15 May 2018

Top 5 Board Games for Grades 5-6, voted by Grade 5-6 Students!

This school year I started a board game club at a school where I am a school counsellor. It has been a great experience for me and the students.

Now that we are entering the final weeks of school, I had the students pick their top five games, and then from everyone's votes we will be playing their favourite games for the last weeks of school.

These rankings are from the students themselves, which I think will help those looking for board/card games to play with this age group.

Please do keep in mind that since it was a club during lunch break we only had 30 minutes to play, so many of the games that we played were short and easy pick up and play games.

A fun card game where you collect different fruits to make juices. With the fabled system, the game continues from where you left off. No two games will be a like (except for the start).

The creative art work and character titles created a lot of chuckles for this age group. It is a simple who-dunnit card game where you don't want to get caught with the character that farted!

This game has been around FOREVER! It's a fast paced trading game that simulates the stock market as each player trades goods to corner the market.

A game where you risk the odds of picking a card and then passing the hand along as you try to make the highest scoring meal.

A cut throat game. Players try to be the last one standing as they diffuse exploding kittens, while intentionally trying to blow up their peers. This game allowed for opportunities to express winning and losing in helpful ways (didn't always happen, given how cut throat the game is).

Now you know our play list for the last weeks of school!

Honorable mentions (to round out a top 10): Beasts of Balance, Formula D, King of Tokyo, Fauna, and Timeline.

23 March 2018

What if Wade Watts (ParZival) had a good counsellor? #parzival #readyplayerone #aces #psychology #positivepsychology

Wade Watts is one of the heroes in the book and upcoming movie Ready Player One. Spoilers are ahead. The movie may change the background of the Wade, so this assessment is purely based on the book by Ernest Cline.

What Happened (Spoilers!)
Wade is the only child of his teenage parents. Both his parents were refugees to the United States of America. When Wade was a couple of months old, his dad was shot and killed while searching a grocery store during a power outage. Loretta, Wade's mom, raised him alone while working two jobs. Wade was babysat by the virtual world, OASIS; this is where Wade learned his life skills.

At age 11, Wade would find his mother dead from an overdose. He then lived with his aunt Alice who only wanted Wade for the food vouchers. She had abusive boyfriends and tenants in her double wide trailer. He slept in the laundry room, the only free space from everyone in the trailer. However he spent most of his time in his secret hideout in an abandoned vehicle.

Wade went to school in the OASIS. He excelled academically, but spent most of his time researching James Halliday, the creator of the OASIS, and the quest for the easter egg that Halliday left in the OASIS after he died.

Around the age of 18, just prior to graduating high school, Wade was the first to uncover the first clue in the hunt for Halliday's egg. This led to him forming close ties with the "high-five", five egg-hunters: Atr3mis, Aech, Shoto and Daito. Wade was known online as ParZival. Wade also became a main threat to a corporation seeking to win the hunt.

Adverse Childhood Experiences
  1. Did a parent or other adult in the household often swear at you, insult you, put you down, or humiliate you? OR Act in a way that made you afraid that you might be physically hurt?
    • YES - his Aunt Alice brought home less than desirable boyfriends, and she poorly cared for Wade
  2. Did a parent or other adult in the household often push, grab, slap, or throw something at you? OR Ever hit you so hard that you had marks or were injured?
    • NO - It's hard to think that this didn't happen given the boyfriend situation, but I can't recall any mention of it.
  3. Did an adult or person at least 5 years older than you ever touch or fondle you or have you touch their body in a sexual way? OR Try to or actually have oral, anal, or vaginal sex with you?
    • NO - this was not reported.
  4. Did you often feel that no one in your family loved you or thought you were important or special? OR Your family didn’t look out for each other, feel close to each other, or support each other?
    • YES. His mom was working hard to provide for him. But at the same time, he learned his basic skills in the OASIS. With his Aunt, she didn't include him.
  5. Did you often feel that you didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? OR Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
    • YES. His dad was stealing from a grocery store. His mom died from an overdose. His aunt only wanted him for the vouchers - and at times would take Wade's stuff and pawn it.
  6. Were your parents ever separated or divorced?
    • NO. They were not separated by choice.
  7. Was your mother or stepmother: Often pushed, grabbed, slapped, or had something thrown at her? OR Sometimes or often kicked, bitten, hit with a fist, or hit with something hard? OR Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
    • YES. Aunt Alice had abusive boyfriends.
  8. Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?
    • YES. His mom (and most likely his aunt)
  9. Was a household member depressed or mentally ill or did a household member attempt suicide?
    • YES. His mom was not stable, nor was his aunt Alice.
  10. Did a household member go to prison?
    • NO. This was not reported. It could be stretched to say that Wade's dad could have served jail time instead of being shot while looting.
Discussion about ACE's
Wade has an ACE's score of 6. With each additional adverse experience so does the likelyhood of health problems in adulthood. In a recent study, male's who experienced six or more ACE's were more than 46 times more likely to an injection drug user.

As we will discuss later, ACE's are not a life-sentence. There are also protective factors that we will look at.

Current Mental State
Going strictly by DSM V terminology, Wade would be diagnosed with major depressive disorder, recurring, with no psychotic features.

Wade says many times himself that he is a depressed shut-in. That may be the best description of his mental state.

He is struggling with his sleep patterns, lost interest in some of his social connections. He had a plan for suicide.  He also had to order new suits because of his weight gain. All indicators of depression

Anxiety is often concurrent with Depression. It becomes difficult to figure out which one is "driving the bus." Is anxiety present because of how depressed someone is, or is depression present because of the anxieties? He does report some anxieties, such as racing thoughts.

While it may be understandable that he is suffering traits of acute traumatic stress disorder, given threats to his life, but he doesn't report flashbacks or other symptoms.

A depressive disorder is the best fit.

Positive Psychology (PERMA)
  • Positive Emotions - Despite his history and experiencing six ACE's, Wade does an excellent job of experiencing positive emotions. Not just the idea of being "happy" but experiencing and expressing silliness, fun-loving, curiousity, gratitude, trust and many other positive emotions as outlined by Barbara Fredrickson.
  • Engagement - Wade often expresses slipping into the zone when playing a video game, or going on a quest - the state of flow where the challenge meets the skill level. His engagement level was low until he found the first clue - until then he escaped or transported his brain into his passion. But as he earned credits and experience with his avatar in his late teens, his engagement increased.
  • Positive Relationships - It is easy to identify Art3mis, Aech, Shoto and Daito as positive relationships, which they are. An overlooked positive relationship is Mrs Gilmore, Wade's only real-world friend. He valued that relationship with her, and became one of his motivators.
  • Meaning - This one is of course complicated. He comprehended and understood his meaning as he began finding the clues. Until then, meaning was a struggle. He was lacking his self-concept, understanding his past, present, and future self - until he uncovered the first clue. His self-efficacy, was low to start; he lacked the resources to even think that he could succeed; once he unlocked the first clue, boom, he had self-efficacy. Self-worth - low until the first clue, and then everyone valued what he contributed to the online and offline world.
  • Achievement - Has the same theme as meaning. He had a goal of finding the egg - many people did. He lacked the sense of achievement in his life, until that first clue. A smaller achievement, that is worth acknowledging, is Wade's education. He was self-taught, and had a passion for learning.
Post Traumatic Stress vs Post Traumatic Growth
So where is ParZival at? Is he stressed or is he growing. The answer is definitely yes to both. He is currently stressed with the crisis he is in, so since the stress is present, we can't really say he is experiencing 'post' traumatic stress. This is where, despite everything that is and has happened, Wade is experiencing post traumatic growth. As outlined in meaning, self-esteem is on the rise as each component (self-concept, self-efficacy, and self-worth) came to have more meaning. He found online friendships within the high-five. As he began fighting his depression with PTG, we were able to see him increase in mental processing and planning.

It's important to realize we are just going to stick with interventions at the individual level, not at any of the systems: family, community, societal; which all could use an intervention or two as well.

With a young Wade, he could have benefited from human baby-sitting to help him learn how to navigate in the real world. There is safety and comfort that comes from nurturing human contact that allows the brain to grow healthily.

Grief support. Losing anyone is hard, especially a parent, not to mention both. Grief is a natural reaction to an unnatural event and doesn't always need a therapeutic intervention. But due to his new living situation, being without either biological parent, extra support would be beneficial as he transitioned.

Exercise. This was something that Wade became aware of himself during the story. Exercise is an excellent combatant of depression. It doesn't need to be marathon running, but simple walks or lifting weights. An extra bonus, exercising with someone.

Healthy eating. The only food that Wade cooked was microwave brownies. Nutrition is an important component to mental health and well-being.

Trauma therapy. Being an EMDR trained clinician, I'd recommend that mode. But any trauma informed therapy would be beneficial to Wade when he is ready to deal with his ACE's and then his experiences finding the easter egg. The narrative he did of his experiences is a great start to healing.

Natural supports. What often makes a traumatic event a traumatic experience is the reaction of, or having natural supports. Having people around to provide support and care help buffer against the effects of a traumatic event. Wade was lacking natural supports in the offline world.

To finish, here is a clip that summarizes everything we have discussed about depression including interventions, called the Black Dog.

Closing Thoughts
Wade, definitely would benefit from therapy. However, timing is the important piece here. Therapy is needed when Wade is ready. When someone is in crisis, therapy for historical events is not appropriate, the crisis needs to be dealt with first.

The difficult piece with therapy with teenagers is that their past, present, and future is at stake. If the present counselling was forced and Wade perceived it was a waste, he then would not seek out therapy when he is 25, 35, or 75.

20 March 2018

Introduction to: "What if (this hero or villan) had a good counsellor?" series

I am working on a new personal project combining mental health and nerd culture together. This idea was inspired from a panel at the Calgary Comic Expo where two psychiatrists (Dr. Sterling Sparshu and Dr. Sudhakar Sivapalan) discussed What if Batman had a good Psychiatrist? and then proceeded to talk about PTSD and Grief in a none-threatening and entertaining way. As I am not a psychiatrist, I am going to use my therapist lens.

Life History - What happened to the Character
Whenever the magic hits, I am going to choose a fictional character (i.e. Anakin Skywalker, Katniss Everdeen, Luna Lovegood) and look at their life history up to the age of 18.

ACE's Score
I'll be using their lifestory to inform the Adverse Childhood Experiences score. A tool that is being used as a predictor of health, but also an intervention.

You can check out the full-test here.

Discussion about ACE's
After looking at the adverse experiences, we'll look at each one individually, and see how it has contributed to the current mental state of the character.

Current Mental Status
Craftily using DSM V we'll look at what the character would currently be diagnoused with, and try to tie together their current mental state with their life story. Other instruments may be used as well, depending on what the situation is.

PERMA (Positive Psychology)
Since the goal is to not just look at what it is wrong, let's also look at what is going well for the character. Do they have positive emotions and relationships, are they engaged, do they have meaning, and how is their sense of accomplishment. These will be indicators that will help determine if they are in a place of post-traumatic stress - and stuck there; or post-traumatic growth.

Post Traumatic Stress vs Post Traumatic Growth
Looking specifically at relationships, self-esteem, appreciation for life, and meaning, and how those have been impacted by ACE's.

Interventions, Past & Present
Then we will look at possible interventions for the current mental state, and what the implications would be. Then we will get creative and look at interventions that could have been implemented in the past and what the potential outcomes would have been.

Please keep in mind
This is the tentative layout, or this could change depending on the character, situation, and as the series grows.

And that this is to create discussion about mental health and how it is portrayed in many, if not all, characters what we love.