In yesterday’s blog post, we looked at the finalists in the Singularity University Global Impact Challenge on Digital Wellbeing. One of the contestants who really stood out is MangaChat, a smartphone application that uses “art-driven emotional journaling” to build mental resilience in young people. Let’s look at how these principles can be applied to addiction treatment.

Mental resilience is a problem area for people with substance use disorders and behavioral disorders. Scoring low on tests for patience and delay discounting is correlated with a greater tendency toward substance abuse and compulsive behavior. Add to that tendency the fact that addictive and compulsive behaviors wear down mental resilience, and this is a real problem area in the field of addiction treatment.

Conditioning to Build Will Power

Treatments that include conditioning to strengthen mental stamina and determination have proven their ability to reduce relapse. One conditioning treatment developed by Dr. Reinout W. Wiers, involves pushing away images of indulgence and pulling towards images of calm restraint. Even a few hours of this has a pronounced impact on patients’ ability to resist urges.

Motivational Interviewing

Another cognitive behavioral therapy (CBT) technique that helps to repair damaged reward systems is motivational interviewing. An experienced counselor or AI guides the patient through sessions aimed at helping them build a picture of who they want to be, in the near future as well as the long run. The process of imagining oneself under improved circumstances enhances the ability to avoid detours and build delay discounting.

Episodic Future Thinking

Episodic future thinking is the ability to see oneself in the future. It is correlated with scores on mental resilience and delay gratification. Episodic future thinking helps people to envision the negative consequences of their actions as well as the positive benefits of refraining from indulgence. The goal of motivational interviewing is to strengthen episodic future thinking.

Medical Journaling

Medical journaling is a process whereby a patient takes a few moments each day to write down their experiences, whether feelings, emotions, medications, vital functions, or whatever is on their mind, regarding their health, their treatment, and their recovery. Patients who do this get better faster. Patients who do medical journaling and share their journals with their doctors and medical providers get better even faster.

One study found that:

Positive affect journaling was associated with decreased mental distress and increased well-being relative to baseline. Positive affect journaling was also associated with less depressive symptoms and anxiety after one month and greater resilience after the first and second month, relative to usual care.

The journaling creates an ability for the patient to better articulate their experiences. It engenders tracking, so that patients have data to point to when assessing their care over time. It induces a longer-range perspective, especially since many illnesses have cycles that can be observed and disrupted to some extent. Medical journaling strengthens delay discounting. It makes patients more patient.

Avatar Caregivers

It comes as a shock to some counselors and mental health providers that many people prefer to interact with an avatar than a human being. Patients in therapy do not have to worry about an avatar being judgmental, or running into them in an awkward setting, or saying something honest that you wouldn’t dare say to a human psychiatrist. Avatars have been shown to have the potential to deliver CBT more successfully than in-person sessions, especially with children.

MangaChat

Put it all together and you get MangaChat, an ingenious emotional journaling app. MangaChat encourages children to tell stories (motivational interviewing) which it turns into comics (avatars) using artificial intelligence (AI). The AI encourages episodic future thinking and the use of the imagination. Children who play MangaChat improve their scores in delay gratification and mental resilience.

MangaChat stands out from the many apps that try to put barriers around the use of technology. It encourages the use of technology. Many of the apps surveil students or patients for the purpose of setting off alarms if poor behavior appears imminent. They frequently suffer from privacy invasion, hackability, and exposure to bad actors on the platform. MangaChat avoids all that because no one has to see what the AI sees in order for the app to work. It can be 100% private, even more private than a conversation with a psychiatrist.

MangaChat helps children talk through their issues, creating story books as they work through them. They control the artwork, the avatars, and the colors, to some degree. As the story continues, the AI gets better at asking good questions. Again, it is a positive use of technology — not a limiting restriction — that encourages children to think through their problems and develop helpful tools for strengthening their imagination and their resolve.

With just a little tweaking, something like MangaChat could work well in addiction treatment programs. It could help people teach themselves ways to fight off temptation. People can see themselves shedding bad habits and adopting healthy habits and improving physically, mentally, and financially. With a little incentive, they could see a new and improved person down the road and a clear path to getting there.

Congratulations to MangaChat, a finalist for Singularity University’s Global Impact Challenge on Digital Wellbeing. You have come up with something that many of the great therapy apps should consider adopting.

Written by Steve O’Keefe. First published November 14, 2024.

Sources:

“Efficacy of journaling in the management of mental illness: a systematic review and meta-analysis,” Family Medicine and Community Health, March 18, 2022.

“Online Positive Affect Journaling in the Improvement of Mental Distress and Well-Being in General Medical Patients With Elevated Anxiety Symptoms: A Preliminary Randomized Controlled Trial,” JMIR Mental Health, October 12, 2018.

Screen capture of MangaChat “Try Me” Page, retrieved November 13, 2024, and used under Fair Use: Commentary.