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Archive February 2020

GAME: a board game co-designed by clients at the Psychosis Therapy Project

Not every game has a ball, nor two competing teams; even, sometimes, there is no notion of “winning.” Marvin Minsky, in reference to Wittgenstein’s Philosophical Investigations (1980)


This collaboration was part of a PhD project aimed at understanding the design process and the experiences of participants, clients of the Psychosis Therapy Project, to see if this engagement is beneficial to mental health. The co-design project was not set up with the intention of developing an artefact, and participants were encouraged to engage in the process freely. The process started with activities that aimed to begin to understand and define what design means; for instance by bringing objects and reflecting upon their significance or carrying out short design projects. Through some co-design tools and activities, a broad design purpose emerged, that of expressing a notion of Stewardship, or taking care of, which resulted in the development of GAME.

GAME is a tremendous achievement, stemming from participants unique knowledge and insights on Stewardship, or taking care of, each other and the world, and an intellectual and creative engagement with the meaning and diversity of human experiences.


The board game is designed to encourage collaboration over competition, and the exchange of ideas and perspectives in a non-judgmental way. Some players for instance commented ‘I have shared things I wouldn’t have done otherwise’ or ‘I didn’t know I was so self-conscious’.

Game is designed to help participants wonder, get to know themselves and connect with one another and the en­vironment. There are no winners or losers and interaction among participants is the main bene­fit. To achieve this, the board game involves players in addressing questions that relate to different themes, through different forms of interaction.

Game is composed by a set of cards with questions pertaining to the different themes in different colours, and a board offering 3 different ways to address each card. There is also a set of empty cards where players can write their own questions.

The different themes are: green, philosophical, spiritual, mind & body, cre­ativity and (?) which refers to any area not included in the main themes.

Figure 1. Prototype of guidelines booklet (themes descriptions) and cards.


Randomly through a wheel, each question can be addressed in three different ways: Tell & share, Think & discuss, and Act & ask.

Figure 2. Prototype of guidelines booklets – ways to address questions and tokens


Through sharing opinions, non-judgemental discussions and reflections with others, players may identify areas in which they may want to further reflect and develop themselves, individually or as a group. In order to keep track of these reflections, tokens are distributed among players, which reflect each theme.

Figure 3. Game, box of cards, board and box with tokens corresponding to each theme.


Unlike most games, tokens are allocated subjectively. Throughout the game, when the player feels they need help with some area (e.g. spirituality), they can take a token as a reminder of this need (e.g. spirituality token). Tokens can also be given by others, if the player accepts them. At the end of the play session, the number of tokens of each type reflects where the player needs development. Rewards corresponding to each theme are given to those who have most tokens of one type, to motivate them to develop that part of themselves. For instance, if you feel you are not very environmentally aware, fellow players could encourage you to take some green corresponding to­kens. At the end of the game, if you have mostly green tokens, you may be given a reward that encourages you to become more environmentally friendly. These rewards could be created ad hoc by the group or selected from a booklet of ideas.

Step by step – with example:

  • First player randomly picks a card. The card is placed in the middle of the board, and spinned.
  • Where the pointer lands determines the way in which the card needs to be addressed (tell & share, think & discuss or act & ask).
  • Each card has a question (e.g. what colour is your soul?). The same question would be addressed in different ways depending on whether the pointer lands on tell and share (e.g. player expresses first thing that comes to mind ‘my soul is pink’ and others share their views), on think and discuss (players individually think their responses and then discuss with one another) or act and ask ( player acts, addressing the question via mimics or gestures, and others ask, by joining the act or verbally).
  • After discussing each card, the individual or group can reflect on any needs, and distribute tokens.
  • At the end of the game, these tokens are used to distribute the rewards. The participant who has more tokens in one area (e.g. spirituality) will gain the corresponding reward (e.g. meditation event).

Principles of GAME

  • It values diversity of lived experience over accuracy of factual knowledge. As one of the co-designers put it ‘in this game we are all equal’
  • The subjective nature of the token system reflects how people judge, value, as well as support one another and make decisions in everyday life.
  • People who identify themselves, or are helped to recognize, an area where they may want to seek further development, are given rewards to encourage this process. This symbolic gesture also reflects the principles behind peer-to-peer support, recovery and rehabilitation.

Try it any time at the Despard Road centre – feedback and ideas welcome!

Erika Renedo-Illarregi


Creative Commons Licence
GAME is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License

Addiction psychiatry could be wiped out in the next 10 years unless urgent measures are taken to tackle the dwindling numbers of doctors training in addictions, according to a landmark report published by the Royal College of Psychiatrists.

It reveals the number of higher training posts across England have fallen by 58%, from 64 in 2011 to just 27 in 2019, leaving some regions without a single trainee.

The College is calling for urgent government funding to protect existing places and to create training posts especially in England, as the falling numbers cannot be solved by the current funding arrangements.

The findings come at a time when both drug-related deaths and alcohol-related hospital admissions in England have reached record levels.

“This report reveals the meltdown that has occurred within addiction psychiatry across the UK, but especially in England,” said Professor Julia Sinclair, chair of the addictions faculty at the Royal College of Psychiatrists and co-author of the report.

“Without urgent investment from government, training in the specialist skills that are an essential part of the treatment system could be wiped out in a decade, depriving thousands of people with this life-threatening condition access to the specialist help they need to recover and rebuild their lives.”

“Assessment and treatment of people with complex medical and social needs arising out of addictions are the essential skills of the addiction psychiatrist. Helping bring people back from the brink of death and turn their lives around are just two of the many reasons why addictions psychiatry is such a vital career.”

The report – Training in Addiction Psychiatry: Current Status and Future Prospects – found in 2019 there were just 16 people in higher training posts that would give them a qualification in Addiction Psychiatry in England, with five out of 12 English Regions – South West Peninsula, Severn, Wessex, Thames Valley and Kent Surrey and Sussex –  having no such posts.

This means there are no opportunities to gain skills needed to equip psychiatrists to improve patient care, nor are there opportunities for a trainee to gain an endorsement in addiction psychiatry and work as a specialist addiction consultant.

Full article: Mental Health Today

Outcome, Islington Mind’s client-led LGBTQ+ service, has been shortlisted for Charity or Non-Profit Organisation of the Year at the British Diversity Awards.

The British Diversity Awards promote the values of equality, diversity and inclusion by rewarding those individuals, organisations and unsung heroes who help to make the world and the workplace a better place for others.

Outcome is one of eight nominees shortlisted for the Charity or Non-Profit Organisation of the Year award for 2019. The winner will be announced on 26 March and will automatically be shortlisted for the European Diversity Awards in November.