1/31/2017: Can An Online Game Help You Learn To Help Struggling Friends?

It can be difficult to know what to say when a friend is struggling. The conversation is hard to even start. Maya Cohen, a first-year student at Tulane University, says she knows better how to intervene after playing a video game created to help people learn how to recognize signs of psychological distress like depression, anxiety and substance abuse, and get them professional help.

Like all incoming students at Tulane, Cohen had to participate in an online conversation simulation game titled “At-Risk For College Students.” The purpose is to teach empathetic conversation skills. In the game, you play Jesse, a friend of Travis, a depressed young man who’s been failing his classes. Jesse notices that Travis hasn’t been the same lately, and goes to his apartment to see how he’s doing.

Checking in is the kind of supportive effort that friends ideally do for one another, and the game is supposed to encourage more of that. We hear out each other’s burdens. Friends are the first bulwark of support when times are a little rough or when something’s deeply wrong. We might pride ourselves on the advice we give, the shoulders we offer, the general “being there” for our friends.

But our skill at doing that varies, says Glenn Albright, a psychologist at Baruch College at the City University of New York and cofounder of Kognito, the company that developed the game. “It’s the sad reality that a lot of people don’t know how to help people,” he says. “How to identify those who are struggling, to approach them, talk to them and give them a level of comfort.”

Albright thought that the right conversational training program could help people help those around them. “You’re talking about 40 percent of college students reporting systems of depression where they say it’s interfering with their functioning,” Albright says. Kognito’s first simulation, released in 2009, focused on faculty-student conversations. The company has since developed over a dozen simulations.

Many focus on peer conversations, like the game that Cohen played; others address patient-doctor or family interactions. At the end of the conversation, participants get examples of how to sensitively suggest mental health services. In simulations for medical professionals, that might mean managing care collaboratively with other health professionals.

Kognito grounds all of these simulations in psychological counseling methods such as motivational interviewing, which stresses conversation techniques like using open-ended questions and listening and reflecting on what someone says during a conversation.

“[This] is really trying to engage the other person in dialogue, understand what’s happening and what’s influencing their behavior,” says Marlyn Allicock, a health behaviorist at the University of Texas in Dallas who is not involved with Kognito. “Those skills are really grounded in empathy.”

In the game that Cohen played, when Jesse relates to the things his friend is saying, Travis responds much more warmly. If Jesse is brusque during the conversation, Travis clams up. “They’ve done a really nice job modeling a person’s behavior,” Allicock says.

The games also shows things that might push people apart, Allicock notes. Giving unwarranted advice, for example, might give the impression that you think you know better than your friend. “Those are things that push people away,” Allicock says. “I’m not going to open up to you if you’re saying, ‘You’re not doing this right.’ ”

Cohen says she didn’t realize any of this until she started playing through the Kognito simulation. “A speech bubble came up with tips,” she says. One says using “I” statements is good, but not when a judgment is attached. That reminded Cohen that when a friend of hers would complain about something, Cohen would make a judgment. “I would approach her and be like, ‘I think you’re overreacting,’ ” she says.

Cohen, 19, says she kept thinking back to one time last year when she feels she really should have talked to her friend. She got a screenshot of text messages that her friend Angie had sent to her boyfriend. We aren’t using her last name to protect her privacy. The reason will become clear later in this story. “[Angie] was texting her boyfriend saying, ‘I feel none of my friends care about me. Would anybody even notice if I was gone?’ ” Cohen says. She was worried, and wanted to ask Angie about it. “I just didn’t know how to start that conversation. And once I did I wouldn’t know how to continue it.”

Instead, Cohen brought the text to her school counselor, who pulled Angie out of class. “At the time I was really mad because I was like, so depressed, and now you’re making my life harder,” Angie says now. “They added this entire like new situation.”

Angie, 18, says that at the time she was considering killing herself. The counselor’s intervention got her the help she needed, but the fact that none of her friends tried talking to her first made her upset. Cohen feels like it put a strain on their relationship, even after they made amends. “We could never go back to how we were before,” Cohen says.

After the Kognito training, Cohen says she’d been thinking a lot about how she could have handled the situation better. At the very least, she says, she could have gone to Angie first to check in on her, talk to her and find a way to get her help, but with her consent. “That would have been more inclusive of Angie,” Cohen says.

Read the full article here.

11/30/2016: Journal of mHealth: Kognito’s Case Study about Harnessing the Power of Conversations with Virtual Humans to Change Health Behaviors

We are excited to share a newly published article in the Journal of mHealth that discusses the work of Kognito and how we are changing health behaviors through role-play simulations with virtual humans.

This article provides readers with an in-depth look at Kognito’s behavior change model as well as its overall approach to improving health behaviors. Our behavior change model draws upon components of game mechanics, virtual human simulation technology, and evidence-based instructional design. It also incorporates the principles of social-cognitive theory and neuroscience, including motivational interviewing, emotional regulation, empathy, and mindfulness.

Numerous longitudinal studies have shown that users who complete Kognito simulations demonstrate statistically significant and sustained increases in being confident and competent to lead real-life health conversations.

The article can be accessed at: http://mhealth.amegroups.com/article/view/12530/12915

11/18/2016: Managing Post-election Emotional Distress

Karen Carlucci, LCSW, Director of Mental Health Strategic Partnerships and Brian Nido, Director of Client Experience

All of us at Kognito have been processing the outcome of the presidential election, along with the rest of the country. It seems the complex emotional reactions were rather unexpected, adding to a collective sense of uncertainty. We are aware that this is a critical time in many settings, specifically PK-12 and Higher Education schools, as there may be an overwhelming swell of emotions and concerns amongst students, faculty, and staff.

We want to ensure that everyone in your school community, from the school nurse to resident advisors, are prepared to respond to any emotional distress that a student may be facing during these times. We know that having certain resources readily available can make a significant difference when faced with an increased need to provide student support. Our education clients are equipped with Kognito’s easy to access role-play simulations that empower faculty, staff, and students to readily help connect students experiencing emotional distress with support services.  If your school currently has access, we encourage the use of these simulations, including our emotional wellness programs such as At-Risk, LGBTQ on Campus, Veterans On-Campus, as well as our bullying prevention programs Step In, Speak Up! and Friend2Friend. (learn more at  https://kognito.com/products)

As we gear up for the new semester and new year, our Client Experience team is ready to assist with suggested use cases and implementation ideas that you may want to try in these next few weeks. We wanted to share a few below:

For Faculty/Staff Use:

  • Include simulation information into upcoming faculty workshops or as a recommended professional development offering
  • Encourage use during staff/faculty meetings and in-service days
  • Promote re-training (or re-certification) for individuals to start in the second half of the school year

For Student Use:

  • Suggest or assign as coursework for students to start the new year
  • Encourage Resident Advisors, Fraternity and Sorority Life, and Student Government to adopt this into their training regiment
  • Partner with traditionally overlooked groups such as student employees, athletic clubs, sororities/fraternities, study abroad groups, international students, multi-cultural awareness organizations, and LGBTQ clubs

As a reminder, the Kognito team is here to help and to be an additional resource to you and your communities. Please do not hesitate to contact your Account Manager if you would like additional dissemination ideas or simply to share what you may be observing in your school environment.

If you currently do not have access and would like to learn more about the Kognito simulations listed above, please contact info@kognito.com.

11/11/2016: Talking About Talking with a High School Counselor

Jennifer Spiegler, SVP Strategic Partnerships, Kognito

In addition to leading for Kognito’s PK-12 practice, I am the parent of a teenager and once in a while my worlds collide. That happened in a recent conversation with the guidance counselor at my son’s school. I loved the metaphor she chose when she said, “Sometimes using the right words is like watering a plant.” The effect of her words on me was instantaneous. Yes, it’s just like that. We’ve all seen it – language that either helps the listener to flourish or causes them to wither. That plant-watering image has stayed with me for weeks; its simplicity makes it an easy touchstone for remembering that you always have a choice with your words – to water or to wither. I even thought about it yesterday while watering our much neglected houseplants. The water hits the soil; there’s a slight shudder as the water soaks the roots and rises in their stems.

As a parent, spouse, friend, or colleague I can easily lose sight of this essential truth – words matter. Using them consistently well – so that we are watering instead of withering – takes practice and mindful vigilance. As the employee of a company that has dedicated itself to changing the way people use conversations to promote positive change, you’d think I’d be good at this by now. Well, the reality is: not always. I’m reminded anew as I demonstrate a Kognito role-play conversation between a high school teacher, Mr. Lyons, and Rene, a virtual student he suspects may be cutting herself. Rene bristles and stiffens defensively when Mr. Lyons says she seems stressed lately, but if he says, “I’ve been concerned about you lately” she sighs, softens and looks thoughtful, saying, “Oh, really? Why?” With my own high-schooler at home, this is still a work in progress for me. The reflexive words that come are not always the ones I would choose if I were always mindful of watering vs. withering. I’ll keep using the plant metaphor and my frequent conversations with Rene to help improve my averages!

11/3/2016: The Challenging Journey from High School to College: A Moment with Kognito’s Co-Founder Dr. Glenn Albright

We met with Kognito’s Co-Founder and Director of Research, Dr. Glenn Albright, last week to discuss some topics on his mind . . .

What’s currently a hot topic for you in the field of school mental health? Because I’m a college professor, spending much of my time around freshman, I’m thinking a lot about the transition they make from high school to college and how that transition is often very challenging for some. It’s a passionate subject for me and I’d like to somehow make that transition easier for them. For many young people, it’s the first time they’re away from home, pulled from the current emotional support system they’ve been used to, whether that support came from friends, home or school. Theyexperience a whole new world in college, new people, new environments, new responsibilities.

Try Kognito’s At-Risk on Campus Simulation to Promote Emotional Wellness in Universities

The stress of this transition can be many-fold. In addition to the normal stress most experience, some are bringing already-existing problems: depression, anxiety, eating disorders. They are entering college already struggling; into another environment which creates new stressors, and can exacerbate those that already exist. And due to the stigma surrounding depression and other mental health issues, many students suffer in isolation. We see studies that show up to 40% of college students report symptoms of depression that are serious enough that it interferes with their academic and social functioning. That’s a profound statistic!

How can we prepare them better to make this transition? What if we could prepare them before they leave high school or empower parents to take some of the lead to support them better? Often parents don’t have a full understanding of what emotional hurdles their children will face in both leaving one environment and entering a completely new one. We buy clothes and other things for their new adventure but we , and we also need to prepare them emotionally. This means that we have to educate parents which includes addressing their own stereotypes and stigma.

Try Step In, Speak Up! to Create a Safe, Supportive Campus Environment

There has to be a degree of psycho-education, not only for those with already-existing conditions, but for every student making this transition. This involves helping them understand and communicate some basic things:

  • What is stress?
  • How does it manifest physically and mentally?
  • When is it normal and when does it become more serious, like in the case of depression?
  • It’s normal to feel stress on campus; it’s part of everyday life.
  • Many students feel it.
  • How can we reduce stress and get support when we need it?
  • What are students’ beliefs around mental health and seeking support if they should need it?
  • Just because a student might need or want mental health support does not mean he/she is incapable, inadequate, etc. In fact, it’s a sign of strength and courage.

I’d love to see, and of course Kognito is always working towards this, a culture shift in which college-age students, parents, high school personnel, and indeed everyone becomes more aware of the stressors surrounding this transition for our young people, and it becomes a normal part of life to talk about them and address them at every step of the way.

10/27/2016: News from the 21st Annual Advancing School Mental Health Conference

Kognito’s SVP of Strategic Partnerships attended the 21st Annual Conference on Advancing School Mental Health in San Diego from Sept 29-Oct 1. The Center for School Mental Health (CSMH), organizers of the conference, reported record attendance as school mental health continues to mature and gain acceptance as having an essential role in ensuring students’ health and as critical component of their academic success.

The theme of the conference was Shape the Future of School Mental Health: Advancing Quality and Sustainability. The conference emphasized a shared school-family-community agenda to bring high quality and evidence-based mental health promotion, prevention, and interventions to students and families. Clinicians, educators, administrators, youth and family members, researchers, primary care providers, advocates, and other youth-serving professionals attended the conference.

Several conference presenters talked about their use of Kognito simulations as part of their universal prevention and early intervention efforts in support of student mental health. Among these were:

∙ Scott Bloom and Marci Bouchard of the New York City Department of Education who discussed their work supporting the citywide NYC Thrive mental health initiative, championed by NYC first lady, Chirlaine McCray. As part of this groundbreaking mental health initiative, which seeks to remove barriers to treatment for mental health and substance use disorders, all NYC public schools have free access to Kognito simulations for elementary, middle and high school educators. We look forward to making great strides for NYC youth by reaching all 100,000 educators who support 1.1 million students, 

 Janet Pozmantier of MHA of Greater Houston mentioned the use of Kognito simulations as part of system change efforts in large urban school districts.

 Mike Lombardo of Placer County (CA) Office of Education pointed to the value of Kognito simulations as part of PBIS programming.

 Carrie Freshour of the Baltimore County Public Schools discussed Kognito simulations in the context of implementing Multi-Tiered Systems of Support (MTSS)

If ASMH is new to you, be sure to sign up for news about next year’s conference and opportunities to present. Join the listserv, here.

10/21/2016: Fairfax County Schools Using Kognito to Stop Anti-LGBT Bullying

”You’re so gay!”

We’ve all heard it before. Friends teasing each other. A bully displaying negative behavior. Someone looking for attention by saying something risky enough to look bad, but not bad enough to reprimanded. And why are there no consequences for this anti-LGBTQ behavior? The problem is faculty and staff members don’t always know how to intervene in any type of bullying situation. So, how do we get those on the front lines to not only show their support for all students, but build the skills necessary to approach these situations with the required respect and understanding?

Kognito’s Sr. Strategist, LGBTQ Programs Wes Nemenz sat down with NBC Washington’s David Culver in Fairfax, VA to explore how one of many schools across the country are utilizing Kognito’s Step In, Speak Up simulations, training their faculty and staff in understanding the struggles of their LGBTQ students.

Kognito on NBC Washington

Spirit Day 2016 brought millions all over the globe together to take a stand against bullying, specifically that of LGBTQ youth. Lesbian, gay, bisexual, transgender and queer or questioning (LGBTQ) youth are at higher risk than their non-LGBTQ peers of being verbally or physically harassed or assaulted with negative consequences for their mental and physical health as well as their academic achievement. Step In, Speak Up! is a 30-minute online role-play simulation that helps youth-serving adults increase understanding and appreciation for the challenges faced by LGBTQ youth and build confidence and competence to intervene in these incidents.

Step In, Speak Up

This simulation is part of a suite created to address bullying and mental health in PK-12 and higher education. It has been widely adopted across the country in states like Texas and Illinois and cities such as New York. Learners get practice in curtailing the use of biased language, addressing harassment, and reaching out to a student who has been harassed. These actions help send signals that these words and behaviors are not okay. The learners are introduced to three youth coaches based on real people who help guide them through scenarios to practice positively intervening with realistic virtual students.

The virtual students in the simulation are coded with their own personality and emotions; they mimic real-life behavior which makes the experience accurate, giving a stronger learning experience. Face-to-face role play training has inherent limitations that Kognito’s simulations overcome, resulting in a skills building experience that is more enjoyable to the learner. Some schools have implemented the simulation as their sole source of professional development while others use it to supplement their existing anti-bullying initiatives.

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