gained to objects of industrial design. According to this definition, product semantics concerns the relationship between, on the one hand, the user and the product and, on the other, the importance that artefacts assume in an operational and social context.”8 Each CDI Object has the capabilities to express its properties, describe its purpose and function, exhort specific reactions, and identify the product’s origin. With the design of the CDI Objects defined, how the Objects are integrated in the existing clinic-based PCIT program, such as allotted time in therapy, in the home, and cost for production are considered. Considerations

As an evidence-based treatment, PCIT requires significant and consequential considerations. The testing of the objects, or materialized

7 Grocott, Lisa. Speculation-led Reflective Practice of Figuring: A Case Study. Lisa Grocott’s PhD. October 13, 2013, from lisagrocott.net. 8 Roto, Lee, Pihkala, Castro, Vermeeren, Lew, Väänänen-Vainio-Mattila, Hoonhout, & Obrist. (2013). Product Semantic Analysis (PSA). All About UX: Information for user expe-rience professionals. Oct. 18, 2013, from allaboutux.org.

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skills, have implications that impact the time and emotional and financial investments of those involved. Therefore, testing will be conducted outside of the intimate setting of the sessions, and will be in the form of retroactive off-site dialogues. Off-site findings should be made to be tightly connected to on-site contexts. Teacher Child Interaction Training (TCIT) is a modification that takes the interaction training framework for PCIT and adapts it to the school and classroom setting. The therapist-parent relationship becomes a trainer-teacher relationship, respectively. The proposed augmentation may be capable of being applied to both PCIT and TCIT due to the fundamental nature of interaction therapy skills.

Transdisciplinarity

Transdisciplinary Design uses design to raise questions and find solutions for where there may be room for improvement. Transdisciplinary methods, such as Material Communications, are contingent to the context of the problem its aims to address. This means the process and results take different forms by adopting concepts and methods from multiple disciplines. For example, the CDI Objects adopt one of Michael White’s methods of externalization and narrative perspective. Externalization is a way to re-author conversations and “contribute to the identification of and to the exploration of the very knowledges of life and practices of living.”9 For example, formulating a question to ask ‘How has your family changed since depression entered your life?’ rather than stating, ‘How has your depression changed your family?’ Similar to how systemic art techniques use externalization, CDI Objects offer an effect where the objects themselves are externalizations of a quality of emotion and behavior.

5 Conclusion

Material Communication’s research, production, and integration methods call for continued research around in-home PCIT. Ware’s valuable study on the effectiveness of in-home PCIT allowed for comparison to clinic-based PCIT and helped to uncover a gap in the field of emotion and behavior management. If embodied cognition is the notion that cognition is fundamentally shaped by the interaction of the human body with its environment10, this augmentation introduces the ‘environment’ as

9 White, M. (2001). Narrative practice and the unpacking of identity conclusions. Gecko: Journal of Deconstruction and Narrative Ideas in Therapeutic Practice, (1), 28-55.10 Wilson M. (2006). Six Views of Embodied Cognition. Psychonomic Bulletin and Review, 9: 625–636.

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variable for opportunity in research and practice of emotion and behavior management techniques such as PCIT. Material Communications provides clinic-based PCIT with parts of what make in-home PCIT attractive and identifies two disciplinary fields that are innately linked and leverages them for a projected outcome that could improve the experience of families and therapists as well as make contributions to the field of cognitive science. This augmentation works to engage in a sensitive exchange between cognitive material worlds.

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P A R E N T F E E D B A C K

The following is feedback provided by a parent on the conversation and the 5 smaller dialogues during the Integrating phase.

Parent B

How might you summarize the conversations we had?

We warmed up with some PCIT terms as a refresher to the vocabulary used. We spoke about using skills throughout the day and discussed which ones were used most often at which times. We identified a skill that was particu-larly important and looked at a situation in which is was very important to use this skill, but also challenging. I thought it was refreshing to think about the CDI skills in depth and in abstract ways such as color and shape. I never really thought about which skill was most important before, but I think it is helpful to name the skill out loud.

What are 3 main take-aways for you?

Visual Cues, especially ones which have been discussed with regard to a par-ticular skill and specifically how they relate to it, will be helpful reminders. It is important to revisit the specifics of the skills. It is helpful to revisit the theory and process behind PCIT from time to time and can bring more meaning to the script used.

What should be considered as this initiative moves forward?

One thing that comes to mind is that I feel that I do fairly well using my skills. I feel that I, and probably many other people, struggle most consis-tently with ignoring disruptive behavior, this is very difficult to do especially in stressful situations, when disruptive behavior is negatively influencing other children in the environment, or when the parent is tired. I think that an object that is a reminder to ignore disruptive behavior would be

extremely helpful.

What are some risks, benefits, weaknesses and strengths of the PCIT Objects?

A risk might be that a family may rely too heavily on the objects as remind-ers and not do as well in locations without the objects, for instance, running errands or on vacation locations outside of the home which are generally more challenging environments.A benefit of the objects is that they may help a family moreconsistently incorporate the skills in to daily life within the home.A weakness of the objects is that they are, in fact, objects and some people may respond better to verbal cues or auditory reminders than visual cues. And that they are not effective if you are not looking at them.A strength of the objects is that they can become permanent fixtures in areas of the home which are most challenging, providing support where it is most needed.

How might you redesign some of the PCIT Objects?

We spoke about a more durable object material, such as Plexiglas, to replace the glass so that it would be more sturdy if used in a location that the kids might have access to.

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PART 5 APPENDIX

intro to CDI CDI at CMI CDI at home CDI mastery PDI 1 2

3

4

5 6

1

2

3

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1 M A P

Question What are the parts that make up PCIT? What stands out?Goal To jog memory and share experience with the culture of PCIT

I N T E G R A T I N G W O R K S H E E T S

2 T H E R A P Y S K I L L S :P A R T A Question When and where at home do/did the CDI skills take placewhile going through PCIT?Goal Reflecting on and pinpointing locations and times for one CDI skill

[ ]

noon

morning

night

During a typical week while in therapy, I used this CDI skill during these moments and locations.

skill timeline worksheet

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�is skill is di�cult here because...

�is skill is important here because...

location & time

[ ]�is CDI skill is important for these reasons

skill focus worksheet

Goal Focusing on one key location and time where one of the 3 therapy skills is important yet difficult.

2 T H E R A P Y S K I L L S : P A R T B

INTEGRATING WORKSHEETS

3 T H E R A P Y O B J E C T

Goal 1 Reveal and introduce the therapy object associated with the chosen skill 2 Review the skill 3 Personalize the object

Above is the CDI skill I am focusing on�is is how I might relate my personal experience to this object

color shape

[ ]

object worksheet

this color relates to CDIgoals and/or my personal experience...

this shape relates to CDIgoals and/or my personal experience...

this relates to CDIgoals and/or my personal experience...

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4 T A K E - A W A Y

Question How might this object be used at home?Goal Taking the therapy object home, practicing the therapy skills, and document.

�e object had or did not have an impact in these 3 ways

Using this CDI skill is notable here because...

[ ]I prototyped this CDI skill and it’s corresponding object.

Below is one notable moment during this prototyping period.

takeaway worksheet

location and time period...

�e object was located...

INTEGRATING WORKSHEETS

5 R E F L E C T I O N

Question What were your main take-aways?Goal Self-reflecting, Providing feedback, and Re-designing PCIT objects

How might you summarize the conversations we had?

What are 3 main take-aways for you?

What should be considered as this initiative moves forward?

What are some risks, benefits, weaknesses and strengths of the PCIT Objects?

REFLECTION + FEEDBACK PCIT OBJECTS WORKSHOP 1How might you redesign some of the PCIT Objects? What helped guide these designs?

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PART 3 IMPLICATIONS

F U T U R E S P E C U L A T I O N S

Sacred Artifacts

Juan Enriquez coined the term ‘homo-evolutis,’ meaning we are in control of our own evolution and that we are emerging as a new human species. In the not-too-distant future, we grow artificial organs and transplant at an affordable price. Longevity is as accessible as sunlight. Our lifespans start to reach triple digits. Our 401k kicks in at 100 and we still enjoy 50+ years of retirement. Kindergarten starts at 15, and we graduate college at 45. Technology outgrows us, and the microchips embedded in us and the augmented realities that surround us make the once fortifying life events take little to no toll on our emotional lives.

In a future bound towards overwhelming amounts of virtual realities, and artificially reconfigured human nature, we begin encountering cases where people are yearning and rebelling for something, anything, tangible. We’ve started to make a strong push back towards our primitive instincts to toy with artifacts as a holder of meaning and as a maker of meaning. The few remaining objects in our every day lives become sacred. What, then, should be the purpose of these spare artifacts?

Material Communications speculates that these artifacts be psychologically connected, being the concrete vessels for our memories and experiences in the family home setting.

The Evolving Smart Home We’ve started putting in to place technologies in our homes such as remote or automatically controlled lighting, heating, and entertainment. If we imagine this technology’s future, the smart home becomes more than convenience. It starts to enter the realm of security, and not just the kind that keep burglars away, but the kind that supports our emotional security. It does this by tracking our movements and reactions, remembering that instance we became accepting of our child’s idiosyncrasies, or when we didn’t cope well with being laid off from work.

Our smart homes of the future catalogue these emotional experiences and respond accordingly, helping us to better cope with the emotional and behavioral challenges that come with life. What form might this support

take? Perhaps the smart home deduces the armchair in the corner of the living room is personally, and historically the best condition for you to practice acceptance.

Material Communications speculates that in the case of the smart home of the future, the conditions of our environment, while we experience constructive life events, are replicated and evolve along with us.

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PART 3 IMPLICATIONS

The Critical Point

1951. The first commercial computer was created. 1959. The first bank industry computer is in use. 1962. The first computer game is invented. 1974. The first consumer computers created. 1983. The first home computer with a graphical user interface. All of these machines were built with the intention for increased efficiency, professional performance, and entertainment. They’ve come a long way and have a great influence on culture.

Rewinding back to the critical point in 1951, how might the advancement of technology and culture be reconfigured to heighten our interpersonal performance, and ecological awareness as opposed to efficiency? Our iPhones no longer hold mental, social, and emotional health applications like Luminosity or Emotionary, but our mobile devices are primarily designed and built for this purpose. Our Roombas no longer pick up crumbs and dog hair, but follow us and provide supportive cues for happier life.

What Material Communications speculates is that if

TECHNOLOGICAL SINGULARITY

HUMAN INTELLECT MACHINE INTELLIGENCE

?

TIME 1950

INTELLECTUAL POWER

this mid-20th century movement were to have different goals, that perhaps we might have avoided some of the issues raised around technology, artifacts, and the urban condition that some argue promotes disconnect. What other critical points are approaching, and how are we equipped to handle them? What is our priority?

FUTURE SPECULATIONS

courtesy of quirksandpatterns.com

d o r e m y d i a t t a . c o m