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Using Avatars and Apps to Help Troubled Vets

Partnered with the VA, a Manhattan-based company has developed an interactive game to aid those who are close to a veteran — to sharpen skills to notice warning signs and guide vets to seek help.

Hector hasn’t left his house in weeks, and he’s been drinking alone. Hector is a veteran who needs help.

Hector also is an avatar, a virtual character, featured in one of the scenarios presented in a new online and mobile application called Together Strong.

The app is an interactive game designed to aid those who are close to a veteran — to sharpen skills to notice warning signs and guide troubled vets to seek help. It allows users to role-play situations involving troubled military veterans with virtual characters, and to choose responses that might help them.

People who have had traumatic experiences or fall into substance abuse may avoid seeking help as a rule, but veterans are especially vulnerable, worrying that they may be seen as weak if they seek help or tell others their problems, experts said.

The app — developed by Kognito, a Manhattan-based company that creates virtual situations to help improve health care, in partnership with the U.S. Department of Veterans Affairs — helps the player navigate each scenario, offering tips and information. It awards gold stars when the player makes a good decision.

The app was developed over seven months with teams of VA staff, military service members and veteran volunteers, said Ann Feder, manager of the VA’s New York/New Jersey mental health programs. While available to anyone free until the end of the year, the app was developed for the mental health system’s veterans.

Kognito CEO Ron Goldman said the company is offering the application to other veteran-focused organizations to use with their clients after the deadline, but it will not be available for individual purchase or download outside of the New York/New Jersey VA network after Dec. 31.

The VA estimates there are more than 720,00 veterans living in New York and New Jersey area covered by the network, and about 300,000 are enrolled. About 80,000 vets visit VA facilities each year.

VA staff and Kognito wanted the app to have as real a feel as possible, so they adjusted the program based on feedback during several rounds of tests. They got notes about specific issues, such as how a despondent veteran might speak to others, dress, or take care of himself or herself.

Inside Hector’s apartment, for example, there’s a dead houseplant, multiple six-packs of beer atop the refrigerator and clothing scattered about. Hector looks tired, there are bags under his eyes and he slumps into the couch. The main character — activated by the player — knows this is not Hector’s usual demeanor.

A common thread in each scenario is the way in which veterans downplay their problems or avoid asking for help.

This is common to many people who have had traumatic experiences, said Sam Spinelli, chief of the Substance Use Disorder Services at the VA Medical Center in East Orange.

Spinelli worked in the VA development team to give feedback on the behaviors he’s seen in his nearly 25 years of working with veterans.

“What are they going to listen to? What are they not going to listen to?” Spinelli said, noting that those concerns always are the focus of building the conversations in developing the application.

This is the second app produced by Kognito with the New York/New Jersey system. The first, Family of Heroes, was released in 2011, to help families of veterans learn how to talk with their veteran about potential problems and how to seek help.

Since its release, it has been used by more than 62,000 people, Feder said.

It cost $200,000 to produce. The Together Strong program was made at a cost of $215,000.

In 2011, the New York/New Jersey VA network looked at non-traditional ways to reach veterans, Feder said.

“How do you find that veteran that isn’t knocking on the door?” she said. Two ways are through the family and through fellow veterans, she said.

The VA in the last three years has built a peer network of 800 veterans working in VA facilities to assist other veterans. Feder said a way to expand the peer initiative was by giving anyone the tools to approach a fellow veteran, and Together Strong was enlisted to advance that mission.

Over its 10 years in operation, the 45-employee company has worked mostly with educational software, serving more than 450 clients, including Rutgers University, the American Academy of Pediatrics and the U.S. Air Force Space Command, Goldman said.

Goldman said that the expectations of learners, especially the generations familiar with the Internet and video games, require education to be interactive.

“You are active in it, making decisions, navigating the experience, you are in control learning through practice,” he said. “If we don’t give that to them, they’ll just ignore what we’re doing.”

©2014 The Record (Hackensack, N.J.)