Authors: (including presenting author): :
Tang WH, So PK, Tong TK, Jim HYC
Affiliation: :
Occupational Therapy Department, Castle Peak Hospital
Keyword 1: :
Severe mental illness
Keyword 2: :
Gamification
Keyword 3: :
Psychoeducation
Keyword 4: :
Illness Management and Recovery Program
Keyword 5: :
Self-management
Keyword 6: :
Personal recovery
Introduction: :
Individuals with severe mental illness (SMI) commonly experience challenges in personal recovery, including hopelessness, reduced self-efficacy, loss of meaning, and difficulties in illness self-management. Illness Management and Recovery (IMR) is an evidence-based psychoeducational intervention to improve self-management, relapse prevention, life meaning and recovery outcomes. However, adherence and engagement level to IMR was widely suboptimal. Gamification has emerged as a promising strategy to enhance motivation, engagement, and learning in education and health interventions. Gamification mechanisms included use of rewards, promotion of self-determination, social learning, and experiential learning. This project involves the development of Recovery Chess – a board game simulating recovery milestones, which incorporate gamification techniques and psychoeducational materials, followed by a pilot study.
Objectives: :
This pilot study aims to evaluate the feasibility, acceptability, and preliminary effectiveness of Recovery Chess as an adjunct to IMR for individuals with SMI.
Methodology: :
A single-group, pre–post mixed-methods pilot study was conducted using convenience sampling. Thirteen participants (aged 18–65) with schizophrenia, bipolar affective disorder, or major depressive disorder were recruited from acute wards, rehabilitation wards, and psychiatric day hospital. Participants received a group-based gamification-enhanced IMR program incorporating Recovery Chess, delivered by occupational therapists. Quantitative outcomes included engagement (attendance, dropout), patient-rated acceptability, appropriateness, feasibility, and recovery-related measures (IMR Scale, Hope Scale, Warwick–Edinburgh Mental Wellbeing Scale(WEMWBS), Self-Stigma Scale). Pre–post differences were analyzed using paired t-tests. Qualitative feedback was collected to supplement feasibility evaluation.
Result & Outcome: :
Participants attended 95% of scheduled sessions (88/92), with no treatment-related dropouts or adverse effects reported. Mean acceptability, appropriateness, and feasibility scores were high (4.5, 4.25, and 4.35 out of 5, respectively). Significant improvements were observed from pre- to post-intervention on the IMR Scale (t(12)= 2.67, p = .026) and Hope Scale (t(12)= 2.92, p = .017). No change was found in WEMWBS and Self-Stigma Scale. Qualitatively, positive feedback included enjoyment process, benefit from social learning and meaningful message on recovery. Improvement feedback included difficulties in memorizing some of the rules of the game. To conclude, Recovery Chess is feasible and highly acceptable adjunct to IMR, and can significantly improve recovery outcomes and hope. Future studies with larger samples and a randomized controlled design are warranted to establish its comparative efficacy.
