Philip Lindner

Research questionsCan Feedback Informed Treatment (FIT) increase the effects of and prevent drop-outs in psychosocial interventions at social services while also increasing user participation? Does FIT increase cost-effectiveness of psychosocial efforts at social services?Data and methodWe will conduct a randomized controlled trial in social services´ outpatient care, addiction care and in residential treatment. In addition to direct effects of using FIT, cost-effectiveness, instrument psychiometrics and predictive value will be examined. In addition to the instruments used in FIT -- Outcome rating scale (ORS) which measures development and Session Rating Scale (SRS) which measures working alliance -- the project will include additional outcome measures for quality of life, behavior and symptoms which will be selected in collaboration with representatives of the users (social workers and clients). The project will also examine both clients´ and social workers´ experiences of giving and receiving feedback using FIT, as well as examine factors that influence implementation within social services.Social relevanceSocial services have an ambition to use evidence based practice, but there is a lack of methods that can help social workers and the social service to systematically follow and adapt the interventions based on the clients´ situation, context and preferences. FIT is an internationally proven system for doing this. If findings of the current project are positive, it can be spread within social services through an existing network of practitioners and with existing digital tools.PlanParticipating units with experience and interest in FIT will be recruited in collaboration with the Swedish FIT network and with already engaged municipalities and treatment units. The project will ensure that participating social workers have sufficient skills and that their workplace is ready to work with FIT. Clients who are granted treatment at the unit will be asked if they want to be included in a study where they can give feedback on the interventions they receive and help to follow their progress. After baseline, they will be randomized to treatment as usual or treatment with the addition of FIT. To support implementation, the therapists in the FIT group will be offered regular supervision. Follow-up will be at 3, 6 and 12 months. A number of clients and social workers will also be asked to participate in semi-structured interviews to explore experiences.

Research problem and specific questionsThis study will investigate the complex associations between game play and mental health using objective behavioral data. Specifically, our objectives are to: 1) describe the complex longitudinal associations between objective video game play and mental health, 2) study the objective behavioral markers of gaming disorder, and how do they differ from unproblematic gaming behavior in terms of frequency, duration, intensity, and engagement patterns, and 3) take the first steps toward disentangling the reciprocal causal effects of game play and mental health.Data and methodThis study will use a longitudinal design to collect objective game play data from multiple platforms by linking video game accounts to our independent research platform. We will follow a large cohort of Swedish gamers aged 15 and above for a duration of 12 months. Participants will complete surveys at baseline and at follow-up waves to assess mental health indicators, such as depression and anxiety. We will analyze the complex associations between game play and mental health, as well as the reciprocal effects between these factors and health behaviors.Societal relevance and utilisation This study will be the first to leverage independently collected objective game play data from multiple platforms, combined with longitudinal survey data on mental health indicators. Screen time, and especially gaming, is frequently brought up as an important factor behind the decrease in young peoples’ mental health, and excessive gaming has recently been classified as a formal psychiatric disorder. The study has significant implications for healthcare professionals, parents, and policymakers. The results from our studies will help answer if and how gaming is related to mental health problems, and if it is a good intervention target or if our efforts should be focused elsewhere.Plan for project realizationThe participants will donate their objective play data via a purpose-built website, that we have already developed. The project is a collaboration between researchers at Karolinska Institutet and researchers at the University of Oxford. Participants will be recruited using targeted advertisements and using a digital marketing company and they will be reimbursed for their time. We will use a planned missingness design to improve the efficacy of the survey data collection.