Testing the Value Game

Hello again!

I apologize for the rather abrupt ending to my last post. I will admit that was due to both a lack of motivation during my blogging session as well as a genuine feeling that the value game needed its own post. So here goes.

Out of the ten patients in the geropsych ward at the time, Ms. Endreson helped me identify one who would be most suited for the value game activity. We decided that it would work best with a higher functioning patient--that is, one who doesn't have severe dementia or schizophrenia. So we selected one of the younger patients--we can call her P for confidentiality sake-- who has major depression and is a partial paraplegic.

I believe some of you might have been confused by my last description of the game so I'm going to give a quick review. The idea was to identify the changes visuals make when patients have to sort what is most important to them. We had P sort 50 images first and then 50 words afterwards. Here was our series of steps:

Step 1. Split the 50 visuals into "Important" and "Not Important"

Step 2. Put the "Not Important" visuals to the side and split the remaining "Important" cards in half, again categorizing them as "Important" or "Not Important"

Step 3. Repeat step 2, again narrowing down the "Important" pile

Step 4. Narrow the final "Important" group of images down to 8.

Here are 5 of the 8 images that P picked (it seems I left the other 3 she picked back at Bridges...I will have to retrieve those later):

From top left the visuals were meant to correspond to "Genuineness," "Openness," "Nurturing," "Service," and "Popularity." 

After P picked her images, I watched closely as Ms. Endreson encouraged her to explain what each images meant to her and why she picked them as her most important. I found that the images all meant more than the single-word descriptions I had originally paired them to. For instance, the top left image represented "family" to P, rather than genuineness, because she was of african american descent. P explained that the butterfly image represented "freedom" to her, which was very close to "openness," but the images was obviously more complex to her. Other image interpretations were more obvious, like the mother-daughter image and the soldier; P reminisced about her relationship with her daughter and informed us of her military family. And finally, the bottom right image reminded P of "attractiveness" because, as she explained to us, she and her friends used to go out and enjoy themselves and that is when she felt beautiful.

P seemed to really enjoy the image sort and had a definite smile on her face after she was able to explain all her choices. So we quickly channeled her excited attitude and had her sort the word cards. The steps were exactly the same, but this time she only had small cards with single words and brief descriptions on them. I noticed that it took P a bit longer to categorize the cards; she would look at a card and have to wait a few moments to grasp the meaning of it, whereas--when she had a visual--she would quickly connect to it and place it in a category right away.

Despite the slower reactions, P was able to narrow her value cards down to the 8 most important. The three she seemed most sure about were "Purpose," "Fitness," and "Family." Our last step was to have P lay out her 8 image choices and 8 word choices and try to make connections between them. Her way of making connections was to group them. So she proceeded to put several of the images in the group with her "family" card and other images with "Purpose" and "Fitness."

I noticed that she did not make any matches that were originally intended; she did not match the "Purpose" card with the image that I had originally picked to represent purpose. But I had a feeling something like that would happen and was happy that she found her own connection in the images. Our final task for P was to ask her to single out one image-word pair that was her most important, her greatest priority at the moment. After long deliberation, she ended up choosing "Purpose."

Overall, throughout the entire 45 minute session with P, I was able to observe some major differences in her reactions based on the visuals we provided. The images brought more stories out of her and led to long conversations about her family and childhood. At the end of the session, as P wheeled out of the art room, she asked if I could make copies of the 8 images she selected (and one of a magazine cut-out of David Beckham I cleverly stuck in the game to represent "attractiveness"...I don't blame her) for her to keep. She eagerly thanked Ms. Endreson and I for spending the time with her and told us she though the activity was "really fun." As she rolled away she said: "I feel so much better after doing that, so thank you...Everything happens for a reason. I was crying before but now I feel so much better."

The positive reaction we got was incredibly encouraging and Ms. Endreson and I both agreed that we would like to have more 1on1 sessions with other patients very soon. I hope you are as excited to hear about future results as I am.

Until next time!
Tia