Data Collection and Token Management System for Group-Based Therapy

Background:  Motivity is a cloud-based software system for data collection and therapy management that is being developed with grants from the National Institute of Mental Health. Motivity is unique in its ability to support group-based therapy with multiple observers using mobile devices to collect data simultaneously on large groups of individuals, providing real-time data visualization to all users, updating instantly when new data is collected. The Motivity prototype was tested at the University of Washington Apex Summer Camp for 5 weeks. Apex is an evidence-based program serving over 90 children each summer that utilizes a naturalistic day camp environment and structured recreational activities to teach behavioral and social skills. Therapy is conducted by 40 trained interventionists. Over 25 different behaviors are tracked continuously throughout the day to monitor progress and develop individualized goals. The program includes a reward system in which children earn points for appropriate behavior, such as helping peers and staying on task, and lose points for behaviors targeted for decrease, such as interruption and teasing. At the end of each day, children redeem points for prizes.

Objectives:  The Motivity prototype was deployed to Apex with the goal of evaluating the real-time feedback capabilities and scalability of the system to support large group therapy and school-based interventions.

Methods: Prior to deployment of Motivity, Apex data collection was entirely paper-based and was extremely tedious and time-consuming for Apex staff, involving over 150 hours per week of staff labor to tally up points and enter data for analysis and point tracking. For the field test, the paper system was completely replaced by the Motivity prototype on iPads and Kindle Fire devices. The camp director (BA) used Motivity’s Knowledge Authoring Interface (KAS) to model the Apex scoring system and measures in Motivity. To support groups, a Group Teach interface was added to Motivity in the form of a scrollable grid, with each column representing one child. Staff were trained for 1 hour on the use of Motivity prior to camp. Children were divided into 8 groups of 12 children each; each group had 4-5 staff members facilitating group therapy with 2-3 mobile devices (iPads and Kindle Fires) per group.

Results: The Motivity model and navigational structure fully supported the Apex behavior tracking and token economy requirements. After five weeks of use, over 150,000 behaviors were recorded. Apex staff reported high satisfaction with the system, including usability, performance, and functionality.

Conclusions: The camp director reported that Motivity saved each staff member over 4 hours of manual labor per week, and allowed much quicker evaluation of student progress, clinical responsiveness, and ability to provide comprehensive information to parents. For example, counselors were able to monitor behavioral changes in response to a medical adjustment and share definitive data with the family and primary care providers immediately. Motivity allowed interventionists to provide a level of clinical support that would not have been possible using the original paper methods.